Omega-3 Fats Lower the Risk of Macular Degeneration

Reposted from Life Extension
http://blog.lef.org/2013/05/omega-3-fats-lower-risk-of-macular.html

By Michael A. Smith, MD

Age-related macular degeneration is the number one cause of blindness in the Unites States for people over 60.

In fact, as many as 11 million people in the United States have some form of age-related macular degeneration. This number is expected to double to nearly 22 million by 2050.¹
And not to state the obvious here, but this can have devastating and life-altering consequences.

That’s why it’s refreshing to see that something as simple as fish oil may be able to help reduce your risk.

What is Age-Related Macular Degeneration?

The macula or macula lutea (from Latin macula, "spot" + lutea, "yellow") is a highly pigmented yellow spot near the center of the retina of the human eye, providing the clearest, most distinct vision needed in reading, driving, seeing fine detail, and recognizing facial features.

Age-related macular degeneration (AMD) is a devastating condition characterized by the deterioration of the macula in which central vision becomes severely impaired. There are two forms of macular degeneration: atrophic (dry) and neovascular (wet). Both forms of the disease may affect both eyes simultaneously.

Age-related declines in retinal carotenoid antioxidants, coupled with photo damage induced by harmful ultraviolet (UV) rays, give rise to this debilitating condition. The progression and severity of macular degeneration, as with all age-related diseases, are exacerbated by factors such as oxidative stress, inflammation, high blood sugar, and poor vascular health.

What are the Risks for Age-Related Macular Degeneration?

At the top of the list of risk factors is low carotenoid intake. Low levels oflutein, zeaxanthin, and meso-zeaxanthin are linked to AMD. All three are carotenoids present in the retina and positively affect central vision and the pigment density in the macula.²

Lutein and zeaxanthin help to prevent AMD by supporting the macular density, resulting in less retinal tearing or degeneration. The therapeutic effect of lutein and zeaxanthin in AMD is significant, according to the Lutein Antioxidant Supplementation Trial (LAST), which showed improvement in several symptoms accompanying AMD.³
The next risk factor is a high fat diet. Higher intake of specific types of fat, rather than total fat, may be associated with a greater risk of advanced AMD. A French study found that high total fat, saturated fat, and monounsaturated fat intake were all associated with an increased risk of developing AMD.⁴
Eating red meat 10 or more times per week appears to increase risk for developing early AMD, while eating chicken more than 3.5 times per week may confer protection against the disease.⁵
Lastly, high blood pressure appears to increase your risk. A study of 5,875 Latino men and women identified a pronounced risk for wet AMD if diastolic blood pressure was high, or if individuals had uncontrolled diastolic hypertension.⁶
Besides replacing carotenoids, eating less fat and maintaining healthy blood pressure, let’s take a look at how omega-3 fats can help reduce your risk.

Omega-3 Fats Reduce Age-Related Macular Degeneration Risk

An article published in The Journal of Nutrition reports an association between high omega-3 levels and a reduced risk of age-related macular degeneration in older men and women.⁷
The investigation included 963 participants, aged 73 and older. Blood samples collected between 1999 and 2001 were analyzed for plasma alpha-linolenic acid and the long-chain omega-3 fatty acids eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA).

The subjects underwent initial eye examinations during 2006–2008 and were followed for an average of 31 months. Having a higher level of total omega-3 fatty acids was associated with a decreased adjusted risk of late macular degeneration in this age group in comparison with lower omega-3 levels.⁷

So there you have it — a really simple strategy for reducing your risk of age-related macular degeneration: Eat more fish and supplement daily with omega-3 fats. Think you can swing it?

References:

1. http://www.brightfocus.org/macular/about/understanding/facts.html
2. Surv Ophthalmol. 2005 Mar-Apr;50(2):183-93. Review.
3. Optometry. 2004 Apr;75(4):216-30.
4. Eur J Clin Nutr. 2007 Nov;61(11):1341-4. Epub 2007 Feb 14.
5. Am J Epidemiol. 2009 Apr 1;169(7):867-76.
6. Am J Ophthalmol. 2008Feb;145(2):308-16. doi: 10.1016/j.ajo.2007.10.007.
7. J Nutr. April 2013 143: 505-511; first published online February 13, 2013. doi:10.3945/jn.112.171033

How Sugar Leads To Toxic Glycation

Reposted from Life Extension
http://blog.lef.org/2013/03/sugar-leads-to-toxic-glycation.html

By Michael A. Smith, MD

We’ve all heard it many times by now - the consumption of refined sugar is killing people.

And it’s true. As a matter of fact, I often refer to sugar as the “American diet culprit” — a statement that I stand behind 100%.

But how exactly is sugar killing us? Or let me ask it this way: What is sugar really doing to our cells and tissues that is so very harmful?

Below, we’ll answer this by investigating the pathological reaction involving sugar. We’ll also explain how you can prevent it from happening to you, naturally.

Sugar Reacts to Cause Dangerous Glycation

First off, sugar is very reactive … chemically speaking. It readily combines, or reacts, with cell-surface proteins and fats. This reaction is called glycation and it’s not a good thing at all.

Every molecule of protein and fat in your body has a distinct structure and form. If the structure or form is changed, even just slightly, the result can be complete dysfunction of the protein or fat.

We call this the “structure-function” relationship of molecules. The need for a specific structure to perform a function can easily be envisioned if we think about the way a key has to fit into a lock.

In fact, the “lock and key” model in biochemistry is used to describe the need for a perfect match between a protein enzyme and its binding site. In another example, think about it on a more grand scale.

Look at your hand. It has a very detailed and specific structure to it. Crushing your hand in an industrial accident and breaking all of your fingers, changes your hand’s structure.

In a “crushed” form, your hand cannot function as a hand. Your hand has lost its “structure-function” relationship.

Sugar Destroys Structure-Function Relationships

The same is true for proteins and fats on the surface of your cells. When sugar reacts with a surface protein, say a receptor for a hormone, it changes the receptor’s structure and ultimately its function as a specific hormone receptor.

What does this mean to the cell? Well, the hormone, which carries a specific message for the cell, can no longer pass on its message. And keep in mind that the hormonal message could very well be essential for the cell’s function and survival. And that’s just one example.

Destroying the structure of a cell-surface protein or fat through glycation will destroy its function. The cell membrane becomes damaged and the cell dysfunctions. This inevitably is followed by tissue damage, organ failure, and organism death.

Bottom-line: Too much sugar undergoes a dangerous reaction called glycation. So let’s take a look at some ways of preventing it.

Carnosine Sacrifices Itself to Protect Your Cells

Carnosine is a unique small protein, called a dipeptide, which can interfere with the glycation process.^1,2 It probably protects against glycation in two ways.

First, it may, in a sense, “sacrifice itself.” Instead of sugar reacting to critical cell proteins, it will attack supplemented carnosine instead. I like to call it the glycation martyr.

Secondly, carnosine seems to have an ability to help “unfold” (return to normal) the structure of glycated proteins. In a laboratory study, researchers showed that glycated alpha-crystallin (a protein) unfolded and returned to normal structure after carnosine was added.¹

Supplementing with 1 gram a day of carnosine may help people with sugar issues reduce the amount of glycation their cells and tissues experience.

Benfotiamine Manages Normal Sugar Reactions

Another way to prevent glycation is to make sure sugar undergoes normal metabolism — meaning it’s used properly for energy or safely stored away for later use. This is where benfotiamine comes into play — a fat soluble form of vitamin B1. It can help ensure sugar is correctly metabolized.³ Benfotiamine is a co-factor for the enzyme transketolase — which is critical to blood sugar metabolism. In a landmark study, it boosted healthy transketolase activity in cell cultures. The result was activated glucose metabolism, resulting in healthy blood sugar levels and less sugar available for glycation reactions.³

The researchers concluded that benfotiamine could help inhibit advanced glycation reactions, maintain healthy endothelial, retinal, kidney and nerve cell function.

Special Forms of B6 Inhibit Glycation

Sub-forms of vitamin B6, like pyridoxamine and pyridoxal-5’-phosphate, have been shown to protect critical cellular fats and proteins against glycation reactions.⁴ They probably work similar to benfotiamine by helping our cells manage sugar better and stopping glycation early on, before too much damage occurs. In any case, research has clearly shown that supplementing with them can minimize glycation reactions.

A team of biochemists at the University of South Carolina, for instance, were able to show that these sub-forms of B6 trap reactive metabolites formed during the initiation of glycation. They then chaperone them harmlessly into the urine before too much damage occurs.⁵

Sugar – How Sweet It Isn’t

So here’s the takeaway: Sugar is not a sweet, innocent compound. It’s highly reactive and can cause great structural damage to critical proteins and fats. Once structurally damaged, these proteins and fats cannot function properly.

So what can you do to protect yourself? First, start off by eating less sugar. Then, also consider supplementing with the triad of anti-glycation nutrients mentioned above — carnosine, benfotiamine and special forms of vitamin B6.

References:

1. Arch Biochem Biophys. 2004 Jul 1;427(1):110-5.
2. Exp Gerontol. 2009 Apr;44(4):237-42.
3. Nature Med. 2003 Mar;9(3):294-9.
4. J Lipid Res. 2006 May; 47(5): 964-74.
5. J Biol Chem. 2003 Oct 24;278(43):42012-9.

Can Probiotics Help Reduce Anxiety?

Reposted from Life Extension
http://blog.lef.org/2012/10/can-probiotics-reduce-anxiety.html

Maylin Rodriguez-Paez, RN

Normally, we think of probiotics as digestive supplements. However, more and more research is showing that they could do much more than help your gut.

In fact, a double-blind placebo controlled study found that two probiotic strains, Lactobacillus helveticus R0052 and Bifidobacterium longum R0175, actually alleviated symptoms of anxiety.

The French researchers also found those treated had lower levels of cortisol, a hormone which elevates due to stress.¹

This research is actually pretty interesting. It’s beginning to paint a clearer picture of how our gut can influence our minds and emotions. This might explain why stressful situations may cause “butterflies” in our stomachs and wreak havoc on our digestive system.

But just how is it that probiotics influence our mood? The science isn’t 100% clear, but we’ll explore some ideas below.

Probiotics Boost Neurotransmitters and Lower Inflammation

Scientists have referred to the gut as the “second brain.” Why? Because it contains a vast network of neurons. In fact, it contains over 100 million neurons, which is more that what’s found in your spinal cord.²
Just like the neurons in your brain, the neurons in your gut communicate with neurotransmitters. One particular nerve, called the vagus nerve, communicates directly to your brain. This is why your digestive system responds to stress and outside stimuli.

Rat studies show probiotics increase the number of GABA receptors³ in the brain and the production of GABA⁴, a neurotransmitter which supports rest and relaxation. The anti-anxiety class of meds called benzodiazepines work by modulating GABA levels.

Probiotics also lessen gut inflammation.⁵ The French scientists think this is one possible mechanism behind its mood enhancing effects. Studies indicate that inflammation is tied to mental health problems like anxiety.⁶

How to Get More Probiotics Into your System

Yes — yogurt does contain probiotics. However, they only supply a small dose of beneficial bacteria. For more therapeutic effects, we suggest a high quality probiotic supplement.

And not all probiotics are created equal — there are many strains and preparations on the market. It’s important that you actually get the clinically effective strains in whatever product you choose. Remember, the French study used Lactobacillus helveticus and Bifidobacterium longum.

The amount of live bacteria is important as well. Look for products that contain several billion CFUs per serving. That way you’ll increase the odds of the probiotic colonizing your gut. It’s also important that you take your probiotics frequently so that the dying bacteria are replaced.

What You Need to Know

Can probiotics help you feel less anxious? Possibly. As is often the case, more research needs to be done to come to a solid conclusion.

What we do know is that scientists are uncovering new ways that your mind is connected to your gut. Specifically, science is now suggesting that mental health is not just about your brain; it’s about your gut too.

What do you think?

References:

1. Br J Nutr. 2011 Mar;105(5):755-64. Epub 2010 Oct 26.
2. Available at: http://www.scientificamerican.com/article.cfm?id=gut-second-brain. Accessed October 8th 2012.
3. Proc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5. Epub 2011 Aug 29.
4. Biosci Biotechnol Biochem. 2008 Feb;72(2):278-85. Epub 2008 Feb 7.
5. Gut Microbes. 2012 Jan-Feb;3(1):25-8. Epub 2012 Jan 1.
6. Gastroenterology. 2010 Dec;139(6):2102-2112.e1. Epub 2010 Jun 27.

Can Coconut Oil Treat Alzheimer's Disease?

Reposted from Life Extension
http://blog.lef.org/2012/09/coconut-oil-treat-alzheimers-disease.html

By Maylin Rodriguez-Paez, RN

Coconut oil has been brought up a lot as a potential cure for Alzheimer’s disease lately.

In fact, if you do an internet search, you’ll probably find many accounts of people who claim coconut oil has reversed Alzheimer’s in their loved ones. But is there any science behind this? Let’s dig into the facts.

Coconut oil has actually been making a serious comeback in the health food world lately. For years, many health enthusiasts shied away from it for one reason or another.

However, these days, it’s gaining in popularity for several reasons. One of which is the fact that coconut oil contains a rich supply of medium chain triglycerides or MCTs, which are fats that the body can use as an energy source.

But how can this impact brain disorders like Alzheimer’s? Below we’ll take a closer look.

Alzheimer’s is “Diabetes of the Brain”

Alzheimer’s disease may be tied to a situation in which the brain can’t use glucose, its preferred source of energy. That’s why some researchers have labeled Alzheimer’s as “diabetes of the brain.” And there’s evidence for this too.

Scientists have discovered that people with Alzheimer’s disease may have defective brain insulin signaling.¹ This is not a good thing.

The brain, like other cells in the body, needs insulin in order to use glucose. Insulin transports the glucose into your brain’s cells — kind of like a gatekeeper of sorts.

