Preview from Dr. Howard’s new book, Alive and Well: Your Suvival Guide for the Health Care Apocalypse, coming in March! How Mary Zuk Got Off Insulin

No More Needles for Mary Zuk
In February 2015, Mary Zuk,73, came to see me in Chicago. I am using her real name—Mary encouraged me to tell her story in case it could help someone else. She was a long way from her hometown in Ocean Isle Beach, North Carolina. She had a long list of worrisome issues: Her diabetes was out of control, she had abdominal pain, and she had bouts of diarrhea after eating. A previous doctor told her she was “lactose intolerant,” but the recommended Lactaid milk didn’t help.
She was an insulin-dependent diabetic. Despite the insulin and an oral anti-diabetic pill, her blood sugar was “all over the place”—it could swing from 94 one morning to 290 the next. We tested her for allergies and learned she was reactive to aspartame, MSG, sulfites, grain alcohols, cane sugar, corn, gluten, and dairy.
I advised her to avoid all her allergenic foods and additives, and recommended a Paleo-style low-carb diet and exercise. I gave her the corn-free multivitamin Perque 2, NOW Foods Ultra Omega-3 fish oil, and a Renew Life probiotic with 50 billion organisms in each capsule. We set up a phone consult for March 26, after she was back home.
When we spoke in March, just one month after our first visit, Mary was happy. By removing additives, dyes, artificial sugars, cane sugar, corn, dairy, and gluten from her diet, she found that her fasting glucose had gone from 299 to 69 in a month. Her doctor in North Carolina was amazed. She was still taking one oral anti-diabetic pill, but no longer needed her insulin. Plus, she’d lost 8 pounds.
Mary called again on April 17. She said, “It’s been fabulous. You have changed my life.” Her A1C (a measure of long-term glucose levels) was down from 8.5 to 7.0. She was still taking just one anti-diabetic pill, and no insulin.
I called Mary again on October 10 to follow up. She said, “I feel really good if I follow my diet.” Her A1C had stayed down at 7.2 despite a bout of pneumonia. She said she had lost a total of 60 pounds, was still off insulin, and was taking her one anti-diabetes pill. She said, “It’s like a miracle. People keep telling me how wonderful I look.”

Swine Flu and Traditional Chinese Medicine

Here’s what I wrote about swine flu, from the point of view of integrative medicine, before all the flurry of writing about swine flu.

PREVENTION The most important preventive measure is the old standard–frequent hand washing. Also, do not rub or touch your eyes or nose when you are out in public and haven’t washed your hands. Buy, carry and use the non-alcohol based ecologic hand sanitizers. Cough into a tissue or your bent arm.

IMMUNE BOOSTERS Now, on to boosting the immune system. One of the best immune boosters is still Vitamin C. Take at least 500 milligrams, with 6 to 8 ounces of water, 4 times a day. Other immune boosters are strong anti-oxidants including Oprah’s current favorite, acai berry. Another one, which is known specifically to work for flu, is elderberry. There an alternative version of Airborne, Source Naturals “Wellness Fizz” which contains forsythia, and all the other herbs in the Yin Chiao formula I will describe below in the treatment section. as well as zinc, selenium, and elderberry.

SYMPTOMS It’s important to recognize the symptoms early: they are any combination of these–headache, cough, sore throat, fever, nausea, dizziness.

TREATMENT If you have any of these symptoms, get a prescription of Tamiflu and start it right away–it is effective only if you start it within 48 hours of the beginning of symptoms. Some types of flu viruses are already resistant to it, but the one that is causing the current outbreak isn’t. Probably the most effective treatment is Chinese herbs. They are effective in both killing the virus and helping resolve the flu symptoms. The best thing to take is a combination of two Chinese formulas–Yin Chiao Chieh Tu Pian, and Zhong Gan Ling. They should be taken as a combination–two to four Yin Chiao tablets twice a day, and four to six Zhong Gan Ling tablets three times a day. They should be taken with food. It is also important to remember that if the person has signs of prostration–that is, too sick to get up–or shows any sign of dehydration, they should go to the hospital.

