Adverse drug reaction
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When my children were young, a their doctor, who was describing side effects turned to me to confirm his statement that all drugs have side effects. I didn’t. Coming from a Chinese Medicine tradition where we individualize herbal formulas and dosages to an individual’s constitution, symptoms and underlying conditions, I see “side effects” as the result of sloppy prescribing and one size fits all dosage.
What is a “side effect”? A side effect is one or more of the effects of a drug that does not have to do with a current (arguably restricted) treatment goal. It is not incidental, it is the property of a drug. Drugs are widely assumed to be designed to target a specific organ or medical issue, but they rarely do. They have effects on multiple organs and interact in complex feedback loops. Side effects are just drug effects interacting with a specific individual.
Suppose two young women come to a medical doctor with the same bacterial respiratory infection. “A” is quite thin, pale, vegan, of southern European ancestry and wears heavy sweaters in moderate weather because she always feels cold. Perhaps she also suffers from Renaud’s with cold hands. “B” is robust, omnivorous, has a reddish complexion, drinks alcohol, is perhaps of Nordic extraction and wears sandals and short sleeves well into winter. The doctor could give them the same antibiotic for the infection and it would probably work in the short term, but the longer term consequences would be different: patient “A” might recover initially, but the treatment would tax her immune system and set off a new round of diseases while “B” might do quite well.
Most antibiotics are energetically cold, which makes sense since feverishness is usually present in acute bacterial illnesses. Cold: like mint, yogurt, cucumbers, beans, winter weather, light clothing, insulin and steroids. Thin people tend to run colder than well-insulated fatter people. The elderly tend to be colder than the young. There are certain epigenetic differences in people who originate from different climates. And while the individual’s presentation is more important than any given factor, the energetics of the drug (hot/cold, dry/damp, anabolic/catabolic and suppressive/expressive) should match the needs of a patient. Continue reading…
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Ten years ago my youngest son pulled me up to the roof where we could see the smoke from the destruction of the first World Trade Center tower. We watched in horror as smoke billowed, soon to be followed by windrifts of shredded paper and air full of a peculiar dust smelling of construction debris and dead bodies which lasted for weeks. Subways and roads had been closed so I couldn’t grab my EMT bag to help the survivors, and word soon came that there was no need for additional EMTs with so few injured survivors. People apparently either got out or they were pulverized.
At that time I was at Old First Church, serving as the top layperson in a church without permanent clergy. I decided we should open the church since people would be worried and the walkers escaping Manhattan would need somewhere to sit down on their way towards home. Soon a crowd formed, exchanging information, needing to share fears. Someone brought a radio since cell phones were out. Others brought flowers. The front steps of Old First became a nerve center for the community, for people regardless of affiliation. Continue reading…
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Pain is complex and there are many facets to it. Here are a few things that may help. But do what you need to in order to minimize pain rather than toughing it out because pain isn’t good for you.
- Pain may be fixed and stabbing (usually nerve pain) or throbbing and movable. Try to figure out the nature of your pain, what makes it better or worse, how many inches into your body it is found and how broad the area is and whether it radiates. Is it better or worse with heat? In Chinese medicine we do not use ice, which we believe only suppresses the pain but we do use cooling medicinal herbs that help release the pain at the skin level. Continue reading…
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Your pelvis, referred to as the Lower Jiao in Chinese medicine is the area that lies roughly between your hips below the umbilicus (belly button), within the pelvic girdle of the skeleton. It includes the intestines, rectum, bladder, genitals and their supporting and connecting structural elements like the messentery (connective tissue attaching the intestines), urethera, ureters, muscles holding the structures in place and the external skin. Continue reading…
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Hippocrates said, “Let food be your medicine.” Similar things have been said in Ayurveda and in Chinese medicine. Food can balance your immune system, provide seasonal relief (think watermelons in the heat of summer) and can even provide specific cures or extra help when you are treating diseases with herbs or medications. The chart below shows specific effects of many common foods. Continue reading…
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Artemisia annua. Image via Wikipedia
Say you were just visiting a country with bad water like Guatemala, or were swimming in a lake with pollution or had the Louisiana fish fry for Mother’s Day where the spicing could cover up any off flavors. And somehow you ended up with hot watery diarrhea that wouldn’t stop, even after days of the BRAT diet (Banana- astringent with potassium, Rice-absorbent and easy on the stomach, Applesauce- colloidal with its pectins and Tea- astringent with its tannins, or depending on your interpretation, Toast to absorb.) You need something stronger.