When brain cells lack glucose, they die. This in turn could lead to brain damage and neurological diseases, like Alzheimer’s.

Here’s where coconut oil may come into play. The medium chain triglycerides found abundantly in coconut oil can be readily used by brain cells as a fuel source.

The liver transforms these triglycerides into ketones, which in turn are used as energy to support brain cell structure, function, and connections — all of which are important factors in treating Alzheimer’s disease.² Unlike sugar, these ketones act independently of insulin.

Medium Chain Triglycerides Improve Memory

All of this information about coconut oil and medium chain triglycerides sounds great, but is there any scientific support? Well, research shows that they do, in fact, improve cognitive function in both animals and humans.

Aged dogs, for instance, performed better on cognitive tests after receiving medium chain triglycerides.³ Not only that, the dogs that received these high-energy fats also had reduced amounts of amyloid beta plaque precursors, which are commonly seen in early Alzheimer’s disease.⁴
People taking MCTs also did better on cognitive tests as well. In a study involving type I diabetics, the participants were split into two groups. One group was given a placebo, while the other was given a drink rich in medium chain triglycerides.

Both groups were given insulin to lower their blood sugar which would impair the ability to think. They were then asked to complete cognitive tests. The medium chain triglycerides group performed better than placebo on the tests.⁵ Can we expect the same results in Alzheimer’s patients? Perhaps.

Remember, medium chain triglycerides produce ketones. Ketones are used as an insulin-independent energy source. This is important because, as stated above, Alzheimer’s patients may have problems with using insulin in their brains.

In a different study, Alzheimer’s patients were given ketones for 90 days. Researchers used a tool called the AD Assessment Scale-Cognitive Subscale to assess the cognitive function of the participants.

The results of the study turned out to be positive, with the Alzheimer’s patients showing significant improvement in cognitive function.⁶

Is Coconut Oil a Potential Treatment for Alzheimer’s?

The truth is that there’s no clear answer yet. However, according to studies, medium chain triglycerides certainly seem to protect brain cells and improve cognitive function. Of course, more research is needed.

What do you think? Do you see coconut oil as becoming a viable treatment for Alzheimer’s disease? Please share your thoughts in the comments!

References:

1. J Clin Invest. 2012;122(4):1339–1353.
2. Neurotherapeutics. 2008 Jul;5(3):470-80.
3. Br J Nutr. 2010 Jun;103(12):1746-54.
4. Brain Res. 2008 Aug 21;1226:209-17.
5. Diabetes. 2009 May;58(5):1237-44.
6. Nutr Metab (Lond). 2009 Aug 10;6:31.

Dietary Saturated Fat Has Undeserved Bad Reputation, Says Review

Reposted from Medscape Today
http://www.medscape.com/viewarticle/804400?utm_content=bufferaaa43&utm_source=buffer&utm_medium=twitter&utm_campaign=Buffer

By Steve Stiles

"The influence of dietary fats on serum cholesterol has been overstated," concludes a review in an American Society for Nutrition publication that, in its words, "calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs [saturated fatty acids], for which mechanisms for adverse health effects are lacking" [1].
Indeed, argues the author, Dr Glen D Lawrence (Long Island University, Brooklyn, NY), it is likely other factors, such as oxidized polyunsaturated fatty acids (PUFAs) or preservatives in processed meats, that are also present in high-SFA foods that lead to adverse health effects typically associated with high SFA intake.
"The meager effect that saturated fats have on serum cholesterol levels when modest but adequate amounts of polyunsaturated oils are included in the diet, and the lack of any clear evidence that saturated fats are promoting any of the conditions that can be attributed to PUFA, makes one wonder how saturated fats got such a bad reputation in the health literature," Lawrence writes in the review published May 1, 2013 in the journal Advances in Nutrition.
The article's case is built on interpretations of research from the biochemistry, epidemiologic, and clinical literature but which, nonetheless, does not reference a tremendous body of research supporting alternative views. Still, Lawrence describes:

• The role of lipid peroxidation in promoting atherogenesis, arguing that its effects are more pronounced on PUFA than on SFAs or monosaturated fatty acids.
• An arguably protective effect of omega-3 PUFAs against proinflammatory effects of omega-6 and other PUFAs.
• Evidence that potentially carcinogenic preservatives in processed meats as well as high-heat cooking methods have influenced perceptions that red meat per se has adverse health effects.
• How "the preparation and cooking methods used for foods that are traditionally classified as saturated fat foods may be producing substances from PUFAs and carbohydrates in those foods that are promoting disease."
• Studies suggesting positive health effects from dairy fat and tropical oils, both high in SFAs and therefore discredited as unhealthy.
• The hazards of diets with increased carbohydrates as a result of being lower in fat, in low-fat diets followed to improve health, especially cardiovascular health.

"The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs," the article concludes. "Consequently, the dietary recommendations to restrict saturated fats in the diet should be revised to reflect differences in handling before consumption . . . It is time to reevaluate the dietary recommendations that focus on lowering serum cholesterol and to use a more holistic approach to dietary policy."
Lawrence had no disclosures.

No Benefit Seen in Sharp Limits on Salt in Diet

Reposted from The New York Times
http://www.nytimes.com/2013/05/15/health/panel-finds-no-benefit-in-sharply-restricting-sodium.html?hp&_r=1&

By GINA KOLATA

Published: May 14, 2013 312 Comments

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In a report that undercuts years of public health warnings, a prestigious group convened by the government says there is no good reason based on health outcomes for many Americans to drive their sodium consumption down to the very low levels recommended in national dietary guidelines.

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Tony Cenicola/The New York Times

Related

• Health Guide: Heart Disease

Those levels, 1,500 milligrams of sodium a day, or a little more than half a teaspoon of salt, were supposed to prevent heart attacks and strokes in people at risk, including anyone older than 50, blacks and people with high blood pressure, diabetes or chronic kidney disease — groups that make up more than half of the American population.

Some influential organizations, including the American Heart Association, have said that everyone, not just those at risk, should aim for that very low sodium level. The heart association reaffirmed that position in an interview with its spokesman on Monday, even in light of the new report.

But the new expert committee, commissioned by the Institute of Medicine at the behest of the Centers for Disease Control and Prevention, said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day. The group examined new evidence that had emerged since the last such report was issued, in 2005.

“As you go below the 2,300 mark, there is an absence of data in terms of benefit and there begin to be suggestions in subgroup populations about potential harms,” said Dr. Brian L. Strom, chairman of the committee and a professor of public health at the University of Pennsylvania. He explained that the possible harms included increased rates of heart attacks and an increased risk of death.

The committee was not asked to specify an optimal amount of sodium and did not make any recommendations about how much people should consume. Dr. Strom said people should not eat too much salt, but he also said that the data on the health effects of sodium were too inconsistent for the committee to say what the upper limit of sodium consumption should be.

Until about 2006, almost all studies on salt and health outcomes relied on the well-known fact that blood pressure can drop slightly when people eat less salt. From that, and from other studies linking blood pressure to risks of heart attacks and strokes, researchers created models showing how many lives could be saved if people ate less salt.

The United States dietary guidelines, based on the 2005 Institute of Medicine report, recommend that the general population aim for sodium levels of 1,500 to 2,300 milligrams a day because those levels will not raise blood pressure. The average sodium consumption in the United States, and around the world, is about 3,400 milligrams a day, according to the Institute of Medicine — an amount that has not changed in decades.

But more recently, researchers began looking at the actual consequences of various levels of salt consumption, as found in rates of heart attacks, strokes and death, not just blood pressure readings. Some of what they found was troubling.

One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet. Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and more than twice as many deaths — 15 as compared with 6 in the higher-salt group.

Another study, published in 2011, followed 28,800 subjects with high blood pressure ages 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming fewer than 3,000 milligrams of sodium a day.

There are physiological consequences of consuming little sodium, said Dr. Michael H. Alderman, a dietary sodium expert at Albert Einstein College of Medicine who was not a member of the committee. As sodium levels plunge, triglyceride levels increase, insulin resistance increases, and the activity of the sympathetic nervous system increases. Each of these factors can increase the risk of heart disease.

“Those are all bad things,” Dr. Alderman said. “A health effect can’t be predicted by looking at one physiological consequence. There has to be a net effect.”

Medical and public health experts responded to the new assessment of the evidence with elation or concern, depending on where they stand in the salt debates.

Is Red Meat Delicious or Dangerous?

Reposted from Dr. Kaayla T. Daniel
http://drkaayladaniel.com/is-red-meat-delicious-but-dangerous-does-its-carnitine-put-us-at-risk-not-likely/

Is Red Meat Delicious but Dangerous? If the Cholesterol and Saturated Fat Won’t Get Us, Will the Carnitine Kill Us Dead?

• 

Red meat has a reputation of being both delicious and dangerous.   And the mainstream media tries its darndest to make us afraid .  .  .  really afraid.
Yet red meat’s a red hot source of zinc, the number one mineral needed to fire up the libido.  It’s high in the B vitamins needed for stress reduction, mental balance and physical energy.   What’s more, red meat comes pumped with carnitine, the amino acid that stokes the mitochondrial furnaces in our cells.   We need carnitine to maintain our perfect weight, increase immune function, enhance brain function and promote heart health.    Lamb is the very best source; beef has plenty; chicken, turkey, fish and dairy have some; and plant foods nearly none.
Indeed the copious amount of carnitine found in red meat alone is reason enough to eat it.  It was therefore  probably inevitable that carnitine would come under attack, and it happened April 7, when researchers who’d published in Nature Medicine announced  l-carnitine could increase the blood levels of trimethylamine-N-oxide (TMAO), a compound that may alter the metabolism of cholesterol and slow the removal of  accumulated cholesterol from arterial walls.
Given that numerous studies, including randomized trials, have suggested carnitine will help patients with heart disease, this struck me as highly unlikely.   My friend and colleague, the late Robert Crayhon, author of The Carnitine Miracle, must be rolling in his grave.   But now that even Dr. Oz has allowed that cholesterol and saturated fat might not be so bad after all, a new demon needed to be found.  Carnitine — a key component of red meat and a popular nutritional supplement — must have seemed a good candidate.
Fortunately, Chris Masterjohn PhD quickly exposed the study’s flawed conclusions in a long and brilliant blog posted at the Weston A. Price Foundation’s website.  His detailed analysis is well worth reading, and the link can be found below.    For readers who’d prefer a quickie  that’s fun to read with a takeaway that’s easy to remember, I bring you the words of the incomparable Dr. William Campbell Douglass II, MD.
“If you ever had even the slightest doubt that the mainstream media was pushing a radical anti-meat agenda, just take a look at how news outlets covered two recent studies.  
“Actually, a more accurate way to put it is to take a look at how they covered one study — and ignored the other.  
“Study #1 claims L-carnitine, an amino acid found in red meat, can cause heart disease. Study #2 finds that same compound can help protect the heart — especially in heart attack patients.  
“Do I even need to tell you which one was covered and which was ignored? 
“Study #1 made headlines around the world, from the New York Times (“Culprit in Heart Disease Goes Beyond Meat’s Fat”) to London’s Daily Mail (“Red meat nutrient used in weight-loss and muscle-building supplements could cause heart disease”). 
“Study #2, on the other hand, came from the prestigious Mayo Clinic — yet it was virtually ignored by the mainstream media. 
“So allow me to do their job for them — again — and give you the REAL scoop on this ‘tale of two studies.’
“Study #1 didn’t find a direct link between meat and heart problems. Not even close. In fact, it had more steps between meat and heart disease than a Rube Goldberg contraption.  
“Experiments on mice found that gut bacteria convert L-carnitine into a compound called trimethylamine N-oxide, which has been linked to hardened arteries (at least in mice).  
“Then, they gave steak to just six humans — including a vegan — and found that meat eaters got a boost in trimethylamine N-oxide after eating. The vegan didn’t.  
“Is your head spinning yet?  The study proves exactly nothing — especially when you consider that it didn’t involve a single case of actual heart disease in humans.  .  .  .  
“Study #2, on the other hand, is a look at data from 13 HUMAN controlled clinical trials.  
“This is REAL data and it confirms that very same carnitine actually reduces the risk of death in heart patients. And if that’s not enough, this healthy amino acid can also slash the risk of heart failure, repeat heart attacks, ventricular arrhythmias, angina, and more in heart patients.  
“In other words, keep eating your steak.  It’s good for you — just be sure to eat the RIGHT stuff.”  
That sums it up.   Couldn’t have said it better.    Eat your steak.  Grass-fed and not factory-farmed, of course.   And when you read about red meat in the mainstream media, take it, as Yogi Berra would say,  “with a grin of salt.”

GMOs, Roundup and a host of common diseases - VIDEO

Reposted from Weston A Price

Perhaps one of the most important videos of our day.

Dr. Stephanie Seneff explains how the RoundUp on our food & in the air causes leaky gut, obesity, Alzheimer's, autism, heart disease, depression, infertility, cancer and diabetes! You can bet this won't get out in mainstream media, unless we take it VIRAL! So it's up to us! Let's see how far and wide we can spread

https://www.youtube.com/watch?v=MqWwhggnbyw

https://www.youtube.com/watch?v=9VUfV8wWr_8

Vaccine Rights Lawyer Speaks Out: There Is *Extensive* Corruption

Reposted from Kelly the Kitchen Kop
http://kellythekitchenkop.com/2013/03/vaccine-rights-lawyer-speaks-out-on-the-extensive-corruption.html

In my past posts lamenting our lack of rights in this country to deny vaccines we believe to be harmful (for us or our children), some of us have said how much we’d love to have a vaccine rights attorney on our side, helping us to fight the fight.  Well he has found us!  Attorney Alan Phillips commented on one of these posts and then agreed to answer some questions for us…

First, though, did you see these previous posts?