Now I just noticed an email from Consumer Reports (one of my favorites, by the way) that pretty much issues a blanket warning against use of any supplements or “immune boosters” which they put in quotes, as if there is nothing that can really boost the immune system. That inspired me to comment on my own recommendations, especially the ones regarding Traditional Chinese Medicine, which I have been practicing since 1978. Let me just make my own blanket statement here–Chinese herbal formulas can be effective for flu. Here’s the way I made my recommendations. Last year I did some research on formulas which had been used successfully in China for bird flu. I found one, but it was a formula that requires getting packets of raw herbs at a Chinese pharmacy, boiling them, and then drinking the (generally nasty tasting) tea. That’s not any help it this country because it’s just not going to happen here. Before I looked any further I checked with my partner, Dr. Leon Chen, who was an orthopedic surgeon in China, and was head of a large hospital department of orthopedic surgery in Kansu before he came here. He confirmed that the formula I had found was the real thing. Then we looked for Chinese patent formulas that had the same herbs in them, and came up with the combination of Yin Chiao Chieh Tu Pian and Zhong Gan Ling, which I recommended. I have actually used this for flu for myself and for patients and it has worked. I have not specifically used it for swine flu. However, the way Chinese herbs work is different than Western drugs. They are very complex, and it is nearly impossible for viruses or bacteria to develop resistance to them. As a matter of fact, there are antimicrobial formulas that were first recorded in 200 A.D. that are still used, and still work. So with all due respect to Consumer Reports, an appropriate formula from Traditional Chinese Medicine is something that you can use to help you if you get the flu. By the way, there is also the issue of quality control for the Chinese patent formulas, a legitimate worry with all the contaminated products of various kinds coming from China, and something I am very careful with in my practice. The company I recommend is Mayway, which distributes Plum Flower herbs, all rigorously quality controlled. Mayway doesn’t sell the formulas directly, but you can buy them at

Our health care mess: now deadly for Haitians as well as Americans

I just read a headline that Haitians are dying because of a dispute about funding their care in the United States. We could be airlifting them out, and bringing them here for medical care. Instead, our system, full of its usual “wars” between the states, and wrangling about payment, has stopped the airlifts. For those who are so badly injured, waiting means dying. Why can’t we get them here, give them the care, and then negotiate the payment? They closed a hospital in Chicago because they refused care to a person who was not insured, and who died on their steps. This is the same thing. And some people are still saying we don’t need health care reform. More than 18,000 Americans die each year solely for the reason that they are uninsured. Now Haitians are dying too.

Update, Sunday January 31–Flights have resumed! I hope the delay was not fatal to too many people.

B Vitamin better than expensive drug for people with cardiovascular risk

Here is an abstract of an article from the prestigious New England Journal of Medicine describing a study that showed that extended release Niacin–a B Vitamin–outperforms a new, expensive drug and creates better outcomes for people with cardiovascular risk.
Extended-Release Niacin Outperforms Ezetimibe in Lowering Cardiovascular Risk
In patients with high cardiovascular risk, extended-release niacin is associated with better outcomes than ezetimibe, according to a New England Journal of Medicine study released online.
Researchers randomized over 350 patients on long-term statins to added therapy with either niacin or ezetimibe. The primary endpoint was the difference in change of carotid artery intima-media thickness from baseline to 14 months between groups. After 208 patients had completed the trial, it was stopped when results significantly favored niacin.
Two accompanying editorials bemoan the trial’s early end, arguing that all patients studied up to the point of stoppage should have been analyzed, not just those who completed 14 months’ therapy. Nonetheless, both support the use of niacin over ezetimibe in high-risk patients, and both point to trials, now under way, that may provide more definitive results. In Journal Watch Cardiology, Dr. Harlan Krumholz says that these results “will not be available for many years. In the meantime, ezetimibe should be a drug of last resort, if it is used at all.”

Not the best health care system in the world!

Here’s a reprint of a great BBC article:
The US spends more money on mothers’ health than any other nation in the world, yet women in America are more likely to die during childbirth than they are in most other developed countries, according to the OECD and WHO. The BBC’s Laura Trevelyan has been trying to find out why.