This entry is about how to formulate herbs for a more effective cure, but it is also on diarrhea, so if you are squeamish, be advised.
First off, while there may be wisdom in starting antimicrobial herbs early on, it is a good idea not to take antidiarrheals until what needs to get out has a chance to get out. DuPont and Homick found in 1973 that treating Shigella- caused diarrhea with Lomotil extended the course of the fever because diarrhea itself is a protective mechanism. But diarrhea is the number two killer of children under five and kills over 1.1 million people over the age of 5 annually. It imbalances electrolytes which can kill, especially the elderly and it dehydrates. It isn’t something to leave untreated. I’ll give it three days before looking at an antidiarrheal strategy.
BRAT diet lunchbox. Image by Kelly Sue via Flickr
What exactly happens? First an organism, usually microbial but sometimes a parasite like giardia, upsets the digestive tract. You may become feverish. Water stops being absorbed from the small intestine, allowing it to flush out organisms and associated toxins, along with a panoply of necessary electrolytes. Even if you drink, you tend not to hydrate your tissues. The liver’s secretion of bile is off and toxins secreted by the organism stress the liver’s detoxification pathways. The bacterial overgrowth, burrowing of a parasite like giardia or entameba histolytica into the intestinal walls or composition of the fluids can upset the ecology of your gut bacteria. Your anal sphincters may be stressed. You need an herbal formula that will deal with all of these issues.
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So what properties should such a formula have? It should be antimicrobial since you want to deal with the first cause, although that alone may not be enough. It should absorb fluids to get a more solid stool and to reduce pressure on the sphincters. It should astringe fluid loss. It should replace minerals and allow hydration. It should support the liver.
And it should be diuretic. Diuretic? Aren’t I losing enough fluid through the bowel? You may not have noticed that you stopped peeing with all that fluid loss. And if you continue to lose fluid through the bowel, you will not hydrate. One of my herbal professors used to tell of saving the life of a hospitalized baby dying of diarrhea by injecting her with a diuretic.
Dandelions. Image by JP.. via Flickr
Now think of how you want to make up the formula: raw herbs decocted or infused into a tea, tinctures or fluid extracts, granules or pills. If you are using raw herbs, you need someone in the home who isn’t affected to cook them up and administer them. Tinctures are lousy sources of minerals, so you will need to supplement your electrolytes. Granules have electrolytes and are easily customized, but tend to be restricted to Chinese herbs, with a few exceptions. Pills are not well absorbed in a body with diarrhea, don’t allow your taste to stimulate body secretions but may be the most tolerable way to take strong antiparasite herbs. You are allowed more than one method.
So first, I would look at antimicrobial and antiparasite herbs like black walnut, Artemesia annua, wormwood, cloves or quassia. These tend to be intensely bitter, cold and to affect the liver as well as the parasites. I’d add to that one of the berberine-rich herbs like coptis, phellodendron or goldenseal which are antimicrobial but also stop diarrhea and dysentery. The antimicrobials would be assisted by an alterative herb which enhances nonspecific elimination. For this I’d use oregon grape or echinacea if I wanted a stronger antimicrobial kick. And I would use plantain or calendula for healing the internal mucosa. If there is bleeding, add notoginseng (san qi) or shepherd’s purse. If there is pus, add pusatilla (pasque) flowers. Whole herb dandelion will be diuretic, will add potassium if given in a raw, granule or pill form and the root’s inulin will aid the gut bacteria in re-establishing balance. Plantain seeds or cornsilk are diuretics which can be found in granule form. Avoid irritating diuretics like uva ursi, since you are already irritated.
Corn silk. Image via Wikipedia
Because I want the minerals, I’d throw a handful of nettle leaves in chicken-miso soup with rice. Boil the nettles, but add the miso for probiotic effect after it cools down a bit. This will replace fluids and electrolytes while being a bit astringent. You could use astringent herbs in the formula instead, but go for the ones with tannins- barks or tea, and avoid acid astringents which will upset your stomach.