• How we came to our personal vaccination choices:  Part 1: Vaccination safety issues and the 7 factors that led to our decisions.  Part 2: Our 5-part plan for vaccinations and how do school exemptions work?
• Healthcare workers:  how to refuse mandatory vaccines and not get fired.  Still more posts on mandatory flu vaccinations.  And another:  150 Employees Fired for Not Getting the Flu Shot.  See all my flu shot related posts.
• Read about a chat I had with the nurse at our doctor’s office. And here’s the follow-up story to that post.  And one last update to the story with info on the school getting in on this, too, and what my doctor said when we sat down to discuss everything.
• More like these! (You’ll first have to scroll past these ones, but then there are tons more.)

Q & A with Alan Phillips, vaccine rights lawyer:

1.  How did you get involved in vaccine rights and what got you passionate about the topic?

>>>When my first child was born, a friend said another friend’s child had been permanently disabled by a vaccine, so I might want to look into it before vaccinating my own child. I was stunned–had never heard of that. I began researching and never looked back. I was moved to go to law school, after being out of school 17 years, by this issue. I’m now the only attorney in the U.S. whose practice is focused on vaccine rights issues–exemptions, waivers, and legislative activism.
2.  What are some of the more memorable cases you’ve worked on?
>>>I work with clients and attorneys around the U.S. in a consulting practice that involves over a dozen different vaccine exemption and waiver contexts–schools (public, private, military, college, college healthcare that require clinical work in local hospitals), military (members, families, civilian contractors), immigration (includes foreign adoptions), employment (concerns fed civil rights law–most state exemption laws apply only to students), vaccine custody disputes (where parents separate or divorce and disagree about vaxing the kids), foreign travel–each of these areas concern or involve different law, and laws vary from state to state with state law exemption and waiver matters.  Most of my clients are successful, and that’s most memorable, of course.
But the insight I’ve gotten into the medical, legal and political worlds has been most disturbing.
While I have great faith in humanity generally, there is extensive corruption in each of these arenas where health (among other areas) is concerned, and with vaccines in particular. E.g., state legislatures have been passing unconstitutional laws restricting access to exemptions and actually granting consent authority to children for vaccines (the latter is just plain bizarre); hospitals around the U.S. are requiring employees who don’t want flu shots to get them to get or keep their jobs (it’s disconcerting to see healthcare policy dictated to healthcare professionals against their will instead of being guided by their professional expertise!), most states have laws that remove routine vaccine exemptions if the state declares an emergency, doctors are increasingly refusing to treat any unvaccinated children regardless of the reason (violates parents’ Constitutional rights in many cases), etc.
3.  What do you see is the biggest obstacle in retaining and/or regaining parental rights to deny vaccines and/or an employee’s rights to deny mandatory workplace vaccines?
>>>Vaccine policy is driven by a corrupt industry that controls the system. E.g., pharmaceutical companies get billions of criminal and civil fines every year, increasingly in recent years. Glaxo: $1 billion *criminal* fine in 2012; Pfiser: $1 billion *criminal* fine in 2009 (4th time they were caught since 2002 doing the same criminal behavior); criminal (and civil) fines in the $100′s of millions are common. This is an industry that routinely engages in criminal behavior (but no one ever goes to jail, and it’s profitable to do it, so they keep doing it). A lot of this is verifiable at the Justice Department’s website. Anyway, this industry “partners” with government to control policy, lobbies for more vaccines and fewer exemption rights (with disturbing effectiveness), “buys” or otherwise persuades state and federal legislatures.
Look: The federal government subsidizes vaccines research and development ($billions/year); has passed laws making vax manufacturers immune from liability; state and federal governments mandate vaccines (increasingly for more and more people, and more and more vaccines for each person); and the Federal government compensates vaccine victims and their families. It’s the ultimate dream to maximize profit a business could ever hope for, except that people are unnecessarily disabled and killed in the process. There are other means of addressing infectious disease concerns that work better, cost profoundly less, and don’t injure and kill people.
Vaccine policy is not about health, it’s about profit, and possibly population control.
In any event, vaccines introduce widespread chronic disease into the population, which produces a huge market for more pharmaceutical drugs. Pharmaceutical drugs focus on managing symptoms; if they actually healed, they’d be cutting off a market. Most of us wouldn’t make decisions like this, but there are people who would and do, and some of them run pharmaceutical companies and occupy important decision-making positions in state and federal government.
4.  Is there a way that groups, such as health care workers for example, could band together, with you at the helm, to fight the growing push toward mandatory workplace vaccines?
>>>I’m not sure that the “helm” is the place for me, but I have worked closely with legislative activists around the U.S. and am available to continue doing so as long as the system remains corrupt and I’m still breathing. While being informed is a critical first step, that alone does nothing. We have to organize and become legislatively active to oppose laws furthering the destructive pro-vaccine agenda while supporting freedom of choice. This is not a decision we have the luxury of taking lightly. Laws are changing as we speak; our rights are going away; and the industry and government have plans to vaccinate *all* of us.
If you’re not confronted with a vaccine requirement right at this moment, you will be!
So, it’s better to become active now to prevent ever being in that situation in the first place if at all possible. However, many of us are already in that situation. So, it’s critical to learn what your rights are right now, so you can exercise them effectively; and then become legislatively active so you can expand your right to choose, and prevent that right from being taken away as is happening all over the country.
A healthcare worker client of mine reported that the system she worked for received over 1,000 exemptions, and the system allowed *4*.
This, and any other exemption situation where you have to state religious beliefs opposed to vaccines, are difficult arenas to manage on your own. On the one hand, anyone who is not an atheist can potentially qualify for a religious exemption (in the employment context, there’s even a narrow category of beliefs one could hold as an atheist that are protected ‘religious’ beliefs!), when it comes to writing a statement of beliefs, most people who do that on their own wander into one or more “legal pitfalls” that can cost them the exemption. The law in this area is just not consistent with most people’s common sense approach. In the employment arena, a further complication is that the vast majority of hospitals (in my experience with over 150 healthcare workers in 26 states just this past fall and early winter) implement unlawful exemption policies that are overly restrictive–they reject qualifying exemption requests. So, having an attorney’s help can be critical.
5.  What can the average person do to FIGHT back on the invasion of their rights like this?
>>>To repeat, become legislatively active. If you also take steps to learn more about your rights, you’ll understand better where we are right now, and what needs to change to fix that. With humble but great respect, anti-vaccine websites are not a good place for exemption advice. They mean well but they don’t understand the law, and often have a mixture of accurate and inaccurate information, or make recommendations that can backfire. Some people have lost exemption rights by relying on them. So, get your information from an authoritative source–the state or local health department, your state’s statutes and regulations from the web or your local library, or a knowledgeable attorney. My site has lots of free information, an e-book that goes into depth, and I’m willing to help individuals or groups with vaccine rights issues. Most of what I do is volunteer–radio shows, articles, and legislative activism.
A complete explanation of all of the important points would take many hours to document, and the issue is constantly evolving, so “complete” is constantly growing.
Meanwhile, I co-host 2 weekly radio shows and am a regular guest on two others, and am an intermittent guest from time to time on still others. Anyone can call in with questions, or email me and have their questions answered on the air (if I can get to it!):
1. The Know Your Rights Hour, Monday nights, 9 pm ET: http://www.blogtalkradio.com/knowyourrightshour
2. Vaccines and Your Rights in the U.S., Thursdays at 1pm ET: http://www.blogtalkradio.com/homeopathyworldcommunity, or freedomizerradio.com
Also:  Here is documentation of my assertions in my articles: http://www.vaccinerights.com/articles.html
6.  One confirmation/clarifying question:  How SPECIFICALLY should someone get involved with changing the laws?!!!  Or is that something that is only known on a case by case basis, depending on the specific issue?
>>>The National Vaccine Information Center’s Advocacy Portal is a website dedicated to vaccine legislative awareness and activism. I *highly* recommend that people go to that site and join: www.nvicadvocacy.org. It’s free, enables participants to easily monitor vaccine legislation (pending bills) in their state and around the U.S. (it’s an eye-opening experience to see the trends–pharmacists to give vaccines, children being allowed to consent to vaccines, more vaccines being required, etc.), and makes it very easy for people to participate in the legislative process, tells you who your representatives are and how to contact them, and lets you know when that’s needed. It’s a work in progress, but a brilliant project.
Beyond that, if someone wants to initiate a piece of legislation, they need to put together a concise, well documented/supported written concern, and then make an appointment with their representatives to sit down face-to-face to request their help (letters and emails get lost in the shuffle in my experience). There are people, including me, who can also provide support along the way. But at minimum, we should all be on the Portal so we know when there’s a bill to support or object to in our state.
Alan, we are very grateful to you for your help, thank you!!!
If you have any questions, he said he’d try to answer in the comments, or also be sure to visit the links above.

What Tests Are More Important Than Cholesterol?

Reposted from The Heart Scan Blog
http://blog.trackyourplaque.com/2013/05/what-tests-are-more-important-than-cholesterol.html

by Dr. William Davis

In the conventional practice of early heart disease prevention, cholesterol testing takes center stage. Rarely does it go any further, aside from questions about family history and obvious sources of modifiable risk such as smoking and sedentary lifestyle.
So standard practice is to usually look at your LDL cholesterol, the value that is calculated, not measured, then–almost without fail–prescribe a statin drug. While there are indeed useful values in the standard cholesterol panel–HDL cholesterol and triglycerides–they are typically ignored or prompt no specific action.
But a genuine effort at heart disease prevention should go farther than an assessment of calculated LDL cholesterol, as there are many ways that humans develop coronary atherosclerosis. Among the tests to consider in order to craft a truly effect heart disease prevention program are:
–Lipoprotein testing–Rather than using the amount of cholesterol in the various fractions of blood as a crude surrogate for lipoproteins in the bloodstream, why not measure lipoproteins themselves? These techniques have been around for over 20 years, but are simply not part of standard practice.
Lipoprotein testing especially allows you to understand what proportion of LDL particles are the truly unhealthy small LDL particles (that are oxidation- and glycation-prone). It also identifies whether or not you have lipoprotein(a), the heritable factor that confers superior survival capacity in a wild environment (“The Perfect Carnivore“), but makes the holder of this genetic pattern the least tolerant to the modern diet dominated by grains and sugars, devoid of fat and organ meats.
–25-hydroxy vitamin D–The data documenting the health power of vitamin D restoration continue to grow, with benefits on blood sugar and insulin, blood pressure, bone density, protection from winter “blues” (seasonal affective disorder), decrease in falls and fractures, decrease in cancer, decrease in cardiovascular events. I aim to keep 25-hydroxy vitamin D at a level of 60 to 70 ng/ml. This generally requires 4000-8000 units per day in gelcap form, at least for the first 3 or so years, after which there is a decrease in need. Daily supplementation is better than weekly, monthly, or other less-frequent regimens. The D3 (cholecalciferol) form is superior to the non-human D2 (ergocalciferol) form.
–Hemoglobin A1c (HbA1c)–HbA1c represents glycated hemoglobin, i.e., hemoglobin molecules within red blood cells that are irreversibly modified by glucose, or blood sugar. It therefore provides an index of endogenous glycation of all proteins of the body: proteins in the lenses of the eyes that lead to cataracts; proteins in the cartilage of the knees and hips that lead to brittle cartilage and arthritis; proteins in kidney tissue leading to kidney dysfunction.
HbA1c provides an incredibly clear snapshot of health: It reflects the amount of glycation you have been exposed to over the past 90 or so days. We therefore aim for an ideal level: 5.0% or less, the amount of “ambient” glycation that occurs just with living life. We reject the notion that a HbA1c level of 6.0% is acceptable just because you don’t “need” diabetes medication, the thinking that drives conventional medical practice.
–RBC Omega-3 Index–The average American consumes very little omega-3 fatty acids, EPA and DHA, such that a typical omega-3 RBC Index, i.e., the proportion of fatty acids in the red blood cell occupied by omega-3 fatty acids, is around 2-3%, a level associated with increased potential for sudden cardiac death (death!). Levels of 6% or greater are associated with reduced potential for sudden cardiac death; 10% or greater are associated with reduced other cardiovascular events.
Evidence therefore suggests that an RBC Omega-3 Index of 10% or greater is desirable, a level generally achieved by obtaining 3000-3600 mg EPA + DHA per day (more or less, depending on the form consumed, an issue for future discussion).
–Thyroid testing (TSH, free T3, free T4)–Even subtle degrees of thyroid dysfunction can double, triple, even quadruple cardiovascular risk. TSH values, for instance, within the previously presumed “normal” range, pose increased risk for cardiovascular death; a TSH level of 4.0 mIU, for instance, is associated with more than double the relative risk of a level of 1.0.
Sad fact: the endocrinology community, not keeping abreast of the concerning issues coming from the toxicological community regarding perchlorates, polyfluorooctanoic acid and other fluorinated hydrocarbons, polybrominated diphenyl ethers (PDBEs), and other thyroid-toxic compounds, tend to ignore these issues, while the public is increasingly exposed to the increased cardiovascular risk of even modest degrees of thyroid dysfunction. Don’t commit the same crime of ignorance: Thyroid dysfunction in this age of endocrine disruption can be crucial to cardiovascular and overall health.
All in all, there are a number of common blood tests that are relevant–no, crucial–for achieving heart health. Last on the list: standard cholesterol testing.