Four million American women give birth every year, and about 500 die during childbirth or from pregnancy-related complications.

In the richest nation in the world, giving birth is more risky than you would think.

“No American woman should die from childbirth in 2009, we can definitely do a lot better,” says Dr Michael Lu, Associate Professor of Obstetrics at the University of California, Los Angeles (UCLA).

In New Jersey, Jim Scythes is bringing up his two-year-old daughter Isabella on his own.

His wife, Valerie, died from blood clots shortly after giving birth to Isabella by Caesarean section.

Jim still cannot believe that Valerie died after giving birth, here in America.

“When Isabella walked for the first time, I sat on the floor and cried, because Valerie should have been there. I believe this could have been prevented and now my daughter will never know her mother.”

One woman dies every minute during childbirth, yet almost all of these deaths are preventable.

In 2001, the UN set itself the goal of slashing maternal mortality by 75% by 2015, but it is nowhere near meeting that target.

Health ministers from around the world are meeting in Ethiopia to work out how to make up for lost ground.

The BBC is publishing a series of reports to mark the occasion.

So why are women in America more likely to die during childbirth than they are in most other developed nations?

The answers are complex. A healthcare system which leaves what Dr Lu estimates are 17 million women of child-bearing age without health insurance could be one factor.

Obesity, poverty and the high rate of C-sections in America all play a part.

Dr Lu says about half of American women are entering pregnancy overweight. “Obesity is a major risk factor for pregnancy-related complications.

“First we need to improve the health of women before they get pregnant, and second we need to improve the quality of maternal care in America.”

Shocking story

The Centres for Disease Control (CDC) in Atlanta is the US government agency that collects national statistics on the numbers of women dying during childbirth.

Dr Bill Callaghan of the CDC says the latest maternal mortality data suggests one in four to one in five women who die have heart disease, or diseased blood vessels.

To the extent that we don’t explain racial disparity in pregnancy-related mortality, we’re going to have difficulty making headway into it
Dr Bill Callaghan
Centers for Disease Control

Could that be due to women being overweight? I asked. “It could be,” replies Dr Callaghan, “the obesity epidemic has not spared women of reproductive age.”

Dr Bill McCool, at the University of Pennsylvania’s School of Nursing, points out that America is far above the World Health Organization’s goal of a 15% C-section rate.

“Surgery of any kind has risk,” he says, and a C-section is, “still the riskiest way to have a baby.

“In the US, almost one third of women have that procedure for delivery of their baby.”

The statistics on maternal mortality in America tell a shocking story when it comes to African-American women.

They are three to four times more likely to die during childbirth than white American women.

Dr Bill McCool says that even wealthy black American women have a higher rate of mortality during childbirth than wealthy white women.

“People have looked at this from different angles.

Maternal mortality around the world

“We know that African-American women tend to have higher blood pressure than the rest of the population, so is there a link there?”

JoAnne Fischer, Executive Director of the Maternity Care Coalition, which works with low income women to help them stay healthy during their pregnancies, says: “We do know that there is extraordinary stress involved in racism and in being poor. ”

“And we know that sometimes this creates hypertension.

“Hypertension, obesity and diabetes are all linked, so we have to make sure women start their pregnancies healthy.”

Dr Bill Callaghan, of the CDC, finds that not knowing why African-American women are at greater risk when giving birth has given him and his colleagues’ sleepless nights.

“We can say that some of this may be due to socio-economic disparities.

“But it does not explain all of it.

“And to the extent that we don’t explain racial disparity in pregnancy-related mortality, we’re going to have difficulty making headway into it.”

As doctors and US officials try to work out why American women are dying in childbirth, and what can be done to prevent it, Jim Scythes is still mourning his wife Valerie, who was all too briefly a mother.