It also helps to take herbs rich in fiber, like marshmallow or slippery elm which will absorb water and lock it into solid form. Since these herbs tend to clump, I usually stir in a heaping teaspoon or two of powdered herb in applesauce which covers up the glop factor, but if you prefer it as a tea, drink it right away. Alcohol tends to inactivate the polysaccharides, so I don’t put these herbs into tinctures. The herbs will also help feed the probiotic organisms.
As you can see, there are several ways to reach your goal, and many herbs serve multiple functions, but I thought I’d give a sample protocol that would work for a hot, watery traveler’s diarrhea without blood or pus.
Tincture – 1/4 teaspoon 4-5 times a day
3 parts Artemisia annua or Qing hao -antimicrobial, aromatic bitter, cold
1 part Black walnut- antiamoebic, extremely bitter, cold and astringent
2 parts Coptis-bitter, antimicrobial, antiviral, antiamobic, alterative, cold, stops diarrhea
2 parts Plantain leaf- antimicrobial, vulnurary, demulcent with affinity for GI mucosa
2 parts whole Dandelion fluid extract – diuretic, bitter and sweet, cool
1 part Calendula-gastroprotective, antinflammatory, antimicrobial, antispasmodic
Soup: Chicken-miso soup with nettle leaves
Other: Applesauce with slippery elm powder. Probiotic foods or supplements.
If you think you might have been exposed to giardia, you will want to treat it aggressively and early because when it burrows into the intestinal wall, it can be extremely difficult to dislodge and can become a chronic condition. Giardia usually comes from polluted waters or fecal contamination. It can be treated with herbs alone, although for children western meds may be easier because the herbs are usually intensively bitter and need to be taken long term.
When should you make this up? If you know you are going to travel somewhere with bad water or unfamiliar biota, make it up before you leave. When you are suffering from intense diarrhea and dizziness, you are unlikely to have the desire or presence of mind to look at your herb cabinet. So be prepared.
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When I was in Chinese Medicine School, my herbal teacher and I got into an intense discussion of plantain seed. In Western medicine, plantain (a related species to psyllium) seed is used as a mild laxative. In Chinese medicine it is used as a diuretic to guide fluids from the small intestine and to stop diarrhea. Usually I’d expect that different parts of the plant would have such different uses, but in this case we were both talking about the seeds. As I was dropping off to sleep that night it hit me: in Western medicine we eat the seeds with all the roughage. In Chinese medicine we make a decocted tea and strain it out.
When I was in Guatemala last week, I spent time talking to herbalists who used the same herbs I do, differently. One Continue reading…
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A few years ago I had food poisoning with severe diarrhea. After a couple of days, I found myself home alone, collapsed on the floor, unable to pull myself to standing. I knew I needed fluid and electrolytes. I even had made up oral hydration salts, proud of my cost-savings venture. But they were high in my medicine closet and I wasn’t able to pull myself to standing to get them or the faucet or a container to mix them up in. There were no sodas or juices, since I don’t use them. Now I keep a bottle of Pedialyte in drinkable form on the floor of my pantry. If I can crawl, I can get to it.
We have all heard that we should keep medicine locked in a medicine chest, if not in the humid bathroom, then somewhere out of reach. (For those of us who have both conventional and herbal medications, the sufficiently large medicine chest hasn’t been built! ) That is fine for infrequently used toxic prescriptions. But don’t do that with emergency medicines. Keep those where you are most likely to use them.
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That means that if you are deathly allergic to bee stings, you might want to carry an epi-pen in your gardening apron (and make sure you have lots of plantain around.) Or your emergency asthma inhaler if Spring pollens leave you gasping. If asthma strikes at night, keep the inhaler near your bed. Wear a nitroglycerine pendant for cardiac emergencies. If arthritis is worse in the morning, keep your turmeric honey and a spoon in the bedroom. Get extra prescriptions so you can keep emergency medicine where you need it.
Bandages and disinfectant should be located near your power tools and in your kitchen. They don’t all have to be in one spot, and you can have them in the bathroom too. Arnica gel or a die de jiao (trauma liniment) is well-located near the bathtub or stairs, if slipping is an issue.