Oral Probiotic Reduces Ear and Throat Infections in Children and Adults

Reposted from GreenMedInfo.com
http://www.greenmedinfo.com/blog/oral-probiotic-reduces-ear-and-throat-infections-children-and-adults

Written By:

Case Adams, Naturopath

Italian researchers have confirmed that a certain oral probiotic species significantly reduces ear infections, throat infections and tonsillitis among children and adults with recurring infections.
In the most recent study, published in March's Journal of Expert Opinion on Biological Therapy from Informa Healthcare, researchers studied 40 adults who had a history of frequent strep throat infections and/or tonsillitis.
They were divided into two groups of 20 adults. For ninety days, one group was given an oral probiotic supplement (European brand = Bactoblis®) containing Streptococcus salivarius K12, while the other group went untreated.
The Bactoblis product is a slow-release lozenge containing five billion CFUs (colony-forming units) of Streptococcus salivarius K12.
The researchers then followed each patient for six months following the 90-day treatment period.
While the control group saw no change, the oral probiotic group experienced an 80% decrease in streptococcal pharyngeal infections (strep throat and tonsillitis). During the six months following the 90-day treatment period, the oral probiotic group had a 60% reduced incidence of strep throat and tonsillitis.
There were no negative side effects reported from the oral probiotic treatment. Nor were there any drop-outs among the oral probiotic group.
The researchers concluded: "Prophylactic administration of Streptococcus salivarius K12 to adults having a history of recurrent oral streptococcal pathology reduced the number of episodes of streptococcal pharyngeal infections and/or tonsillitis."
Another study investigating throat infections and ear infections among children was published last November in the International Journal of General Medicine. This study included 82 children between the ages of four and five years old. Of these 82, 65 had been recently diagnosed with a streptococcal infection of the ears (otitis media) and/or throat infections (strep throat and/or tonsillitis).
The researchers gave 45 of the diagnosed children the same Bactoblis oral probiotic with Streptococcus salivarius K12, leaving 20 diagnosed children untreated, and the remaining 17 who were not diagnosed with any infection as an additional control group. Each of the 45 children were given one tablet a day of the Bactoblis product with Streptococcus salivarius K12 for 90 days.
Among the 45 who started the study, 41 children completed the 90-day treatment period and six-month follow-up. Those 41 had a 90% reduction in throat infections. Among those with recurrent ear infections there was a 40% reduction.
Learn more about oral probiotics to reduce infection, tooth decay and periodontal disease.
In addition, during a six-month follow-up period when the children were not taking the oral probiotics, those who took the oral probiotics for the 90-days had a 65% reduction in reported ear and throat infections overall.
Once again there were no negative side effects reported from the oral probiotic treatment.
The researchers concluded that, "Prophylactic administration of S. salivarius K12 to children with a history of recurrent oral streptococcal pathology reduced episodes of streptococcal pharyngeal infections and/or tonsillitis as well as episodes of acute otitis media."
The patented BLIS (bacteriocin-like inhibitory substance) K12 strain of Streptococcus salivarius was isolated in New Zealand from a healthy child's mouth. The strain has since been studied extensively. It has been propagated and infused into several commercially-available lozenges and gums.
Other oral probiotic strains have also been isolated, and have undergone similar testing and commercial availability.

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Resources

• Di Pierro F, Adami T, Rapacioli G, Giardini N, Streitberger C. Clinical evaluation of the oral probiotic Streptococcus salivarius K12 in the prevention of recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes in adults. Expert Opin Biol Ther. 2013 Mar;13(3):339-43.
• Di Pierro F, Donato G, Fomia F, Adami T, Careddu D, Cassandro C, Albera R. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media. Int J Gen Med. 2012;5:991-7.
• Adams C. Oral Probiotics: Fighting Tooth Decay, Periodontal Disease and Airway Infections Using Nature's Friendly Bacteria. Logical Books, 2012.

Death by Medicine

Reposted from Life Extension

http://www.lef.org/magazine/mag2006/aug2006_report_death_01.htm

By Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD

Something is wrong when regulatory agencies pretend that vitamins and nutritional supplements are dangerous, yet ignore published statistics showing that government-sanctioned medicine is the real hazard. Until recently, Life Extension could cite only isolated statistics to make its case about the dangers of conventional medicine. No one had ever analyzed and compiled all of the published literature dealing with injuries and deaths caused by government-protected medicine. A group of researchers meticulously reviewed the statistical evidence and their findings are absolutely shocking.1-4 These researchers have authored the following article titled “Death by Medicine” that presents compelling evidence that today’s health care system frequently causes more harm than good. This fully referenced report shows the number of people having in-hospital, adverse reactions to prescribed drugs to be 2.2 million annually. The number of unnecessary antibiotics prescribed for viral infections is 20 million per year. The number of unnecessary medical and surgical procedures performed is 7.5 million per year. The number of people exposed to unnecessary hospitalization is 8.9 million per year. The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is nearly 800,000 per year. It is now evident that the American medical system is the leading cause of death and injury in the US. By contrast, the number of deaths attributable to heart disease in 2001 was 699,697, while the number of deaths attributable to cancer was 553,251.5 Life Extension has decided to publish this article in its entirety to call attention to the failure of the American medical system. By exposing these gruesome statistics in painstaking detail, we provide a basis for competent and compassionate medical professionals to recognize the inadequacies of today’s system and at least attempt to institute meaningful reforms. Natural medicine is under siege, as pharmaceutical company lobbyists urge lawmakers to deprive Americans of the benefits of dietary supplements and bioidentical hormones. Drug-company front groups have launched slanderous media campaigns to discredit the value of healthy lifestyles. The FDA continues to interfere with those who offer natural products that compete with prescription drugs. These attacks against natural medicine obscure a lethal problem that until now was buried in thousands of pages of scientific text. In response to these baseless challenges to natural medicine, the Nutrition Institute of America commissioned an independent review of the quality of “government-approved” medicine. The startling findings from this meticulous study indicate that conventional medicine is the leading cause of death in the United States. The Nutrition Institute of America is a nonprofit organization that has sponsored independent research for the past 30 years. To support its bold claim that conventional medicine is America’s number-one killer, the Institute mandated that every “count” in this “indictment” of US medicine be validated by published, peer-reviewed scientific studies. What you are about to read is a stunning compilation of facts that documents that those who seek to abolish consumer access to natural therapies are misleading the public. Nearly 800,000 Americans die each year at the hands of government-sanctioned medicine, while the FDA and other government agencies pretend to protect the public by harassing those who offer safe alternatives. A definitive review of medical peer-reviewed journals and government health statistics shows that American medicine frequently causes more harm than good. Each year approximately 2.2 million US hospital patients experience adverse drug reactions (ADRs) to prescribed medications.6 In 1995, Dr. Richard Besser of the federal Centers for Disease Control and Prevention (CDC) estimated the number of unnecessary antibiotics prescribed annually for viral infections to be 20 million; in 2003, Dr. Besser spoke in terms of tens of millions of unnecessary antibiotics prescribed annually.7,8 Approximately 7.5 million unnecessary medical and surgical procedures are performed annually in the US,9,10 while approximately 8.9 million Americans are hospitalized unnecessarily.1-4 Table 1: Estimated Annual Mortality and Economic Cost of Medical Intervention Condition Deaths Cost Author Adverse Drug Reactions 106,000 $12 billion Lazarou6, Suh11 Medical error 98,000 $2 billion IOM12,13 Bedsores 115,000 $55 billion Xakellis14, Barczak15 Infection 88,000 $5 billion Weinstein16, MMWR17 Malnutrition 108,800 ----------- Nurses Coalition18 Outpatients 199,000 $77 billion Starfield19,20, Weingart21 Unnecessary Procedures 37,136 $122 billion HCUP22 Surgery-Related 32,000 $9 billion AHRQ23 Total 783,936 $282 billion   As shown in Table 1, the estimated total number of iatrogenic deaths—that is, deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures—in the US annually is 783,936. It is evident that the American medical system is itself the leading cause of death and injury in the US. By comparison, approximately 699,697 Americans died of heart disease in 2001, while 553,251 died of cancer.5 Using Dr. Lucian L. Leape’s 1997 medical and drug error rate of 3 million24 multiplied by the 14% fatality rate he used in 199425 produces an annual death rate of 420,000 for drug errors and medical errors combined. Using this number instead of Lazarou’s 106,000 drug errors and the Institute of Medicine’s (IOM) estimated 98,000 annual medical errors would add another 216,000 deaths, for a total of 999,936 deaths annually, as shown in Table 2. Table 2: Estimated Annual Mortality and Economic Cost of Medical Intervention Condition Deaths Cost Author ADR/med error 420,000 $200 billion Leape24 Bedsores 115,000 $55 billion Xakellis14, Barczak15 Infection 88,000 $5 billion Weinstein16, MMWR17 Malnutrition 108,800 ----------- Nurses Coalition18 Outpatients 199,000 $77 billion Starfield19,20, Weingart21 Unnecessary Procedures 37,136 $122 billion HCUP22 Surgery-Related 32,000 $9 billion AHRQ23 Total 999,936     The enumeration of unnecessary medical events is very important in our analysis. Any invasive, unnecessary medical procedure must be considered as part of the larger iatrogenic picture. Unfortunately, cause and effect go unmonitored. The figures on unnecessary events represent people who are thrust into a dangerous health care system. Each of these 16.4 million lives is being affected in ways that could have fatal consequences. Simply entering a hospital could result in the following: In 16.4 million people, a 2.1% chance (affecting 186,000) of a serious adverse drug reaction6 In 16.4 million people, a 5-6% chance (affecting 489,500) of acquiring a nosocomial infection16 In 16.4 million people, a 4-36% chance (affecting 1.78 million) of having an iatrogenic injury (medical error or adverse drug reactions)25 These statistics represent a one-year time span. Working with the most conservative figures from our statistics, we project the following 10-year death rates. Table 3: Estimated 10-Year Death Rates from Medical Intervention Condition 10-Year Deaths Author Adverse Drug Reaction 1.06 million Lazarou6 Medical error 0.98 million IOM12,13 Bedsores 1.15 million Xakellis14, Barczak15 Nosocomial Infection 0.88 million Weinstein16, MMWR17 Malnutrition 1.09 million Nurses Coalition18 Outpatients 1.99 million Starfield19,20, Weingart21 Unnecessary Procedures 371,360 HCUP22 Surgery-related 320,000 AHRQ23 Total 7,841,360   Our estimated 10-year total of 7.8 million iatrogenic deaths is more than all the casualties from all the wars fought by the US throughout its entire history. Our projected figures for unnecessary medical events occurring over a 10-year period also are dramatic. These figures show that an estimated 164 million people—more than half of the total US population—receive unneeded medical treatment over the course of a decade. Table 4: Estimated 10-Year Unnecessary Medical Events Unnecessary Events 10-year Number Iatrogenic Events Hospitalization 89 million1-4 17 million Procedures 75 million22 15 million Total 164 million   Introduction Never before have complete statistics on the multiple causes of iatrogenesis been combined in one article. Medical science amasses tens of thousands of papers annually, each representing a tiny fragment of the whole picture. To look at only one piece and try to understand the benefits and risks is like standing an inch away from an elephant and trying to describe everything about it. You have to step back to see the big picture, as we have done here. Each specialty, each division of medicine keeps its own records and data on morbidity and mortality. We have now completed the painstaking work of reviewing thousands of studies and putting pieces of the puzzle together. Is American Medicine Working? US health care spending reached $1.6 trillion in 2003, representing 14% of the nation’s gross national product.26 Considering this enormous expenditure, we should have the best medicine in the world. We should be preventing and reversing disease, and doing minimal harm. Careful and objective review, however, shows we are doing the opposite. Because of the extraordinarily narrow, technologically driven context in which contemporary medicine examines the human condition, we are completely missing the larger picture. Medicine is not taking into consideration the following critically important aspects of a healthy human organism: stress and how it adversely affects the immune system and life processes insufficient exercise excessive calorie intake highly processed and denatured foods grown in denatured and chemically damaged soil exposure to tens of thousands of environmental toxins. Instead of minimizing these disease-causing factors, we cause more illness through medical technology, diagnostic testing, overuse of medical and surgical procedures, and overuse of pharmaceutical drugs. The huge disservice of this therapeutic strategy is the result of little effort or money being spent on preventing disease.

