UTI: Can We Trust Our Own Immune Systems?

I recently came across a 2005 article published in "Reviews in Urology," titled Practical Management of Recurrent Urinary Tract Infections in Premenopausal Women. The article is a review of past and present treatments for recurrent urinary tract infections, or bladder infections as they are commonly called. 

The author, Dr. Nickel, noted that women in the 18th century, who didn't have access to antibiotics of course, were sick for about four weeks, and once they recovered they did not seem to suffer recurrent bladder infections. He asks whether the modern dependence on antibiotics has actually created recurrent UT infections. 

Modern treatment for recurrent bladder infections does depend on antibiotics. Women with recurrent infections are prescribed larger doses for a longer time, or they are given refillable prescriptions so they can take a three-day course of antibiotics whenever they feel an infection beginning. Some women are prescribed low doses of antibiotics to take over a long period of time, six months or more.

Of course, antibiotics aren't perfect. Overuse of antibiotics leads to drug-resistant superbugs. Women who take a lot of antibiotics often develop yeast infections, which can be nearly as miserable as a bladder infection. And, Dr. Nickel points out, once a woman quits taking the antibiotics, she goes back to having recurrent bladder infections. For those without prescription insurance, the cost may be too high, also.

So why not suffer through the infection and allow your immune system to defeat the bacteria and develop antibodies so that you will likely not have another infection? Well the obvious answer is that bladder infections are very painful and inconvenient. I imagine most women don't want to suffer the infection that long, even if it could possibly prevent future infections.Another risk of just riding it out is that the infection could travel to the kidneys, and kidney infections are very serious indeed.

But, I wonder whether it might not be wiser to endure the infection, taking a medication that controls the pain and drinking lots of water and cranberry juice. As a person who has suffered in the past from recurrent bladder infections, I think I'm willing to try it. I think anyone who tried would have to have the cooperation of her doctor, who could prescribe the pain medication, and she would have to watch carefully for signs of a kidney infection. Or, have we come to the point where we don't really trust our immune systems any more?

Of course, I'm talking about ordinary bladder infections, usually caused by E. coli from the digestive system. I think more serious problems like kidney infection or interstitial cystitis need more serious treatment. If you are a woman with recurrent UTIs, I'd like to hear from you -- what do you think about the points brought up in this article?  The link is here.

Echinacea

Echinacea has been used in north America for centuries as a sort of "cure-all," for infections, wounds and many of the diseases now treated with antibiotics. Now, it is often used to reduce the severity and duration of the common cold. Is it effective, what are the important components of echinacea, and are there any concerns you should know about?

The echinacea plant contains polysaccharides, glycoproteins, alkamides and flavonoids, all beneficial compounds. Polysaccharides in particular are known to trigger the immune system. The above-ground portions of the plant contain more polysaccharides, the roots contain more essential oils. If you are taking echinacea, find out what part of the plant is used in your echinacea supplement. Many supplements contain both root and aerial portions of echinacea.

Research seems to indicate that echinacea does in fact boost the immune system. This might help you overcome an infection faster than it would if you didn't take echinacea. However, because it is an immune stimulant, people with immune disorders such as HIV/AIDS, multiple sclerosis or other autoimmune diseases, tuberculosis, leukemia or liver disorders should not take it. If you are concerned about whether you should take echinacea, discuss it with your doctor.

If you take prescribed medications, check online or with your pharmacist to see whether echinacea interacts harmfully with your other medicines. Herbal supplements might seem safe, because the entire plant is used, not just an extract. But, some herbs such as echinacea can have a potent effect on your body and can interact with other herbs and medicines.

If you are allergic to other plants in the daisy family, such as chrysanthemum, ragweed or marigold, you might possible be allergic to echinacea. So, if you use it and notice any allergic symptoms, especially difficulty breathing or swelling of your lips or face, see a doctor immediately to prevent a severe reaction.

Don't take echinacea for more than two weeks. Taking it for an extended time may stress your liver.

University of Maryland Medical Center: Echinacea
NCCAM: Echinacea
MedlinePlus: Echinacea
Susan G. Komen for the Cure: Echinacea

Essiac Tea: An Example of How Herbal Knowledge Grows and Changes

Continuing the ideas I mentioned in the last blog, let’s use Essiac tea as an example of how herbal knowledge grows and changes, helping you make better decisions about alternative/complementary treatments.

Essiac tea, also called Flor Essence, Tea of Life or Vitalitea, is an herbal formula promoted by many websites as a cure for cancer. The formula for the tea, which includes burdock root, slippery elm inner bark, sheep sorrel and Indian rhubarb root, comes from a Canadian nurse named Rene Caisse, who opened a health clinic in 1924 and treated thousands of patients with the formula.