If you are diabetic, carry glucose with you. I don’t recommend carrying insulin unless you have to (if you must use it.) If you do, label it in obvious letters: Not for emergency use, administer sugar instead. I recently role-played a diabetic slipping into a coma for a first aid class of medical professionals, and nearly everyone reflexively wanted to inject me with insulin instead of giving glucose, which could have killed me. This actually happened to the brother of a Facebook friend, and he was in a long term coma because well-meaning friends didn’t understand that glucose is for emergencies, while insulin is designed for long term problems. Indeed when I was training as an EMT, we were taught that all diabetic comas should be treated with glucose- even if the person had ketoacidosis, lowering sugar was a long term strategy, whereas withholding glucose could potentially kill some one. Follow with food that has protein, fat and fiber so the diabetic won’t crash.
With atopic allergies like penicillin or latex, a medical alert bracelet is a good idea. I might carry a tiny CPR kit with a nonlatex glove on my keyring.
Even a toddler can be taught to dial 911 and ask for help if a parent or babysitter is not responsive. An elder who lives alone may be better off with a medical alert pendant that will automatically dial for help.
Most of my medicine is herbal. Herbal emergency products should also be located where they will be used. But most herbal medicine is best for long term use. There are times when speed will be of the essence. Make sure your emergency medicines are at hand where you will need them.
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This article by pharmacist Suzy Cohen, originally published at Mercola.com is very important because doctors are told that diabetics especially need to go onto statin drugs on the unproven theory that cholesterol causes heart disease. But by increasing blood sugar, lowering Vitamin D and lowering the anti-inflammatory CoQ10, statins can make matters worse.
There are now 900 studies proving adverse effects showing complications from increased risks of moderate to serious liver dysfunction, acute kidney failure, moderate or serious myopathy, and cataracts. (This particular metastudy did not look at the effects of statins on blood sugar.) But if your doctor wants you to go onto statins let him or her know that they increase blood sugar, corrosive blood insulin levels and diabetes.
The Hidden Diabetes Link No One is Telling You About…
By Suzy Cohen, R.Ph.
Coronary heart disease is a leading cause of death in the United States, killing one in five adults, and doctors are very quick to prescribe statins. In fact, statin drug sales rank in the billions each year globally. Continue reading…
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Last night we had a thundersnow, a snowstorm complete with thunder, lightning and hail, that managed to drop almost two feet of snow in 8 hours. Today I awoke to a fairyland of snow, with thick coats of snow on windows and trees, and few signs of the cars buried under drifts. I filled a thermos with Darcy’s spice chocolate, bundled up and sidled between four foot snow embankments towards Prospect Park. Trees with thick branches were weighted down with up to a foot of snow. Cross-country skiers and sledders were scattered across the park. The soft snow sank below my boots, as I sought out packed snow, trying to avoid the cross-country paths.
I love snow, as only someone who grew up in the mild climate of California’s San Francisco Bay Area can do. We had a dusting every five years or so, but it generally melted off within a couple of hours. I love the way snow transforms the city, covering dirt, cleaning the air, glistening in the sunlight, causing tree branches to sparkle. The reflections of sunlight off the snowdrifts in an otherwise dim season cheer me immeasurably.
This is something like the seventh major snowstorm of the season, closing down schools, roads and above-ground transit. But we haven’t had a big snow season for a few years and I missed out on the December snowstorms when I visited family, so I haven’t burned out on it.
I crossed the Long Meadow towards the forested Ravine, stopping to sit on a cleaned bench that barely cleared the snow. Children lined the ridge behind the Tennis House where sledding areas were demarcated. A mother on cross-country skis with a rope around her waist pulled a toddler on a sled. Dogs were chasing Frisbees, reveling in the drifts. Wind caused snow showers as trees unburdened their limbs.
Image by Getty Images via @daylife
I trudged along the path by the Amberkill, where I watch feral goldfish swim in warmer seasons. The stream peeked through where the water ran fast but was covered by ice and snow in the pools. I stopped to watch the falls and an elderly birder photographing in the forest.