Underreporting of Iatrogenic Events As few as 5% and no more than 20% of iatrogenic events are ever reported.25,27-30 This implies that if medical errors were completely and accurately reported, we would have an annual iatrogenic death toll much higher than 783,936. In 1994, Leape said his figure of 180,000 medical mistakes resulting in death annually was equivalent to three jumbo-jet crashes every two days.25 Our considerably higher figure is equivalent to six jumbo jets falling out of the sky each day. What we must deduce from this report is that medicine is in need of complete and total reform—from the curriculum in medical schools to protecting patients from excessive medical intervention. It is obvious that we cannot change anything if we are not honest about what needs to be changed. This report simply shows the degree to which change is required. We are fully aware of what stands in the way of change: powerful pharmaceutical and medical technology companies, along with other powerful groups with enormous vested interests in the business of medicine. They fund medical research, support medical schools and hospitals, and advertise in medical journals. With deep pockets, they entice scientists and academics to support their efforts. Such funding can sway the balance of opinion from professional caution to uncritical acceptance of new therapies and drugs. You have only to look at the people who make up the hospital, medical, and government health advisory boards to see conflicts of interest. The public is mostly unaware of these interlocking interests. For example, a 2003 study found that nearly half of medical school faculty who serve on institutional review boards (IRBs) to advise on clinical trial research also serve as consultants to the pharmaceutical industry.31 The study authors were concerned that such representation could cause potential conflicts of interest. In a news release, Dr. Erik Campbell, the lead author, wrote, “Our previous research with faculty has shown us that ties to industry can affect scientific behavior, leading to such things as trade secrecy and delays in publishing research. It’s possible that similar relationships with companies could affect IRB members’ activities and attitudes.”32 Medical Ethics and Conflict of Interest in Scientific Medicine Jonathan Quick, director of essential drugs and medicines policy for the World Health Organization (WHO), wrote in a recent WHO bulletin: “If clinical trials become a commercial venture in which self-interest overrules public interest and desire overrules science, then the social contract which allows research on human subjects in return for medical advances is broken.”33 As former editor of the New England Journal of Medicine, Dr. Marcia Angell struggled to bring greater attention to the problem of commercializing scientific research. In her outgoing editorial entitled “Is Academic Medicine for Sale?” Angell wrote that growing conflicts of interest are tainting science and called for stronger restrictions on pharmaceutical stock ownership and other financial incentives for researchers:34 “When the boundaries between industry and academic medicine become as blurred as they are now,” Angell wrote, “the business goals of industry influence the mission of medical schools in multiple ways.” She did not discount the benefits of research but said a Faustian bargain now existed between medical schools and the pharmaceutical industry. Angell left the New England Journal in June 2000. In June 2002, the New England Journal of Medicine announced that it would accept journalists who accept money from drug companies because it was too difficult to find ones who have no ties. Another former editor of the journal, Dr. Jerome Kassirer, said that was not the case and that plenty of researchers are available who do not work for drug companies.35 According to an ABC News report, pharmaceutical companies spend over $2 billion a year on over 314,000 events attended by doctors. The ABC News report also noted that a survey of clinical trials revealed that when a drug company funds a study, there is a 90% chance that the drug will be perceived as effective, whereas a non-drug-company-funded study will show favorable results only 50% of the time. It appears that money can’t buy you love, but it can buy any “scientific” result desired. Cynthia Crossen, a staffer for the Wall Street Journal, in 1996 published Tainted Truth: The Manipulation of Fact in America, a book about the widespread practice of lying with statistics.36 Commenting on the state of scientific research, she wrote: “The road to hell was paved with the flood of corporate research dollars that eagerly filled gaps left by slashed government research funding.” Her data on financial involvement showed that in 1981, the drug industry “gave” $292 million to colleges and universities for research. By 1991, this figure had risen to $2.1 billion. The First Iatrogenic Study Dr. Lucian L. Leape opened medicine’s Pandora’s box in his 1994 paper, “Error in Medicine,” which appeared in the Journal of the American Medical Association (JAMA).25 He found that Schimmel reported in 1964 that 20% of hospital patients suffered iatrogenic injury, with a 20% fatality rate. In 1981, Steel reported that 36% of hospitalized patients experienced iatrogenesis, with a 25% fatality rate, and adverse drug reactions were involved in 50% of the injuries. In 1991, Bedell reported that 64% of acute heart attacks in one hospital were preventable and were mostly due to adverse drug reactions. Leape focused on the “Harvard Medical Practice Study” published in 1991,37 which found a 4% iatrogenic injury rate for patients, with a 14% fatality rate, in 1984 in New York State. From the 98,609 patients injured and the 14% fatality rate, he estimated that in the entire US, 180,000 people die each year partly as a result of iatrogenic injury. Why Leape chose to use the much lower figure of 4% injury for his analysis remains in question. Using instead the average of the rates found in the three studies he cites (36%, 20%, and 4%) would have produced a 20% medical error rate. The number of iatrogenic deaths using an average rate of injury and his 14% fatality rate would be 1,189,576. Leape acknowledged that the literature on medical errors is sparse and represents only the tip of the iceberg, noting that when errors are specifically sought out, reported rates are “distressingly high.” He cited several autopsy studies with rates as high as 35-40% of missed diagnoses causing death. He also noted that an intensive care unit reported an average of 1.7 errors per day per patient, and 29% of those errors were potentially serious or fatal. Leape calculated the error rate in the intensive care unit study. First, he found that each patient had an average of 178 “activities” (staff/procedure/medical interactions) a day, of which 1.7 were errors, which means a 1% failure rate. This may not seem like much, but Leape cited industry standards showing that in aviation, a 0.1% failure rate would mean two unsafe plane landings per day at Chicago’s O’Hare International Airport; in the US Postal Service, a 0.1% failure rate would mean 16,000 pieces of lost mail every hour; and in the banking industry, a 0.1% failure rate would mean 32,000 bank checks deducted from the wrong bank account. In trying to determine why there are so many medical errors, Leape acknowledged the lack of reporting of medical errors. Medical errors occur in thousands of different locations and are perceived as isolated and unusual events. But the most important reason that the problem of medical errors is unrecognized and growing, according to Leape, is that doctors and nurses are unequipped to deal with human error because of the culture of medical training and practice. Doctors are taught that mistakes are unacceptable. Medical mistakes are therefore viewed as a failure of character and any error equals negligence. No one is taught what to do when medical errors do occur. Leape cites McIntyre and Popper, who said the “infallibility model” of medicine leads to intellectual dishonesty with a need to cover up mistakes rather than admit them. There are no Grand Rounds on medical errors, no sharing of failures among doctors, and no one to support them emotionally when their error harms a patient. Leape hoped his paper would encourage medical practitioners “to fundamentally change the way they think about errors and why they occur.” It has been almost a decade since this groundbreaking work, but the mistakes continue to soar. In 1995, a JAMA report noted, “Over a million patients are injured in US hospitals each year, and approximately 280,000 die annually as a result of these injuries. Therefore, the iatrogenic death rate dwarfs the annual automobile accident mortality rate of 45,000 and accounts for more deaths than all other accidents combined.”27 At a 1997 press conference, Leape released a nationwide poll on patient iatrogenesis conducted by the National Patient Safety Foundation (NPSF), which is sponsored by the American Medical Association (AMA). Leape is a founding member of NPSF. The survey found that more than 100 million Americans have been affected directly or indirectly by a medical mistake. Forty-two percent were affected directly and 84% personally knew of someone who had experienced a medical mistake.24 At this press conference, Leape updated his 1994 statistics, noting that as of 1997, medical errors in inpatient hospital settings nationwide could be as high as 3 million and could cost as much as $200 billion. Leape used a 14% fatality rate to determine a medical error death rate of 180,000 in 1994.25 In 1997, using Leape’s base number of 3 million errors, the annual death rate could be as high as 420,000 for hospital inpatients alone. Only a Fraction of Medical Errors Are Reported In 1994, Leape said he was well aware that medical errors were not being reported.25 A study conducted in two obstetrical units in the UK found that only about one quarter of adverse incidents were ever reported, to protect staff, preserve reputations, or for fear of reprisals, including lawsuits.28 An analysis by Wald and Shojania found that only 1.5% of all adverse events result in an incident report, and only 6% of adverse drug events are identified properly. The authors learned that the American College of Surgeons estimates that surgical incident reports routinely capture only 5-30% of adverse events. In one study, only 20% of surgical complications resulted in discussion at morbidity and mortality rounds.38 From these studies, it appears that all the statistics gathered on medical errors may substantially underestimate the number of adverse drug and medical therapy incidents. They also suggest that our statistics concerning mortality resulting from medical errors may be in fact conservative figures. An article in Psychiatric Times (April 2000) outlines the stakes involved in reporting medical errors.39 The authors found that the public is fearful of suffering a fatal medical error, and doctors are afraid they will be sued if they report an error. This brings up the obvious question: who is reporting medical errors? Usually it is the patient or the patient’s surviving family. If no one notices the error, it is never reported. Janet Heinrich, an associate director at the US General Accounting Office responsible for health financing and public health issues, testified before a House subcommittee hearing on medical errors that “the full magnitude of their threat to the American public is unknown” and “gathering valid and useful information about adverse events is extremely difficult.” She acknowledged that the fear of being blamed, and the potential for legal liability, played key roles in the underreporting of errors. The Psychiatric Times noted that the AMA strongly opposes mandatory reporting of medical errors.39 If doctors are not reporting, what about nurses? A survey of nurses found that they also fail to report medical mistakes for fear of retaliation.40 Standard medical pharmacology texts admit that relatively few doctors ever report adverse drug reactions to the FDA.41 The reasons range from not knowing such a reporting system exists to fear of being sued.42 Yet the public depends on this tremendously flawed system of voluntary reporting by doctors to know whether a drug or a medical intervention is harmful. Pharmacology texts also will tell doctors how hard it is to separate drug side effects from disease symptoms. Treatment failure is most often attributed to the disease and not the drug or doctor. Doctors are warned, “Probably nowhere else in professional life are mistakes so easily hidden, even from ourselves.”43 It may be hard to accept, but it is not difficult to understand why only 1 in 20 side effects is reported to either hospital administrators or the FDA.44 If hospitals admitted to the actual number of errors for which they are responsible, which is about 20 times what is reported, they would come under intense scrutiny.29 Jerry Phillips, associate director of the FDA’s Office of Post Marketing Drug Risk Assessment, confirms this number. “In the broader area of adverse drug reaction data, the 250,000 reports received annually probably represent only 5% of the actual reactions that occur.”30 Dr. Jay Cohen, who has extensively researched adverse drug reactions, notes that because only 5% of adverse drug reactions are reported, there are in fact 5 million medication reactions each year.45 A 2003 survey is all the more distressing because there seems to be no improvement in error reporting, even with all the attention given to this topic. Dr. Dorothea Wild surveyed medical residents at a community hospital in Connecticut and found that only half were aware that the hospital had a medical error-reporting system, and that the vast majority did not use it at all. Dr. Wild says this does not bode well for the future. If doctors do not learn error reporting in their training, they will never use it. Wild adds that error reporting is the first step in locating the gaps in the medical system and fixing them.46 Public Suggestions on Iatrogenesis In a telephone survey, 1,207 adults ranked the effectiveness of the following measures in reducing preventable medical errors that result in serious harm.47 Following each measure is the percentage of respondents who ranked the measure as “very effective.” giving doctors more time to spend with patients (78%) requiring hospitals to develop systems to avoid medical errors (74%) better training of health professionals (73%) using only doctors specially trained in intensive care medicine on intensive care units (73%) requiring hospitals to report all serious medical errors to a state agency (71%) increasing the number of hospital nurses (69%) reducing the work hours of doctors in training to avoid fatigue (66%) encouraging hospitals to voluntarily report serious medical errors to a state agency (62%). Drug Iatrogenesis Prescription drugs constitute the major treatment modality of scientific medicine. With the discovery of the “germ theory,” medical scientists convinced the public that infectious organisms were the cause of illness. Finding the “cure” for these infections proved much harder than anyone imagined. From the beginning, chemical drugs promised much more than they delivered. But far beyond not working, the drugs also caused incalculable side effects. The drugs themselves, even when properly prescribed, have side effects that can be fatal, as Lazarou’s study6 showed. But human error can make the situation even worse. Medication Errors A survey of a 1992 national pharmacy database found a total of 429,827 medication errors in 1,081 hospitals. Medication errors occurred in 5.22% of patients admitted to these hospitals each year. The authors concluded that at least 90,895 patients annually were harmed by medication errors in the US as a whole.48 A 2002 study shows that 20% of hospital medications for patients had dosage errors. Nearly 40% of these errors were considered potentially harmful to the patient. In a typical 300-bed hospital, the number of errors per day was 40.49 Problems involving patients’ medications were even higher the following year. The error rate intercepted by pharmacists in this study was 24%, making the potential minimum number of patients harmed by prescription drugs 417,908.50 Adverse Drug Reactions More recent studies on adverse drug reactions show that the figures from 1994 published in Lazarou’s 1998 JAMA article may be increasing. A 2003 study followed 400 patients after discharge from a tertiary care hospital setting (requiring highly specialized skills, technology, or support services). Seventy-six patients (19%) had adverse events. Adverse drug events were the most common, at 66% of all events. The next most common event was procedure-related injuries, at 17%.6 In a New England Journal of Medicine study, an alarming one in four patients suffered observable side effects from the more than 3.34 billion prescription drugs filled in 2002.51 One of the doctors who produced the study was interviewed by Reuters and commented, “With these 10-minute appointments, it’s hard for the doctor to get into whether the symptoms are bothering the patients.”52 William Tierney, who editorialized on the New England Journal study, wrote, “given the increasing number of powerful drugs available to care for the aging population, the problem will only get worse.” The drugs with the worst record of side effects were selective serotonin reuptake inhibitors (SSRIs), nonsteroidal anti-inflammatory