Caisse said she got the formula from on Ojibwa medicine man, which may be true, although there is no evidence to support her assertion. Ancient people developed many medicinal formulas using herbs, many of which have been passed down through the centuries, so it is possible that this is actually an old herbal blend.

The principal ingredient in Essiac tea, burdock root, has historically been used to treat conditions like arthritis, diabetes and hair loss. Rene Caisse claimed it could cure cancer. All of these ideas are based on tradition. The question is, does modern science support those uses? Has research discovered any important uses for traditional herbs not known before?    

As for its ability to cure cancer, research indicates Essiac tea is not effective. Does that mean the formula is useless? No. In fact, research has discovered that “Essiac tea possesses potent antioxidant and DNA-protective activity, properties that are common to natural anti-cancer agents,” according to the January 2006 "Journal of Ethnopharmacology.”  In an article published in the November-December 2007 “Anticancer Research,” authors reported that Essiac has “significant antioxidant and immunomodulatory properties as well as neoplastic-cell-specific cytotoxicity, “ particularly mentioning ovarian epithelial carcinoma cells.  Authors of an article published in the June 2010 “Journal of Food Science” agree that burdock contains antioxidants, which help to block free radical molecules that damage your cells. Research indicates that ingredients in Essiac tea may also lower blood sugar and alleviate the severity of liver damage from carbon tetrachloride or acetaminophen.

What’s my point? Well, many of the herbs that have been used for centuries to treat disease are validated by modern research; although the research doesn’t always support traditional uses, it reveals new uses. Essiac tea, for instance, may be more effective for preventing cancer than curing it. 

A final word: if you want to use herbs along with mainstream medical treatment, or instead of it, be aware that not all herbs have been studied for effectiveness or safety. Also, herbs are quite potent and can interact harmfully with other medications you may be taking. Do your research, so you make better decisions. The previous blog post listed several places you can find more information about herbs and alternative treatments, and there are many more reliable sites online that can give you information.

"Am J Chin Med"; Hepatoprotective effects of Arctium lappa on carbon tetrachloride- and acetaminophen-induced liver damage; Lin SC et al.; 2000;28(2):163-73

"Anticancer Res;" In vitro analysis of the herbal compound Essiac; Seely D, Kennedy DA, Myers SP, Cheras PA, Lin D, Li R, Cattley T, Brent PA, Mills E, Leonard BJ; 2007 Nov-Dec

"Eur J Cancer;" How useful are unconventional cancer treatments?; Ernst E, Cassileth BR; Oct 1999

"J Altern Complement Med;" Trial of Essiac to ascertain its effect in women with breast cancer; Zick SM, Sen A, Feng Y, Green J, Olatunde S, Boon H; Dec 2006

"J Food Sci"; Antioxidant Activity and Chemical Composition of the Fractions From Burdock Leaves; Lou Z, Wang H, Li J, Chen S, Zhu S, Ma C, Wang Z; June 2010

"Journal of ethnopharmacology;" Essiac tea: scavenging of reactive oxygen species and effects on DNS damage; Leonard SS et al; Jan 2006

"Nutr Cancer;" Evaluation of the antiproliferative effects of Essiac on invitro and in vivo models of prostate cancer compared to paclitaxel; Eberding A et al; 2007 188-96

"Oncol Rep"; In Vitro Comparison of Essiac and Flor-Essence on Human Tumor Cell Lines; Tai J, Cheung S, Wong S, Lowe C; Feb. 2004

“Am J Chin Med “; Lin CC, Lu JM, Yang JJ, et al. Anti-inflammatory and radical scavenge effects of Arctium lappa. 1996;24(2):127-137.

“Am J Chin Med “; Lin SC, Chung TC, Lin CC, et al. Hepatoprotective effects of Arctium lappa on carbon tetrachloride- and acetaminophen-induced liver damage. 2000;28(2):163-173.

“J Biomed Sci “; Lin SC, Lin CH, Lin CC, et al. Hepatoprotective effects of Arctium lappa Linne on liver injuries induced by chronic ethanol consumption and potentiated by carbon tetrachloride. 2002;9(5):401-409.

“Mutat Res “; Morita K, Kada T, Namiki M. A desmutagenic factor isolated from burdock (Arctium lappa Linne). 1984;129(1):25-31.

Mainstream Medicine or Alternative Treatments? How To Decide

If you have a serious, chronic or life-threatening illness, you are probably worried or frightened as well as sick. And you've probably been inundated with advice from well-meaning friends. Some friends may advise you to try alternative treatments rather than trusting mainstream medical treatments. How do you decide between alternative or mainstream medical treatment?