A woman on cross-country skis with a black lab stopped to ask me if the trail was crowded. I warned her that it was uneven, but she was already cutting through new snow, allowing the lab to walk in the existing path. Urban cross-country skiers are a hardy lot, purchasing sturdy fiberglass skis that can stand up to asphalt or stones peering through the snow. I used to be one, before my feet outgrew my boots and the available bindings changed, meaning that I would need an entire new setup that I could only use in cold years. I left the path and walked up the hill to the ice-covered ponds, stopping to shake snow from the holly so the plants wouldn’t break under the weight.
The children’s calls of delight from the sledding slope filled the air as I emerged. A woman in snowshoes sat texting on the bench where I had rested. As I crossed the meadow, I found a valley behind a tree grove filled with snowmen and half an igloo. Two teens threw snowballs, but everyone else seemed to be engaged in building, using plastic sleds as snow scoops. The trees had significantly less snow and slush was starting to form at the corners as I left, cheered by the experience.
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Angostura Bitters Image via Wikipedia
Yesterday, before Thanksgiving, I advised my Facebook readers to start their meals with some bitters- Angostura bitters, Fernet Branca, radicchio or dandelion greens to stimulate their liver and gallbladder to secrete digestive juices. I also suggested taking a little lemon juice or vinegar in water before the meal to prevent blood sugar spikes and to help with liver detoxification. It also helps to leave a little room in your stomach when you eat. But what if you didn’t? Continue reading…
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I had been making overnight infusions of herbs for several years when David Winston opined that infusing a mineral-rich herb like oatstraw or horsetail was a waste of herb because the minerals were locked up in the structure and that they were not released by steeping in water unless you waited several days. He claimed that his labs had found that simmering for 20-30 minutes (decocting) was necessary to release the minerals. So long as my overnight infusion isn’t aromatic, which would be damaged by simmering, I now decoct my mineral herbs instead of infusing overnight. In fact I often mix herbs, decocting the roots or mineral-rich herbs first, turning off the flame and infusing the aromatics overnight afterward.
I had started making my herbal preparations as tinctures. Tinctures are great. They last for years, they are handy and I enjoyed them. Tinctures grab resins and aromatics, but don’t get minerals at all. Continue reading…
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Two months ago I made a chai tea redolent with cloves, but without milk or sugar. I put it in my water bottle to drink during the day, but it was pushed behind other bottles and I forgot about it. Two weeks later there was not one spec of mold floating in the liquid and a quick smell and taste of a few drops revealed no souring. I was curious and put it back. Two months after making it shows no growth of organisms or off taste or odor. Which got me thinking about the Spice Route.
In the ancient time, refrigeration was unavailable, especially in cities where cellars and ice were generally unavailable. Spices were important not only for food preservation, but to fortify the digestion and to cure food poisoning. In Europe where there was little tradition of fermenting meat, spices or smoking (often with spices or aromatic wood) were the primary way of dealing with meat that might not be fresh. Cloves were one of the most important. Continue reading…
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Turmeric honey is one of my favorite ways to give turmeric. Turmeric is an adaptogen, a nontoxic herb that regulates the immune and endocrine systems. It also is antiseptic, is hepatoprotective, invigorates the blood, and helps prevent or treat infection. Regarded as a panacea in Ayurveda, turmeric is widely used in food, medicine and skin care. Indian curries, Persian dishes like masak lemak, Thai and Indonesian dishes like rendang use curry to color and impart flavor. In skin care, its golden color and medicinal properties enhance dark skin. (I have had people react in alarm when a turmeric foot soak turned my pale legs yellow!) It is used ceremonially throughout South Asia, including Bengali weddings where it adorns the married couple or Pujas where the powder is moistened and formed into an image of Ganesha. Rich in pigments it is used for dyes and to color food. It is one of my favorite herbs. Continue reading…
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For medicinal use you need much higher ratios of herbs to vinegar
The traditional story is that during the Black Plague, a group of men were going into houses where people had died, stealing their goods. The authorities figured that they would soon be infected and die, so did not pursue them until it became clear that they were resistant to the disease. And then the motivation was to find what protected them. Finally the thieves were apprehended and one confessed that his mother, a midwife, had provided them with a protective vinegar that they drank and washed with after handling the cadavers. And in exchange for freedom, shared the recipe. Continue reading…
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In an article on electronic fetal heart rate monitoring (EFM) Traditional Healers, External Fetal Monitoring, and the NICHD, Academic OB/GYN wrote:
Continuous fetal heart rate monitoring is at its core an almost laughable idea. We are checking a single vital sign and using that vital sign to extrapolate a host of ideas and meanings. OBs that have read strips for years can make some sense of them, but would we give so much meaning to any other single vital sign? Would we do it with an adult? Of course not, but there are people who do. In fact, there are entire countries where this is a major methodology for determining the etiology of illnesses.