Health Care Reform and the Real Bottom Line

I just hung up the phone a little over an hour ago–I was on the line with President Obama! What an honor to be included in a conference call about health care reform. One of the questions was about an older couple who were doing fine, until he got sick, and she had a stroke–and then it was the same sad story of hard won life savings swept away by the unbelievable costs of health care. I really should not use the term health care in this case, it should be disease management, which increasingly has been the focus of our system of hospital and office medicine since (believe it or not!) the early 1920’s. We have had almost 100 years of medicine that puts profit of individual doctors and medical insitutions, and sales of pharmaceuticals and related medical goods above every other consideration.

And now, the American people are paying for it. We are paying with childhood obesity, with our own tax money that is allocated for “Cadillac” health insurance policies for members of Congress and other branches of government, while we struggle with high deductibles, medical expense-related bankruptcies, and death because we are not covered by insurance that would pay for our deadly illnesses. Meanwhile, the United States is a poor performer on the list of developed countries regarding important issues like maternal and fetal death in childbirth. The false bottom line–a narrow view of the profit margin of health care providers and institutions, has been the overriding goal of our system for nearly the last century, and has served us poorly.

How to change this? Rather than looking at the false bottom line, let’s look at the real one. We must examine the real costs of illness, and change our goals. Our main goal for health care must be the highest state of health, for the greatest number of people, at the lowest cost. This goal should then be our standard for reducing health care costs.

We need have the tenacity to do the real work of preventive health care as our main effort at achieving that goal. In order to do real prevention, we need to be advocates for healthy diets, exercise, stress reduction, and other healthy choices, and to look for the real causes of illness. Too many of our so-called diagnoses are just descriptions of groups of symptoms, and the possibility of looking for a cause of these diseases is shrugged off. A few examples of these are “Irritable Bowel Syndrome” or “GERD”, “IBD” (inflammatory bowel disease) and “chronic sinusitis.

I just received a message from a woman I saw as a patient more than 20 years ago. This is what she said:

I wanted to let you know I have gotten rid of my Crohn’s Disease! All the things you helped me with–digestive enzymes, vitamins, probiotics, staying away from the foods I was allergic to, and not eating too much meatdoing all this over the years made it go away completely. The last colonoscopy showed NO trace of Crohn’s! Thank you for giving me an open mind to alternative medicine. When my doctor recommended me to you over 20 years ago little did I know how it would change my life. Thank you!

As a result of some persistent investigative work, and some real prevention, this woman just spent the last 20 years as a healthy person instead of a Crohn’s patient. Now imagine the difference in the cost of treating a person with active Crohn’s Disease for the last 20 years, as opposed to the cost of a few vitamins, probiotics, and digestive enzymes over that same period of time. In a 1990 study, it was estimated that the average expenditure per year was $6,561 on every Crohn’s disease patient. Allowing for only a 3% annual rate of inflation, it was $10,221 by 2005. (figures from At an average of $8,391 per year for my patient, that’s $167,820 saved for her alone. With an estimated number of Crohn’s patients in the USA in 2005 at 600,000, that’s a staggering annual cost of just over 6 billion dollars a year for all patients. Now, let’s say that the origin of Crohn’s is undiagnosed food allergies, as it was in my patient, for half of the Crohn’s population. That is an annual savings in direct medical costs of 3 billion dollars per year, as well as uncounted costs in loss of work days or full disability.

Here’s another example in which keeping the goal in mind–the greatest health, for the lowest cost–insisting on looking for the cause of illness, and doing the real work of prevention pays off. I saw a 7 year old girl who had been, in her mother’s words, in “medical hell” for five years, since the age of 2. She had eczema so severe that she woke herself up scratching at night, and her arms and legs were covered with sores, she had asthma, ADD, recurrent ear infections and gum disease. Her mother said she had been to the doctor almost every week with her over the previous five years, and she had had countless courses of antibiotics. We found she was allergic to gluten, dairy, corn products and cane sugar. I only saw her for two visits, but her mother called me a year later and told me that she was free of all her illnesses, including the asthma and ADD, and that in the year following her visits to our office, had been to see a doctor only once, when she hurt her hand on the playground. I haven’t done cost estimates for her, but it’s easy to see the difference between more than 40 doctor visits a year, and medications, versus one visit and no medications. In addition, what is the cost of a child missing important early years of education because of ADD?