In the end the decision is up to you, but I have a few thoughts that may help you make sense of it all. I'm a firm believer in the benefit of herbs, supplements, acupuncture, massage and other treatments. However, I think sometimes people overlook a couple of important points about alternative/complementary health treatments.

The first point is this: ancient people trusted these treatments because it's all they had. It wasn't that they were somehow wiser than modern people, it's just that they used what they had available to them, to the best of their skill. Imagine how different things might be if, for instance, they had antibiotics during the plague years.

The other point is this: although herbal treatments, supplements and manual therapies are indeed often helpful, they are slow. Building your health through improved diet, nutritional supplements, herbs, body therapies and exercise takes time. If your disease is very aggressive, you might not have that time. Mainstream medical treatment may be able to give you more time, even though the treatments might be difficult to bear for a while. You might decide that the best use of both is to combine complementary treatments with medical treatments for the best of both worlds.

Finally, don't allow people to frighten you. Do some research. If someone recommends Essiac tea, for instance, there is a lot of medical research into the herbs in that tea. Learn all you can about the various treatments available to you, so that you can make your decisions from a position of knowledge. The National Institutes of Health have an office of alternative medicine and they publish a great deal of information on their website. You can also search for studies done about many different herbs and herbal combinations on the NIH website.
National Center for Complementary and Alternative Medicine
NCCAM Health Topics A -- Z
Explanation of alternative and complementary health treatments

Chermoula

One of the most useful recipes ever!

In this Moroccan recipe, sweet green peppers are slow-cooked to the point of softness in olive oil with vinegar, garlic and coriander.  You can make it quickly and easily, and store it in the refrigerator to use as needed.  It's called chermoula, and  is delicious served with crackers and cheese, or in a salad, or on an antipasto platter, and is especially good on pizza.  The garlic cloves are wonderful, so delicious it’s tempting to fish one out and eat it every time I see the jar.  The oil is good in a vinaigrette, or drizzled on bruschetta or fresh sourdough bread.  Chermoula looks pretty in the jar, so it makes a good hostess gift.

The vinegar and coriander are essential for the flavor.  The combination of garlic and vinegar is one of those felicitous combinations like bacon-lettuce-and-tomato, a classic taste that everyone loves.  

The recipe:

Slice three large bell peppers into thin strips, using green, red, yellow or orange peppers. Combine the pepper strips with one cup olive oil, ½ teaspoon of ground coriander and ¼ cup of apple cider vinegar in a saucepan.  Add as much garlic as you feel like peeling, an entire head of peeled cloves if you like.  Cook over low heat until the garlic and pepper are tender, which may take up to 15 minutes.  Do not allow this mixture to fry as it will become bitter and won’t taste good.

While the peppers are cooking, wash a pint canning jar in very hot water and rinse it with boiling water. Drain it on a clean kitchen towel. Rinse the lid in boiling water also. When the peppers are tender, use a slotted spoon to put all the vegetables in the sterilized jar, pour in the oil, seal and store in the refrigerator. The mixture keeps for up to two weeks in the refrigerator, although it's so good, it usually gets eaten before then.

To use on a pizza, prepare your usual pizza dough and roll out to the desired size.  Brush with the oil from the chermoula and arrange slices of bell pepper and slivers of garlic from the chermoula over the pizza.  Add cheese, such as goat cheese, and bake as usual until the crust is done and the cheese melted and bubbling.

To serve as antipasto, arrange the bell pepper and garlic on a platter with cheese, olives, celery sticks, cherry tomatoes, sliced sausage such as pepperoni or salami.  Drizzle the oil from the peppers sparingly over all the goodies on the platter.  Serve with toasted rounds of sour dough bread or French or Italian baguettes that have been brushed with the oil.

 

Fresh Fruit Desserts

Take advantage of the wonderful fresh fruit available all summer long to make sweet delicious and entirely healthy desserts.

Watermelon

I had many Korean friends in San Diego. They routinely finished their meals with a slice of sweet watermelon. It's so light, sweet and refreshing, it satisfies your sweet tooth without any damage to your health.

Oranges

Ambrosia is an old-fashioned dessert made with fresh oranges. Peel several oranges, removing all the pith, and then cut out each section of the oranges into a bowl. Add just one tablespoon of sugar to the orange segments and juice, and mix gently. Divide the orange segments and juice between four pretty bowls. Sprinkle grated coconut over the orange segments and let the dishes sit for a while to combine the flavors. You can use unsweetened or sweetened dried coconut, or grate fresh coconut over the orange slices.

Grapefruit

A similar dessert is made with grapefruit, peeled and sectioned just as the oranges are in ambrosia. Combine the fresh grapefruit sections and juice with about 1/4 cup of chopped candied ginger. Cover the mixture and store it overnight in the refrigerator to blend the flavors. Serve in beautiful wine glasses as an elegant dessert.