drugs (NSAIDs), and calcium-channel blockers. Reuters also reported that prior research has suggested that nearly 5% of hospital admissions (over 1 million per year) are the result of drug side effects. But most of the cases are not documented as such. The study found that one of the reasons for this failure is that in nearly two thirds of the cases, doctors could not diagnose drug side effects or the side effects persisted because the doctor failed to heed the warning signs. Medicating Our Feelings Patients seeking a more joyful existence and relief from worry, stress, and anxiety often fall victim to the messages endlessly displayed on TV and billboards. Often, instead of gaining relief, they fall victim to the myriad iatrogenic side effects of antidepressant medication. Moreover, a whole generation of antidepressant users has been created from young people growing up on Ritalin®. Medicating young people and modifying their emotions must have some impact on how they learn to deal with their feelings. They learn to equate coping with drugs rather than with their inner resources. As adults, these medicated youth reach for alcohol, drugs, or even street drugs to cope. According to JAMA, “Ritalin® acts much like cocaine.”53 Today’s marketing of mood-modifying drugs such as Prozac® and Zoloft® makes them not only socially acceptable, but almost a necessity in today’s stressful world. Television Diagnosis To reach the widest audience possible, drug companies no longer just target medical doctors with their marketing of antidepressants. By 1995, drug companies had tripled the amount of money allotted to direct advertising of prescription drugs to consumers. The majority of this money is spent on seductive television ads. From 1996 to 2000, spending rose from $791 million to nearly $2.5 billion.54 This $2.5 billion represents only 15% of the total pharmaceutical advertising budget. While the drug companies maintain that direct-to-consumer advertising is educational, Dr. Sidney M. Wolfe of the Public Citizen Health Research Group in Washington, DC, argues that the public often is misinformed about these ads.55 People want what they see on television and are told to go to their doctors for a prescription. Doctors in private practice either acquiesce to their patients’ demands for these drugs or spend valuable time trying to talk patients out of unnecessary drugs. Dr. Wolfe remarks that one important study found that people mistakenly believe that the “FDA reviews all ads before they are released and allows only the safest and most effective drugs to be promoted directly to the public.”55 How Do We Know Drugs Are Safe? Another aspect of scientific medicine that the public takes for granted is the testing of new drugs. Drugs generally are tested on individuals who are fairly healthy and not on other medications that could interfere with findings. But when these new drugs are declared “safe” and enter the drug prescription books, they are naturally going to be used by people who are on a variety of other medications and have a lot of other health problems. Then a new phase of drug testing called “post-approval” comes into play, which is the documentation of side effects once drugs hit the market. In one very telling report, the federal government’s General Accounting Office “found that of the 198 drugs approved by the FDA between 1976 and 1985 . . . 102 (or 51.5%) had serious post-approval risks . . . the serious post-approval risks (included) heart failure, myocardial infarction, anaphylaxis, respiratory depression and arrest, seizures, kidney and liver failure, severe blood disorders, birth defects and fetal toxicity, and blindness.”56 NBC News’ investigative show “Dateline” wondered if your doctor is moonlighting as a drug company representative. After a yearlong investigation, NBC reported that because doctors can legally prescribe any drug to any patient for any condition, drug companies heavily promote “off label” and frequently inappropriate and untested uses of these medications, even though these drugs are approved only for the specific indications for which they have been tested.57 The leading causes of adverse drug reactions are antibiotics (17%), cardiovascular drugs (17%), chemotherapy (15%), and analgesics and anti-inflammatory agents (15%).11 Specific Drug Iatrogenesis: Antibiotics According to William Agger, MD, director of microbiology and chief of infectious disease at Gundersen Lutheran Medical Center in La Crosse, WI, 30 million pounds of antibiotics are used in America each year.58 Of this amount, 25 million pounds are used in animal husbandry and 23 million pounds are used to try to prevent disease and promote growth. Only 2 million pounds are given for specific animal infections. Dr. Agger reminds us that low concentrations of antibiotics are measurable in many of our foods and in various waterways around the world, much of it seeping in from animal farms. Agger contends that overuse of antibiotics results in food-borne infections that are resistant to antibiotics. Salmonella is found in 20% of ground meat, but the constant exposure of cattle to antibiotics has made 84% of salmonella resistant to at least one anti-salmonella antibiotic. Diseased animal food accounts for 80% of salmonellosis in humans, or 1.4 million cases per year. The conventional approach to countering this epidemic is to radiate food to try to kill all organisms while continuing to use the antibiotics that created the problem in the first place. Approximately 20% of chickens are contaminated with Campylobacter jejuni, an organism that causes 2.4 million cases of illness annually. Fifty-four percent of these organisms are resistant to at least one anti-Campylobacter antimicrobial agent. Denmark banned growth-promoting antibiotics beginning in 1999, which cut their use by more than half within a year, from 453,200 to 195,800 pounds. A report from Scandinavia found that removing antibiotic growth promoters had no or minimal effect on food production costs. Agger warns that the current crowded, unsanitary methods of animal farming in the US support constant stress and infection, and are geared toward high antibiotic use. In the US, over 3 million pounds of antibiotics are used every year on humans. With a population of 284 million Americans, this amount is enough to give every man, woman, and child 10 teaspoons of pure antibiotics per year. Agger says that exposure to a steady stream of antibiotics has altered pathogens such as Streptococcus pneumoniae, Staplococcus aureus, and entercocci, to name a few. Almost half of patients with upper respiratory tract infections in the US still receive antibiotics from their doctors.59 According to the CDC, 90% of upper respiratory infections are viral and should not be treated with antibiotics. In Germany, the prevalence of systemic antibiotic use in children aged 0-6 years was 42.9%.60 Data obtained from nine US health insurers on antibiotic use in 25,000 children from 1996 to 2000 found that rates of antibiotic use decreased. Antibiotic use in children aged 3 months to under 3 years decreased 24%, from 2.46 to 1.89 antibiotic prescriptions per patient per year. For children aged 3 to under 6 years, there was a 25% reduction, from 1.47 to 1.09 antibiotic prescriptions per patient per year. And for children aged 6 to under 18 years, there was a 16% reduction, from 0.85 to 0.69 antibiotic prescriptions per patient per year.61 Despite these reductions, the data indicate that on average, every child in America receives 1.22 antibiotic prescriptions annually. Group A beta-hemolytic streptococci is the only common cause of sore throat that requires antibiotics, with penicillin and erythromycin the only recommended treatment. Ninety percent of sore-throat cases, however, are viral. Antibiotics were used in 73% of the estimated 6.7 million adult annual visits for sore throat in the US between 1989 and 1999. Furthermore, patients treated with antibiotics were prescribed non-recommended broad-spectrum antibiotics in 68% of visits. This period saw a significant increase in the use of newer, more expensive broad-spectrum antibiotics and a decrease in use of the recommended antibiotics penicillin and erythromycin.62 Antibiotics being prescribed in 73% of sore-throat cases instead of the recommended 10% resulted in a total of 4.2 million unnecessary antibiotic prescriptions from 1989 to 1999. The Problem with Antibiotics In September 2003, the CDC re-launched a program started in 1995 called “Get Smart: Know When Antibiotics Work.”63 This $1.6 million campaign is designed to educate patients about the overuse and inappropriate use of antibiotics. Most people involved with alternative medicine have known about the dangers of antibiotic overuse for decades. Finally, the government is focusing on the problem, yet it is spending only a miniscule amount of money on an iatrogenic epidemic that is costing billions of dollars and thousands of lives. The CDC warns that 90% of upper respiratory infections, including children’s ear infections, are viral and that antibiotics do not treat viral infection. More than 40% of about 50 million prescriptions for antibiotics written each year in physicians’ offices are inappropriate.7,8 Using antibiotics when not needed can lead to the development of deadly strains of bacteria that are resistant to drugs and cause more than 88,000 deaths due to hospital-acquired infections.16 The CDC, however, seems to be blaming patients for misusing antibiotics even though they are available only by prescription from physicians. According to Dr. Richard Besser, head of the “Get Smart” program to educate patients about proper antibiotic use, “Programs that have just targeted physicians have not worked. Direct-to-consumer advertising of drugs is to blame in some cases.” Besser says the program “teaches patients and the general public that antibiotics are precious resources that must be used correctly if we want to have them around when we need them. Hopefully, as a result of this campaign, patients will feel more comfortable asking their doctors for the best care for their illnesses, rather than asking for antibiotics.”64 What constitutes the “best care”? The CDC does not elaborate and ignores the latest research on the dozens of nutraceuticals that have been scientifically proven to treat viral infections and boost immune-system function. Will doctors recommend garlic, vitamin C, lactoferrin, elderberry, vitamin A, zinc, or DHEA? Probably not. The CDC’s common-sense recommendations that most people follow anyway include getting proper rest, drinking plenty of fluids, and using a humidifier. The pharmaceutical industry claims it supports limiting the use of antibiotics. The drug company Bayer sponsors a program called “Operation Clean Hands” through an organization called LIBRA.65 The CDC also is involved in trying to minimize antibiotic resistance, but nowhere in its publications is there any reference to the role of nutraceuticals in boosting the immune system, or to the thousands of journal articles that support this approach. This tunnel vision and refusal to recommend the available non-drug alternatives is unfortunate when the CDC is desperately trying to curb the overuse of antibiotics. Drugs Pollute Our Water Supply We have reached the point of saturation with prescription drugs. Every body of water tested contains measurable drug residues. The tons of antibiotics used in animal farming, which run off into the water table and surrounding bodies of water, are conferring antibiotic resistance to germs in sewage, and these germs also are found in our water supply. Flushed down our toilets are tons of drugs and drug metabolites that also find their way into our water supply. We have no way to know the long-term health consequences of ingesting a mixture of drugs and drug-breakdown products. These drugs represent another level of iatrogenic disease that we are unable to completely measure.66-74 Specific Drug Iatrogenesis: NSAIDs It is not only the US that is plagued by iatrogenesis. A survey of more than 1,000 French general practitioners (GPs) tested their basic pharmacological knowledge and practice in prescribing NSAIDs, which rank first among commonly prescribed drugs for serious adverse reactions. The study results suggest that GPs do not have adequate knowledge of these drugs and are unable to effectively manage adverse reactions.75 A cross-sectional survey of 125 patients attending specialty pain clinics in South London found that possible iatrogenic factors such as “over-investigation, inappropriate information, and advice given to patients as well as misdiagnosis, over-treatment, and inappropriate prescription of medication were common.”76 Specific Drug Iatrogenesis: Cancer Chemotherapy In 1989, German biostatistician Ulrich Abel, PhD, wrote a monograph entitled “Chemotherapy of Advanced Epithelial Cancer.” It was later published in shorter form in a peer-reviewed medical journal.77 Abel presented a comprehensive analysis of clinical trials and publications representing over 3,000 articles examining the value of cytotoxic chemotherapy on advanced epithelial cancer. Epithelial cancer is the type of cancer with which we are most familiar, arising from epithelium found in the lining of body organs such as the breast, prostate, lung, stomach, and bowel. From these sites, cancer usually infiltrates adjacent tissue and spreads to the bone, liver, lung, or brain. With his exhaustive review, Abel concluded there is no direct evidence that chemotherapy prolongs survival in most patients with advanced carcinoma. According to Abel, “Many oncologists take it for granted that response to therapy prolongs survival, an opinion which is based on a fallacy and which is not supported by clinical studies.” Over a decade after Abel’s exhaustive review of chemotherapy, there seems no decrease in its use for advanced carcinoma. For example, when conventional chemotherapy and radiation have not worked to prevent metastases in breast cancer, high-dose chemotherapy (HDC) along with stem-cell transplant (SCT) is the treatment of choice. In March 2000, however, results from the largest multi-center randomized controlled trial conducted thus far showed that, compared to a prolonged course of monthly conventional-dose chemotherapy, HDC and SCT were of no benefit,78 with even a slightly lower survival rate for the HDC/SCT group. Serious adverse effects occurred more often in the HDC group than in the standard-dose group. One treatment-related death (within 100 days of therapy) was recorded in the HDC group, but none was recorded in the conventional chemotherapy group. The women in this trial were highly selected as having the best chance to respond. Unfortunately, no all-encompassing follow-up study such as Dr. Abel’s exists to indicate whether there has been any improvement in cancer-survival statistics since 1989. In fact, research should be conducted to determine whether chemotherapy itself is responsible for secondary cancers instead of progression of the original disease. We continue to question why well-researched alternative cancer treatments are not used. Drug Companies Fined Periodically, the FDA fines a drug manufacturer when its abuses are too glaring and impossible to cover up. In May 2002, the Washington Post reported that Schering-Plough Corp., the maker of Claritin®, was to pay a $500 million fine to the FDA for quality-control problems at four of its factories.79 The indictment came after the Public Citizen Health Research Group, led by Dr. Sidney Wolfe, called for a criminal investigation of Schering-Plough, charging that the company distributed albuterol asthma inhalers even though it knew the units were missing the active ingredient. The FDA tabulated infractions involving 125 products, or 90% of the drugs made by Schering-Plough since 1998. Besides paying the fine, the company was forced to halt the manufacture of 73 drugs or suffer another $175 million fine. Schering-Plough’s news releases told another story, assuring consumers that they should still feel confident in the company’s products. This large settlement served as a warning to the drug industry about maintaining strict manufacturing practices and has given the FDA more clout in dealing with drug company compliance. According to the Washington Post article, a federal appeals court ruled in 1999 that the FDA could seize the profits of companies that violate “good manufacturing practices.” Since that time, Abbott Laboratories has paid a $100 million fine for failing to meet quality standards in the production of medical test kits, while Wyeth Laboratories paid $30 million in 2000 to settle accusations of poor manufacturing practices. Unnecessary Surgical Procedures In 1974, 2.4 million unnecessary surgeries were performed, resulting in 11,900 deaths at a cost of $3.9 billion.80,81 In 2001, 7.5 million unnecessary surgical procedures were performed, resulting in 37,136 deaths at a cost of $122 billion (using 1974 dollars).9,10 It is very difficult to obtain accurate statistics when studying unnecessary surgery. In 1989, Leape wrote that perhaps 30% of controversial surgeries—which include cesarean section, tonsillectomy, appendectomy, hysterectomy, gastrectomy for obesity, breast implants, and elective breast implants81— are unnecessary. In 1974, the Congressional Committee on Interstate and Foreign Commerce held hearings on unnecessary surgery. It found that 17.6% of recommendations for surgery were not confirmed by a second opinion. The House Subcommittee on Oversight and Investigations