But the people doing this are not physicians – they are the healers of various cultures. Throughout the world there are practitioners who claim to divinate illness through feeling a person’s pulse for several minutes. This is particularly prominent in Asia. They describe using the rate, strength, and character of the pulse to make all manner of determinations. This practice is fairly laughable to physicians, as it seems crazy to get so much meaning from feeling someone’s pulse.
But is this so much different than EFM? In fact its quite similar….
Here is an elaborated form of my reply: Continue reading…
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Park Slope Tree Downed by Tornado
New York City doesn’t usually have tornadoes or hurricanes, although we are in the path of such storms. The city heat produces a high pressure bubble that usually pushes storms away. Well most of the time. A freak storm toppled 500 trees in Central Park last August and a tornado dipped into a coastal neighborhood in Brooklyn in April. Last Thursday we had two small tornadoes which cut through Brooklyn and Queens in a period of about 20 minutes, with winds up to 80 miles an hour and “microbursts” of 125 mph. One person was killed and a few others injured. When it finished 3000 dead street trees lay in its wake, with the branches of untold others ripped from their trunks.
New York City has, or had until Thursday, about 5 million trees including 650,000 street trees. When I came here as a teen, raised on West Coast horror stories of the city, I was stunned at how green New York City was, especially compared to San Francisco which was relatively bereft of trees at the time. There are oaks of various kinds, London plane trees, maples, beeches, mulberry trees, Callery pears, lindens, ginkgos, blight-resistant elms, birches, liquidambars, osage oranges, sycamores, horse chestnuts, sumacs, catalpas, alianthus trees, magnolias, weeping cherries, various pines and hundreds of other species. My neighborhood has trees that range from a seedlings to 150 years old with much older trees in Prospect Park’s secondary forest where at least 100 trees were killed. But the average life of a street tree is only seven years, making the grandfather trees true treasures. Continue reading…
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Hal Herzog is fascinated with our moral relationships with animals, the contradictions we feel and the ethical problems when we avoid contradictions. A dog, he points out, is a member of the household in the United States, vermin in India, and food in Korea. We humans tend not to eat animals we either adore or despise. As Koreans and Chinese have started keeping pets, they have become more ambivalent about eating dog meat and relegate certain species to the dog trade. The Oglala Indians eat dogs and keep them as pets, but pets are chosen at birth and only pets are named. This is a tactic that many farming families use for animals that could be pets or food.
Herzog is an anthrozoologist who studies the interactions between humans and animals. He is also possessed with a quick eye for absurdity and a broad range of interests. In this book he has visited industrial farms and Appalachian cock fights, dogmeat markets, dolphin treatment centers, loggerhead turtle nest- protection runs,animal research laboratories, and rescue refuges for injured animals. Even his family pets come up Continue reading…
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A two year, $4 million studyof 307 people, purporting to compare low carb to low fat diets has been completed, apparently showing similar weight loss after two years, but improved blood lipids for people who followed the low carbohydrate diet. They tell us study results show it doesn’t matter which way we diet. But the study has several problems:
- The low carb diet went for 12 weeks, after which people were encouraged to add 5 grams of carbohydrates daily for a week, increasing carbohydrates until their weight stabilized.
- The low calorie diet went on for 2 years. So a short term diet was compared to a long term diet. Continue reading…
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Frank Garland, an epidemiologist and cancer researcher who studied the effects of Vitamin D in fighting cancer, has died. He was 60. Photo care of Kim Edwards.
One of the greatest contributors to human understanding of vitamin D, researcher Dr. Frank C. Garland, passed away on Tuesday, August 17 at UCSD Thornton Hospital after a nearly year-long illness. He was 60 years old. Science, and the rest of us, have lost a great researcher.
Dr. Garland, along with brother Dr. Cedric Garland, were the first to make the connection between vitamin D deficiency and cancer, igniting the interest of the Continue reading…
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