Apricot Souffle

Cover 1 to 1 1/2 cups of dried apricots with water in a small saucepan. Bring the mixture to a boil. Turn down the heat and simmer gently for five minutes. Let the apricots cool overnight in the refrigerator.

The next day, combine the drained apricots with 1/2 cup orange juice in a food processor. Process while adding as much of the cooking liquid as needed to make a smooth puree.

Preheat the oven to 350 degrees. Lightly butter a 1 quart souffle dish.

In a mixer, beat 5 room-temperature egg whites with a pinch of cream of tartar or 1/4 teaspoon of lemon juice until frothy. Gradually add 1/3 to 1/2 cup of sugar and keep beating the egg whites until they are stiff and glossy. Stir 1/3 of the egg whites into the apricot puree to lighten it. Gently fold in the remaining egg whites until well combined.

Pour the apricot mixture into the souffle dish. Set it into a larger baking dish and pour 1 inch of boiling water around the souffle dish. Bake the souffle in the oven until it is puffed and lightly browned, 20 to 25 minutes. Serve immediately with a little unsweetened fresh cream. You can also cover the souffle with plastic wrap and chill it in the refrigerator to serve cold the next day. It will deflate slightly but will still have a light texture and tangy taste.

Poached Fruit

Combine  a bottle of white wine with an equal amount of water in a large saucepan. Peel the zest from two lemons in long thin strips and add them to the wine and water. Peel two inches of fresh ginger root and cut it into matchstick pieces. Put those in with the wine, water and lemon zest. Add 2 cups of sugar and bring the mixture to a simmer, stirring until the sugar is dissolved.

Peel your favorite fruits -- pears, apples, peaches, apricots, nectarines, plums or whatever you find in the market -- and cut them into large pieces. Keep adding the fruit to the wine mixture while it simmers, until you can't get any more fruit into the liquid. Simmer for up to 20 minutes until the fruit is tender. Cool the mixture and store it in the refrigerator in closed containers. Serve the poached fruit on its own in pretty wine glasses, or serve it with yogurt, maxcarpone, whipped cream or ice cream, sponge cake or crisp cookies. Be sure each serving gets a little of the lemon peel and the ginger as well as fruit. Makes about two quarts of poached fruit and you haven't tasted anything until you taste this!

Is Cervical Manipulation Dangerous?

Cervical manipulation is a technique used by chiropractors, osteopaths, physical therapists and others to treat neck pain and headaches. There is an ongoing debate about whether neck manipulation is better than other forms of treatment for neck pain or headache, and about whether neck manipulation is in fact dangerous. The most recent “British Medical Journal” – BMJ – has fanned the flame by debating whether cervical neck manipulation should be completely abandoned.

This is an important discussion because there is a risk of stroke associated with cervical manipulation, specifically the rapid thrust used to rotate the cervical spine in order to realign cervical vertebrae. Your vertebral arteries are vulnerable to tearing during this kind of manipulation because of their location, around the top cervical vertebra – the atlas. Any abrupt rotation, such as that in a chiropractic or osteopathic neck manipulation, can stretch and tear the artery. The torn artery can become blocked depriving the brain of oxygen, or form a clot which can break loose and enter the brain. Either way, it can cause a stroke.

The incidence of stroke due to injuries suffered during cervical manipulation is low: the medical journal “Neurologist” reports that the best estimate is that about 1.3 persons out of every 100,000 chiropractic patients who receive a neck adjustment suffer a stroke following the treatment.

While this number is not high, there is still a risk, and the consequences of stroke are heartbreaking and devastating. Since there are other treatments that are more conservative and yet still effective – such as the use of heat, ice, gentle stretching and over-the-counter pain medicine – you might decide that forceful cervical manipulation isn't worth the risk.

Although many chiropractors use screening tests to rule out patients who may be susceptible to arterial damage, the medical journal “Spine” says that stroke after cervical manipulation is so unpredictable that screening tests are unreliable. Researchers who authored this article in “Spine” studied as many known cases as possible to try to identify any pattern that could predict who is most at risk for stroke from a neck manipulation, but were unable to do so.

If you do have a cervical manipulation and feel faint, dizzy or nauseated afterward, report it to your chiropractor right away. If there is a possibility of damage to an artery, immediate treatment is necessary.

BMJ 2012;344:e3679 

Stroke 2001;32;1054-1060 

Canadian Neurologists Warn Against Neck Manipulation 

Spine: Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy: a review of sixty-four cases after cervical spine manipulation. 

http://www.ncbi.nlm.nih.gov/pubmed/20682039 

Neurologist: Does cervical manipulative therapy cause vertebral artery dissection and stroke?