extrapolated these figures and estimated that, on a nationwide basis, there were 2.4 million unnecessary surgeries performed annually, resulting in 11,900 deaths at an annual cost of $3.9 billion.80 According to the Healthcare Cost and Utilization Project within the Agency for Healthcare Research and Quality,22 in 2001 the 50 most common medical and surgical procedures were performed approximately 41.8 million times in the US. Using the 1974 House Subcommittee on Oversight and Investigations’ figure of 17.6% as the percentage of unnecessary surgical procedures, and extrapolating from the death rate in 1974, produces nearly 7.5 million (7,489,718) unnecessary procedures and a death rate of 37,136, at a cost of $122 billion (using 1974 dollars). In 1995, researchers conducted a similar analysis of back surgery procedures, using the 1974 “unnecessary surgery percentage” of 17.6%. Testifying before the Department of Veterans Affairs, they estimated that of the 250,000 back surgeries performed annually in the US at a hospital cost of $11,000 per patient, the total number of unnecessary back surgeries approaches 44,000, costing as much as $484 million.82 Like prescription drug use driven by television advertising, unnecessary surgeries are escalating. Media-driven surgery such as gastric bypass for obesity “modeled” by Hollywood celebrities seduces obese people into thinking this route is safe and sexy. Unnecessary surgeries have even been marketed on the Internet.83 A study in Spain declares that 20-25% of total surgical practice represents unnecessary operations.84 According to data from the National Center for Health Statistics for 1979 to 1984, the total number of surgical procedures increased 9% while the number of surgeons grew 20%. The study notes that the large increase in the number of surgeons was not accompanied by a parallel increase in the number of surgeries performed, and expressed concern about an excess of surgeons to handle the surgical caseload.85 From 1983 to 1994, however, the incidence of the 10 most commonly performed surgical procedures jumped 38%, to 7,929,000 from 5,731,000 cases. By 1994, cataract surgery was the most common procedure, with more than 2 million operations, followed by cesarean section (858,000 procedures) and inguinal hernia operations (689,000 procedures). Knee arthroscopy procedures increased 153% while prostate surgery declined 29%.86 The list of iatrogenic complications from surgery is as long as the list of procedures themselves. One study examined catheters that were inserted to deliver anesthetic into the epidural space around the spinal nerves for lower cesarean section, abdominal surgery, or prostate surgery. In some cases, non-sterile technique during catheter insertion resulted in serious infections, even leading to limb paralysis.87 In one review of the literature, the authors found “a significant rate of overutilization of coronary angiography, coronary artery surgery, cardiac pacemaker insertion, upper gastrointestinal endoscopies, carotid endarterectomies, back surgery, and pain-relieving procedures.”88 A 1987 JAMA study found the following significant levels of inappropriate surgery: 17% of coronary angiography procedures, 32% of carotid endarterectomy procedures, and 17% of upper gastrointestinal tract endoscopy procedures.89 Based on the Healthcare Cost and Utilization Project (HCUP) statistics provided by the government for 2001, 697,675 upper gastrointestinal endoscopies (usually entailing biopsy) were performed, as were 142,401 endarterectomies and 719,949 coronary angiographies.22 Extrapolating the JAMA study’s inappropriate surgery rates to 2001 produces 118,604 unnecessary endoscopy procedures, 45,568 unnecessary endarterectomies, and 122,391 unnecessary coronary angiographies. These are all forms of medical iatrogenesis. Medical and Surgical Procedures It is instructive to know the mortality rates associated with various medical and surgical procedures. Although we must sign release forms when we undergo any procedure, many of us are in denial about the true risks involved; because medical and surgical procedures are so commonplace, they often are seen as both necessary and safe. Unfortunately, allopathic medicine itself is a leading cause of death, as well as the most expensive way to die. Perhaps the words “health care” confer the illusion that medicine is about health. Allopathic medicine is not a purveyor of health care but of disease care. The HCUP figures are instructive,22 but the computer program that calculates annual mortality statistics for all US hospital discharges is only as good as the codes entered into the system. In email correspondence, HCUP indicated that the mortality rates for each procedure indicated only that someone undergoing that procedure died either from the procedure or from some other cause. Thus, there is no way of knowing exactly how many people die from a particular procedure. While codes for “poisoning & toxic effects of drugs” and “complications of treatment” do exist, the mortality figures registered in these categories are very low and do not correlate with what is known from research such as the 1998 JAMA study6 that estimated an average of 106,000 prescription medication deaths per year. No codes exist for adverse drug side effects, surgical mishaps, or other types of medical error. Until such codes exist, the true mortality rates tied to medical error will remain buried in the general statistics. An Honest Look at US Health Care In 1978, the US Office of Technology Assessment (OTA) reported, “Only 10-20% of all procedures currently used in medical practice have been shown to be efficacious by controlled trial.”90 In 1995, the OTA compared medical technology in eight countries (Australia, Canada, France, Germany, the Netherlands, Sweden, the UK, and the US ) and again noted that few medical procedures in the US have been subjected to clinical trial. It also reported that US infant mortality was high and life expectancy low compared to other developed countries.91 Surgical Errors Finally Reported An October 2003 JAMA study from the US government’s Agency for Healthcare Research and Quality (AHRQ) documented 32,000 mostly surgery-related deaths costing $9 billion and accounting for 2.4 million extra hospital days in 2000.92 Data from 20% of the nation’s hospitals were analyzed for 18 different surgical complications, including post-operative infections, foreign objects left in wounds, surgical wounds reopening, and post-operative bleeding. In a press release accompanying the study, AHRQ director Carolyn M. Clancy, MD, noted, “This study gives us the first direct evidence that medical injuries pose a real threat to the American public and increase the costs of health care.”23 According to the study’s authors, “The findings greatly underestimate the problem, since many other complications happen that are not listed in hospital administrative data.” They added, “The message here is that medical injuries can have a devastating impact on the health care system. We need more research to identify why these injuries occur and find ways to prevent them from happening.” The study authors said that improved medical practices, including an emphasis on better hand washing, might help reduce morbidity and mortality rates. In an accompanying JAMA editorial, health-risk research-er Dr. Saul Weingart of Harvard’s Beth Israel-Deaconess Medical Center wrote, “Given their staggering magnitude, these estimates are clearly sobering.”93 Unnecessary X-rays When x-rays were discovered, no one knew the long-term effects of ionizing radiation. In the 1950s, monthly fluoroscopic exams at the doctor’s office were routine, and you could even walk into most shoe stores and see x-rays of your foot bones. We still do not know the ultimate outcome of our initial fascination with x-rays. In those days, it was common practice to x-ray pregnant women to measure their pelvises and make a diagnosis of twins. Finally, a study of 700,000 children born between 1947 and 1964 in 37 major maternity hospitals compared the children of mothers who had received pelvic x-rays during pregnancy to those of mothers who did not. It found that cancer mortality was 40% higher among children whose mothers had been x-rayed.94 In present-day medicine, coronary angiography is an invasive surgical procedure that involves snaking a tube through a blood vessel in the groin up to the heart. To obtain useful information, x-rays are taken almost continuously, with minimum dosages ranging from 460 to 1,580 mrem. The minimum radiation from a routine chest x-ray is 2 mrem. X-ray radiation accumulates in the body, and ionizing radiation used in x-ray procedures has been shown to cause gene mutation. The health impact of this high level of radiation is unknown, and often obscured in statistical jargon such as, “The risk for lifetime fatal cancer due to radiation exposure is estimated to be 4 in 1 million per 1,000 mrem.”95 Dr. John Gofman has studied the effects of radiation on human health for 45 years. A medical doctor with a PhD in nuclear and physical chemistry, Dr. Gofman worked on the Manhattan Project, discovered uranium-233, and was the first person to isolate plutonium. In five scientifically documented books, Dr. Gofman provides strong evidence that medical technology—specifically x-rays, CT scans, and mammography and fluoroscopy devices—are a contributing factor to 75% of new cancers. In a nearly 700-page report updated in 2000, “Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Population,”96 Gofman shows that as the number of physicians increases in a geographical area along with an increase in the number of x-ray diagnostic tests performed, the rate of cancer and ischemic heart disease also increases. Gofman elaborates that it is not x-rays alone that cause the damage but a combination of health risk factors that include poor diet, smoking, abortions, and the use of birth control pills. Dr. Gofman predicts that ionizing radiation will be responsible for 100 million premature deaths over the next decade. In his book, “Preventing Breast Cancer,” Dr. Gofman notes that breast cancer is the leading cause of death among American women between the ages of 44 and 55. Because breast tissue is highly sensitive to radiation, mammograms can cause cancer. The danger can be heightened by other factors, including a woman’s genetic makeup, preexisting benign breast disease, artificial menopause, obesity, and hormone imbalance.97 Even x-rays for back pain can lead someone into crippling surgery. Dr. John E. Sarno, a well-known New York orthopedic surgeon, found that there is not necessarily any association between back pain and spinal x-ray abnormality. He cites studies of normal people without a trace of back pain whose x-rays indicate spinal abnormalities and of people with back pain whose spines appear to be normal on x-ray.98 People who happen to have back pain and show an abnormality on x-ray may be treated surgically, sometimes with no change in back pain, worsening of back pain, or even permanent disability. Moreover, doctors often order x-rays as protection against malpractice claims, to give the impression of leaving no stone unturned. It appears that doctors are putting their own fears before the interests of their patients. Unnecessary Hospitalization Nearly 9 million (8,925,033) people were hospitalized unnecessarily in 2001.1-4 In a study of inappropriate hospitalization, two doctors reviewed 1,132 medical records. They concluded that 23% of all admissions were inappropriate and an additional 17% could have been handled in outpatient clinics. Thirty-four percent of all hospital days were deemed inappropriate and could have been avoided.2 The rate of inappropriate hospital admissions in 1990 was 23.5%.3 In 1999, another study also found an inappropriate admissions rate of 24%, indicating a consistent pattern from 1986 to 1999.4 The HCUP database indicates that the total number of patient discharges from US hospitals in 2001 was 37,187,641,22 meaning that almost 9 million people were exposed to unnecessary medical intervention in hospitals and therefore represent almost 9 million potential iatrogenic episodes.1-4 Women’s Experience in Medicine Dr. Martin Charcot (1825-1893) was world renowned, the most celebrated doctor of his time. He practiced in the Paris hospital La Salpetriere. He became an expert in hysteria, diagnosing an average of 10 hysterical women each day, transforming them into “iatrogenic monsters” and turning simple “neurosis” into hysteria.99 The number of women diagnosed with hysteria and hospitalized rose from 1% in 1841 to 17% in 1883. Hysteria is derived from the Latin “hystera,” meaning uterus. According to Dr. Adriane Fugh-Berman, US medicine has a tradition of excessive medical and surgical interventions on women. Only 100 years ago, male doctors believed that female psychological imbalance originated in the uterus. When surgery to remove the uterus was perfected, it became the “cure” for mental instability, effecting a physical and psychological castration. Fugh-Berman notes that US doctors eventually disabused themselves of that notion but have continued to treat women very differently than they treat men.100 She cites the following statistics: Thousands of prophylactic mastectomies are performed annually. One third of US women have had a hysterectomy before menopause. Women are prescribed drugs more frequently than are men. Women are given potent drugs for disease prevention, which results in disease substitution due to side effects. Fetal monitoring is unsupported by studies and not recommended by the CDC.101 It confines women to a hospital bed and may result in a higher incidence of cesarean section.102 Normal processes such as menopause and childbirth have been heavily “medicalized.” Synthetic hormone replacement therapy (HRT) does not prevent heart disease or dementia, but does increase the risk of breast cancer, heart disease, stroke, and gall bladder attack.103 As many as a third of postmenopausal women use HRT.104,105 This number is important in light of the much-publicized Women’s Health Initiative study, which was halted before its completion because of a higher death rate in the synthetic estrogen-progestin (HRT) group.106 Cesarean Section In 1983, 809,000 cesarean sections (21% of live births) were performed in the US, making it the nation’s most common obstetric-gynecologic (OB-GYN) surgical procedure. The second most common OB-GYN operation was hysterectomy (673,000), followed by diagnostic dilation and curettage of the uterus (632,000). In 1983, OB-GYN procedures represented 23% of all surgeries completed in the US.107 In 2001, cesarean section was still the most common OB-GYN surgical procedure. Approximately 4 million births occur annually, with 24% (960,000) delivered by cesarean section. In the Netherlands, only 8% of births are delivered by cesarean section. This suggests 640,000 unnecessary cesarean sections—entailing three to four times higher mortality and 20 times greater morbidity than vaginal delivery108—are performed annually in the US. The US cesarean rate rose from just 4.5% in 1965 to 24.1% in 1986. Sakala contends that an “uncontrolled pandemic of medically unnecessary cesarean births is occurring.”109 VanHam reported a cesarean section postpartum hemorrhage rate of 7%, a hematoma formation rate of 3.5%, a urinary tract infection rate of 3%, and a combined postoperative morbidity rate of 35.7% in a high-risk population undergoing cesarean section.110 Never Enough Studies Scientists claimed there were never enough studies revealing the dangers of DDT and other dangerous pesticides to ban them. They also used this argument for tobacco, claiming that more studies were needed before they could be certain that tobacco really caused lung cancer. Even the American Medical Association (AMA) was complicit in suppressing the results of tobacco research. In 1964, when the Surgeon General’s report condemned smoking, the AMA refused to endorse it, claiming a need for more research. What they really wanted was more money, which they received from a consortium of tobacco companies that paid the AMA $18 million over the next nine years, during which the AMA said nothing about the dangers of smoking.111 The Journal of the American Medical Association (JAMA), “after careful consideration of the extent to which cigarettes were used by physicians in practice,” began accepting tobacco advertisements and money in 1933. State journals such as the New York State Journal of Medicine also began to run advertisements for Chesterfield cigarettes that claimed cigarettes are “Just as pure as the water you drink . . . and practically untouched by human hands.” In 1948, JAMA argued “more can be said in behalf of smoking as a form of escape from tension than against it . . . there does not seem to be any preponderance of evidence that would indicate the abolition of the use of tobacco as a substance contrary to the public health.’112 Today, scientists continue to use the excuse that more studies are needed before they will support restricting the inordinate use of drugs. Adverse Drug Reactions The Lazarou study6 analyzed records for prescribed medications for 33 million US hospital admissions in 1994. It discovered 2.2 million serious injuries due to prescribed drugs; 2.1% of inpatients experienced a serious adverse drug reaction, 4.7% of all hospital admissions were due to a serious adverse drug reaction, and fatal adverse drug reactions occurred in 0.19% of inpatients and 0.13% of admissions. The