Monday, August 27, 2007

PPCPs in Our Water & What to Do

The current edition of Integrative Medicine has an article by Joel Kreisberg called, "Greener Pharmacy: Proper Medicine Disposal Protects the Environment." It starts with a question:

"What happens to medicines and supplements after they are consumed?"

Pharmaceutical and personal care products (otherwise known as PPCPs) are the bad boys in this article. And, pharmaceuticals, in this case, include nutraceuticals (supplements), veterinary and farm animal drugs, as well as prescription, over-the-counter, and recreational drugs.

Kreisberg, a DC, notes that little attention has been given to PPCPs, even though their use has grown "on par with many agrochemicals" and that these chemicals are "pseudo-persistent," meaning their rate of decomposition into inert substances is exceeded by the rate at which they enter the environment.

Medicines are, in fact, considered naturally resistant to degradation. Kreisberg cited a German study finding outlawed barbituates still circulating in the environment some 30 years after they became illegal.

PPCPs are of concern because they can be active at extremely small concentrations and also have unpredictable interactions when mixed (as they are in our drinking supplies). Common antidepressants like Prozac and Zoloft are being found in frogs and fish and interfering with natural development cycles.

Think about it. A witch's brew of oral contraceptives, antibiotics, steroids, anti-depressants, ibuprofen, fragrances, insect repellants, and more can be found in both surface and groundwater, according to studies by the US Geological Survey.

No drinking water standard for PPCP compounds currently exists and most drinking water treatment plants either cannot or do not treat for these chemicals. Questions emerge such as:

  • What is the impact of ingesting these PPCPs over time?
  • What is the effect of ingesting mixes these compounds?
  • Are certain populations such as the elderly and the immuno-suppressed more vulnerable to the effects of these compounds?

Pat Hemminger's study, published in Environmental Health Perspectives, "Damming the Flow of Drugs into Drinking Water:

"more than 100 kinds of PPCPs in significant concentrations in sampled waterways, the most common being aspirin, statins, hypertension medications, and hormones taken by women."

Consumers can certainly take steps to minimize the impact of the chemicals making it into the water supply, however, some 70% of antibiotics in our water supplies come from livestock farming, as do large quantities of growth hormones and steroids. Thus, dramatic improvements will come only when much greater attention is generated among manufacturers and wastewater treatment plants.

My advice is to consider filtered water (reverse osmosis, ideally) and periodic detoxification programs -- think saunas, fasting, and liver-friendly, glutathione-boosting, detoxifying supplements like: l-glycine, l-glutamine, milk thistle, calcium d-glucarate, n-acetyl-cysteine, turmeric, alpha lipoic acid, fiber, etc.

Meanwhile, here's to our collective detoxification efforts -- of PPCPs, heavy metals, PCBs, you name it, we need all the help we can get to avoid autoimmune conditions and general malaise from toxic compounds.

Friday, August 10, 2007

Slice of Skin Cancer

It was inevitable that one of the many spots on my skin would be sliced off someday, to be shuttled off on a slide to be biopsied.

It was a small spot on my nose. The doc thinks it is a basal cell skin cancer. I'll get the biopsy results back in a week. Maybe he got it all today. Maybe I'll have to go in for a little surgery.

I'm not overly worried just yet. Thankfully, the spot on my nose didn't look like melanoma, which is the evil twin in skin cancer circles. Getting the big "C" diagnosis wasn't so bad given it wasn't melanoma.

You see a basal cell carcinoma cannot spread so easily to the liver or the lungs or the brain. It spreads rather slowly on the skin, and it mostly can injure our vanity, unless, of course, we let it spread to much before sending it on it's way with a surgeon's scalpel.

I wasn't surprised when I got the diagnosis. I have fair skin (which triples my risk) and I had plenty of severe sunburns growing up near the beach in Santa Monica, California. They say that five or more sunburns doubles your risk of skin cancer, and I had dozens of burns over the years.

Okay, so I said I wasn't too worried, but it does rattle me a bit inside to realize that I am a living statistic, underscoring the epidemic reality of skin cancer in today's world.

Sometimes fiercely independent, I've preferred to treat myself over the years whenever possible. Now, I need to get my somewhat lazy self in to see a dermatologist more often -- perhaps as often as the sun goes into equinox.

P.S. For those of you who didn't know, there is a genetic mutation (in the P16 gene), which makes melanoma more likely in family carriers. Here in Utah, there's a major familial melanoma study going on, which tracks families with both genetic and lifestyle risks for getting melanoma.

I happen to know the core researcher, Dr. Sancy Leachman (an amazing MD/PhD researcher from Yale who's making big waves in genetics research out here). If you're interested in being included in Dr. Leachman's work on melanoma, check out her Familial Melanoma Research Clinic.

Wednesday, August 1, 2007

Integrative Gastroenterologist Talks Immune Modulation

My dad's illness last summer made me interested in developing a relationship with an integrative gastroenterologist.

Trouble is they are "rare as rocking horse shit" as my friend, Ian, likes to say. But I kept my tuning fork primed anyway.

I complained about attending the Natural Products show last month, but I did hear a very articulate integrative gastroenterologist, Dr. Stephen Holt, who was speaking about Syndrome X, otherwise known as metabolic syndrome.

Dr. Holt, a Brit who lives on the East Coast, who has a wry sense of humor, spoke again the next week at the American Naturopathic Medical Association's conference on the Aging Immune System.

He started his presentation on a provocative note: "It's diabolical to purvey false hope. It's an absolutely despicable act to offer unproven things for serious diseases without any scientific evidence."

Dr. Holt went on to talk about a lecture he had just attended, where injections of mistletoe were being promoted for cancer treatment. Dr. Holt calmly explained that mistletoe is not approved for oral administration (it's poisonous), and that if anyone were to die of such a treatment, it would be tantamount to "murder."

Dr. Holt had been chatting with a former judge-turned nutritional advocate at the back of the room and asked the (rather portly) ex-judge (with a beeper on his belt) whether such a death would be considered murder.

The response was rather lengthy (legal training does that to folks, it seems) and went something like this: "yes, that's true.....blah blah blah....and, it could be reduced to manslaughter...blah blah blah....but even that would carry 25 to life."

Okay, Dr. Stephen Holt is not one to mince his words nor a stranger to controversy (he often says things like: "managing weight control without managing inflammation may be malpractice" and "calculations of the glycemic index of food is probably a waste of time").

Re the glycemic index thing, Dr. Holt made a compelling case that it's more important to understand factors controlling gastric emptying rates, with efforts to slow gastric emptying in turn slowing glucose absorption.

I have to say, I like this integrative gastroenterologist/scientist/researcher/author character with a pleasing accent.

Anyway, included in Dr. Holt's Aging Immune System presentation was his discussion on the process of "immune senescence," whereby increased suceptibility to illness and reduced ability to differentiate between "self" and "not self" emerges in the elderly.

Dr. Holt cited research that shows 65% of individuals over 65 have antibodies that react to their own bodies' materials as if they were foreign antigens. Not good.

I was intrigued by a formula Dr. Holt developed that modulates the aging immune system. He cited some impressive research, with comparisons to other commercial products, so I am curious to learn more about "immune modulation" in contrast to simple "immune support."

What's particularly interesting is Dr. Holt's research into synergistic combinations of ingredients in smaller amounts than are typically studied when only one active agent is being evaluated in a clinical trial.

We've always had a bias toward "fewer ingredients in more significant amounts" but I appreciate a little challenge every so often! :-)