The point of all this is that each individual act of prevention is important, and that in health care reform, it’s not just a matter of who pays and who is covered. It’s having the motivation to examine what we are really doing. What is our concept of health care and what are our goals? We need to stop following the false bottom line, looking narrowly at the profit margins of health care providers and insurance companies, and instead broadly examine the true financial, social and emotional costs of illness. We need to start at the base, and educate doctors in real preventive practices by requiring comprehensive courses in nutrition, exercise physiology, and psychoneuroimmunology at all medical schools. We need to look for real diagnoses and do real prevention.

The health care industry has just said that it is projecting 20 years of “self-regulated” cost reduction. If we accept this, then we have learned nothing from our recent economic crash, brought to us by the “self-regulated” financial industry. We can no longer afford the insanity of doing the same thing and expecting different results.

Chemicals in sunscreens are “gender benders”

I have been looking at labels for years, on everything under the sun, including sunscreens. It never made sense to me that you should apply chemicals to your skin and then bake it at high temperatures. Now, Margaret Schlumpf and her research group at the Department of Pharmacology, University of Zurich, Switzerland, have confirmed my common sense concerns. They have found that these chemicals have strong estrogenic activity. Chemical estrogens are “gender benders” and can contribute to these health problems

Women: Increased breast and uterine cancer, uterine fibroid tumors, endometriosis, PMS, irregular periods and migraines.

Men: Reduced penis size, increased testicular cancer, undescended testicles, breast enlargement, lowered sperm counts, sexual identity confusion, and impaired male fetal brain patterning.

In addition to the research at University of Zurich, research was done at Tulane University in New Orleans. They found that combinations of the estrogenic sunscreen chemicals and other environmental chemicals, like PCB’s and DDT are more harmful that the single chemicals. One mixture of these estrogenic chemicals was 160 to 1600 times more toxic than each individual chemical in the mixture.

<!–[if !supportEmptyParas]–> <!–[endif]–>Estrogenic chemicals are harmful to adults, and even more harmful in early fetal development. Male hormones trigger genes that activate male development. If female hormones are present, the fetus has female imprinting, whether their genes are male (XY) or female (XX). If a woman pregnant with a male child is exposed to estrogenic chemicals during the time when genes normally cause masculine patterns (weeks 7 to 14 of pregnancy) there may be mental or physical effectssuch as sex role confusion or reduced penis size.

How to prevent these scary gender twisting effects? Get organic, chemical free sunscreens. My favorites are Desert Essence Organics Age Reversal Mineral Sunscreen, SPF 30; MyChelle Sun Shield, and California Baby SPF 30+ No Fragrance Sunscreen. Be sure to use these on yourself, especially if you are pregnant, and your children, and have a happy, healthy, sunny summer.

The health care industry and “self regulation”–haven’t we learned a thing?

Just a quick late night note about the proposed reduction in health care costs that is supposed to be presided over by the health care industries themselves! What an amazing flurry of activity by insurance and drug companies, doctors and hospitals, to convince the Obama administration that they will reduce costs over the next ten years. Would that be anything like the self regulatory brilliance of the financial industry over the last ten years? I’m thinking that it could be. The salaries of CEO’s of these industries are just about as outrageous as those of the bankers and big fund managers, and they have just as big a stake in “business as usual.” Until we have leadership that is able to include management objectives that include other considerations than the amount of money that will flow into the managers’ own personal offshore bank accounts–objectives like a comprehensive, adequately funded public health service, coordination of food programs and health programs, required community clinics in all teaching hospitals, required discounting of pharmaceuticals for the underserved, the end of unfair tax breaks for pharmaceutical companies and insurance companies, and the use of their tax money to fund public health programs, as well as required public health service for all doctors in training–we are likely to have business as usual. How many of the programs I just mentioned do you think that insurance and drug companies, doctors and hospitals would voluntarily take on themselves? Probably about as many as the pay cuts in Congressional salaries that we have seen voted into law by the Congress members themselves!