authors estimated that 106,000 deaths occur annually due to adverse drug reactions. Using a cost analysis from a 2000 study in which the increase in hospitalization costs per patient suffering an adverse drug reaction was $5,483, costs for the Lazarou study’s 2.2 million patients with serious drug reactions amounted to $12 billion.6,57 Serious adverse drug reactions commonly emerge after FDA approval of the drugs involved. The safety of new agents cannot be known with certainty until a drug has been on the market for many years.113 Bedsores Over 1 million people develop bedsores in US hospitals every year. It is a tremendous burden to patients and family, and a $55 billion health care burden.14 Bedsores are preventable with proper nursing care. It is true that 50% of those affected are in a vulnerable age group of over 70. In the elderly, bedsores carry a fourfold increase in the rate of death. The mortality rate in hospitals for patients with bedsores is between 23% and 37%.15 Even if we just take the 50% of people over 70 with bedsores and the lowest mortality at 23%, that gives us a death rate due to bedsores of 115,000. Critics will say that it was the disease or advanced age that killed the patient, not the bedsore, but our argument is that an early death, by denying proper care, deserves to be counted. It is only after counting these unnecessary deaths that we can then turn our attention to fixing the problem. Malnutrition in Nursing Homes The General Accounting Office (GAO), a special investigative branch of Congress, cited 20% of the nation’s 17,000 nursing homes for violations between July 2000 and January 2002. Many violations involved serious physical injury and death.114 A report from the Coalition for Nursing Home Reform states that at least one third of the nation’s 1.6 million nursing home residents may suffer from malnutrition and dehydration, which hastens their death. The report calls for adequate nursing staff to help feed patients who are not able to manage a food tray by themselves.18 It is difficult to place a mortality rate on malnutrition and dehydration. The coalition report states that compared with well-nourished hospitalized nursing home residents, malnourished residents have a fivefold increase in mortality when they are admitted to a hospital. Multiplying the one third of 1.6 million nursing home residents who are malnourished by a mortality rate of 20%15,24 results in 108,800 premature deaths due to malnutrition in nursing homes. Nosocomial Infections The rate of nosocomial (in-hospital) infections per 1,000 patient days rose from 7.2 in 1975 to 9.8 in 1995, a 36% jump in 20 years. Reports from more than 270 US hospitals showed that the nosocomial infection rate itself had remained stable over the previous 20 years, with approximately 5-6 hospital-acquired infections occurring per 100 admissions. Due to progressively shorter inpatient stays and the increasing number of admissions, however, the number of infections has increased. It is estimated that in 1995, nosocomial infections cost $4.5 billion and contributed to more than 88,000 deaths, or one death every six minutes.16 The 2003 incidence of nosocomial mortality is probably higher than in 1995 because of the tremendous increase in antibiotic-resistant organisms. Morbidity and Mortality Report found that nosocomial infections cost $5 billion annually in 1999,17 representing a $0.5 billion increase in just four years. At this rate of increase, the current cost of nosocomial infections would be close to $6 billion. Outpatient Iatrogenesis In a 2000 JAMA article, Dr. Barbara Starfield presents well-documented facts that are both shocking and unassailable.19,20 The US ranks 12th of 13 industrialized countries when judged by 16 health status indicators. Japan, Sweden, and Canada were first, second, and third, respectively. More than 40 million people in the US have no health insurance, and 20-30% of patients receive contraindicated care. Starfield warned that one cause of medical mistakes is overuse of technology, which may create a “cascade effect” leading to still more treatment. She urges the use of ICD (International Classification of Diseases) codes that have designations such as “Drugs, Medicinal, and Biological Substances Causing Adverse Effects in Therapeutic Use” and “Complications of Surgical and Medical Care” to help doctors quantify and recognize the magnitude of the medical error problem. Starfield notes that many deaths attributable to medical error today are likely to be coded to indicate some other cause of death. She concludes that against the backdrop of our poor health report card compared to other Western countries, we should recognize that the harmful effects of health care interventions account for a substantial proportion of our excess deaths. Starfield cites Weingart’s 2000 article, “Epidemiology of Medical Error,” as well as other authors to suggest that between 4% and 18% of consecutive patients in outpatient settings suffer an iatrogenic event leading to: 116 million extra physician visits 77 million extra prescriptions filled 17 million emergency department visits 8 million hospitalizations 3 million long-term admissions 199,000 additional deaths $77 billion in extra costs.21 Unnecessary Surgeries While some 12,000 deaths occur each year from unnecessary surgeries, results from the few studies that have measured unnecessary surgery directly indicate that for some highly controversial operations, the proportion of unwarranted surgeries could be as high as 30%.81 Medical Errors: A Global Issue A five-country survey published in the Journal of Health Affairs found that 18-28% of people who were recently ill had suffered from a medical or drug error in the previous two years. The study surveyed 750 recently ill adults. The breakdown by country showed the percentages of those suffering a medical or drug error were 18% in Britain, 23% in Australia and in New Zealand, 25% in Canada, and 28% in the US.115 Health Insurance The Institute of Medicine recently found that the 41 million Americans with no health insurance have consistently worse clinical outcomes than those who are insured, and are at increased risk for dying prematurely.116 When doctors bill for services they do not render, advise unnecessary tests, or screen everyone for a rare condition, they are committing insurance fraud. The US GAO estimated that $12 billion was lost to fraudulent or unnecessary claims in 1998, and reclaimed $480 million in judgments in that year. In 2001, the federal government won or negotiated more than $1.7 billion in judgments, settlements, and administrative impositions in health care fraud cases and proceedings.117 Warehousing Our Elders One way to measure the moral and ethical fiber of a society is by how it treats its weakest and most vulnerable members. In some cultures, elderly people live out their lives in extended family settings that enable them to continue participating in family and community affairs. American nursing homes, where millions of our elders go to live out their final days, represent the pinnacle of social isolation and medical abuse. In America, approximately 1.6 million elderly are confined to nursing homes. By 2050, that number could be 6.6 million.18,118 Twenty percent of all deaths from all causes occur in nursing homes.119 Hip fractures are the single greatest reason for nursing home admissions.120 Nursing homes represent a reservoir for drug-resistant organisms due to overuse of antibiotics.16 Presenting a report he sponsored entitled “Abuse of Residents Is a Major Problem in US Nursing Homes” on July 30, 2001, Rep. Henry Waxman (D-CA) noted that “as a society we will be judged by how we treat the elderly.” The report found one third of the nation’s approximately 17,000 nursing homes were cited for an abuse violation in a two-year period from January 1999 to January 2001.118 According to Waxman, “the people who cared for us deserve better.” The report suggests that this known abuse represents only the “tip of the iceberg” and that much more abuse occurs that we are not aware of or ignore.118 The report found: Over 30% of US nursing homes were cited for abuses, totaling more than 9,000 violations. Ten percent of nursing homes had violations that caused actual physical harm to residents or worse. Over 40% (3,800) of the abuse violations followed the filing of a formal complaint, usually by concerned family members. Many verbal abuse violations were found, as were occasions of sexual abuse. Incidents of physical abuse causing numerous injuries, such as fractured femurs, hips, elbows, and wrists, also were found. Dangerously understaffed nursing homes lead to neglect, abuse, overuse of medications, and physical restraints. In 1990, Congress mandated an exhaustive study of nurse-to-patient ratios in nursing homes. The study was finally begun in 1998 and took four years to complete.121 A spokesperson for the National Citizens’ Coalition for Nursing Home Reform commented on the study: “They compiled two reports of three volumes, each thoroughly documenting the number of hours of care residents must receive from nurses and nursing assistants to avoid painful, even dangerous, conditions such as bedsores and infections. Yet it took the Department of Health and Human Services and Secretary Tommy Thompson only four months to dismiss the report as ‘insufficient.’”122 Although preventable with proper nursing care, bedsores occur three times more commonly in nursing homes than in acute care or veterans hospitals.123 Because many nursing home patients suffer from chronic debilitating conditions, their assumed cause of death often is unquestioned by physicians. Some studies show that as many as 50% of deaths due to restraints, falls, suicide, homicide, and choking in nursing homes may be covered up.124,125 It is possible that many nursing home deaths are instead attributed to heart disease. In fact, researchers have found that heart disease may be over-represented in the general population as a cause of death on death certificates by 8-24%. In the elderly, the over-reporting of heart disease as a cause of death is as much as twofold.126 That very few statistics exist concerning malnutrition in acute care hospitals and nursing homes demonstrates the lack of concern in this area. While a survey of the literature turns up few US studies, one revealing US study evaluated the nutritional status of 837 patients in a 100-bed subacute care hospital over a 14-month period. The study found only 8% of the patients were well nourished, while 29% were malnourished and 63% were at risk of malnutrition. As a result, 25% of the malnourished patients required readmission to an acute care hospital, compared to 11% of the well-nourished patients. The authors concluded that malnutrition reached epidemic proportions in patients admitted to this subacute care facility.127 Many studies conclude that physical restraints are an underreported and preventable cause of death. Studies show that compared to no restraints, the use of restraints carries a higher mortality rate and economic burden.128-130 Studies have found that physical restraints, including bedrails, are the cause of at least 1 in every 1,000 nursing-home deaths.131-133 Deaths caused by malnutrition, dehydration, and physical restraints, however, are rarely recorded on death certificates. Several studies reveal that nearly half of the listed causes of death on death certificates for elderly people with chronic or multi-system disease are inaccurate.134 Although one in five people dies in nursing homes, an autopsy is performed in less than 1% of these deaths.135 Overmedicating Seniors Dr. Robert Epstein, chief medical officer of Medco Health Solutions Inc. (a unit of Merck & Co.), conducted a study in 2003 of drug trends among the elderly.136 He found that seniors are going to multiple physicians, getting multiple prescriptions, and using multiple pharmacies. Medco oversees drug-benefit plans for more than 60 million Americans, including 6.3 million seniors who received more than 160 million prescriptions. According to the study, the average senior receives 25 prescriptions each year. Among those 6.3 million seniors, a total of 7.9 million medication alerts were triggered: less than half that number, 3.4 million, were detected in 1999. About 2.2 million of those alerts indicated excessive dosages unsuitable for seniors, and about 2.4 million alerts indicated clinically inappropriate drugs for the elderly. Reuters interviewed Kasey Thompson, director of the Center on Patient Safety at the American Society of Health System Pharmacists, who noted: “There are serious and systemic problems with poor continuity of care in the United States.” He says this study represents “the tip of the iceberg” of a national problem.136 According to Drug Benefit Trends, the average number of prescriptions dispensed per non-Medicare HMO member per year rose 5.6% from 1999 to 2000, from 7.1 to 7.5 prescriptions. The average number dispensed for Medicare members increased 5.5%, from 18.1 to 19.1 prescriptions.137 The total number of prescriptions written in the US in 2000 was 2.98 billion, or 10.4 prescriptions for every man, woman, and child.138 In a study of 818 residents of residential care facilities for the elderly, 94% were receiving at least one medication at the time of the interview. The average intake of medications was five per resident; the authors noted that many of these drugs were given without a documented diagnosis justifying their use.139 Seniors and groups like the American Association of Retired Persons (AARP) have accepted allopathic medicine’s overriding assumption that aging and dying in America must be accompanied by drugs in nursing homes and eventual hospitalization.140 Seniors are given the choice of either high-cost patented drugs or low-cost generic drugs. Drug companies attempt to keep the most expensive drugs on the shelves and suppress access to generic drugs, despite facing stiff fines of hundreds of millions of dollars levied by the federal government.141,142 In 2001, some of the world’s largest drug companies were fined a record $871 million for conspiring to increase the price of vitamins.143 Current AARP recommendations for diet and nutrition assume that seniors are getting all the nutrition they need in an average diet. At most, AARP suggests adding extra calcium and a multivitamin and mineral supplement.144 Ironically, studies also indicate underuse of proper pain medication for patients who need it. One study evaluated pain management in a group of 13,625 cancer patients, aged 65 and over, living in nursing homes. While almost 30% of the patients reported pain, more than 25% received no pain-relief medication, 16% received a mild analgesic drug, 32% received a moderate analgesic drug, and 26% received adequate pain-relieving morphine. The authors concluded that older patients and minority patients were more likely to have their pain untreated.145 What Remains to Be Uncovered Our ongoing research will continue to quantify the morbidity, mortality, and financial loss due to: X-ray exposure (mammography, fluoroscopy, CT scans). Overuse of antibiotics for all conditions. Carcinogenic drugs (hormone replacement therapy,* immunosuppressive and prescription drugs). Cancer chemotherapy Surgery and unnecessary surgery (cesarean section, radical mastectomy, preventive mastectomy, radical hysterectomy, prostatectomy, cholecystectomies, cosmetic surgery, arthroscopy, etc.). Discredited medical procedures and therapies. Unproven medical therapies. Outpatient surgery. Doctors themselves. * Part of our ongoing research will be to quantify the mortality and morbidity caused by hormone replacement therapy (HRT) since the 1940s. In December 2000, a government scientific advisory panel recommended that synthetic estrogen be added to the nation’s list of cancer-causing agents. HRT, either synthetic estrogen alone or combined with synthetic progesterone, is used by an estimated 13.5 to 16 million women in the US.146 The aborted Women’s Health Initiative Study (WHI) of 2002 showed that women taking synthetic estrogen combined with synthetic progesterone have a higher incidence of blood clots, breast cancer, stroke, and heart disease, with little evidence of osteoporosis reduction or dementia prevention. WHI researchers, who usually never make recommendations except to suggest more studies, advised doctors to be very cautious about prescribing HRT to their patients.102,147-151 Results of the “Million Women Study” on HRT and breast cancer in the UK were published in medical journal The Lancet in August 2003. According to lead author Prof. Valerie Beral, director of the Cancer Research UK Epidemiology Unit, “We estimate that over the past decade, use of HRT by UK women aged 50-64 has resulted in an extra 20,000 breast cancers, estrogen-progestagen (combination) therapy accounting for 15,000 of these.”152 We were unable to find statistics on breast cancer, stroke, uterine cancer, or heart disease caused by HRT used by American women. Because the US population is roughly six times that of the UK, it is possible that 120,000 cases of breast cancer have been caused by HRT in the past decade. Summary The Office of Technology Assessment (OTA) was perhaps the US government's last honest agency that critically reviewed the state of the nation's health care system. The purpose of the OTA was to provide Congress with objective and authoritative analysis of complex scientific and technical issues. 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