Dear Patients and Friends:

One of the most important things a person can do to maintain or improve health is to eat at least five or more servings of fresh fruits and vegetables a day.  The antioxidants, vitamins and other phytonutrients contained in fresh produce are essential in reducing oxidative stress and supporting immune function.  Consumers want high-quality fruits, vegetables and store-made meals. But is there a risk from chemical sprays and pesticides agriculture uses on our food supply?

Judging Pesticide Risk in Your Foods

In the May 15, 2015 Consumer Reports® magazine, data from the U.S. Department of Agriculture’s Pesticide Data Program involving 14 different countries over a 12 year period was analyzed to determine the  number of pesticide residues on fruits and vegetables, the frequency with which they were found, and the toxicity of the pesticides. The U.S.D.A. measures pesticide residues after produce has been rinsed in cold water and/or inedible peels and rinds are removed.  Consumer Reports® placed each of the 48 foods tested into one of five risk categories ranging from very high to very low, based on the risk to a 3½ year old child.  They also analyzed risk based on country of origin of the fruit or vegetable as the risk was not necessarily the same from different countries.  Highlights from the risk chart (found on page 31 of the magazine) are as follow:

High risk categories where Consumer Reports® suggests buying organic were as follows:

  • Peaches
  • Tangerines
  • Nectarines
  • Strawberries
  • Cranberries
  • Green beans (had the highest risk for non-organic with 200X the risk of a serving of U.S. broccoli)
  • Sweet bell peppers
  • Sweet potatoes
  • Carrots

Lower risk produce included the following where conventional is considered relatively safe:

  • Bananas
  • Cherries
  • Oranges
  • Broccoli
  • Onions
  • Lettuce

The U.S.D.A’s position is that U.S. food does not pose a safety hazard from pesticide residues because the majority of residues identified are below the tolerance levels set by the Environmental Protection Agency (EPA).  The problem with this position is multiple pesticides are used in agriculture and are found on produce samples but the EPA tolerance levels are set for individual pesticides. In addition, the research used to set these tolerance levels is quite limited. I did find one large study by the National Cancer Institute and EPA begun in 1993 that involved 90,000 participants (farmers and their wives) who were exposed to up to 20 pesticides.  The study looked at cancer trends and found an increased rate of leukemia, non Hodgkin lymphoma, multiple myeloma, soft tissue sarcoma, brain, prostate, stomach and skin cancers compared to non-farm populations.

I agree with Consumer Reports® who believe that organic is always the best choice because it is better for your health, the environment and the farm workers, and lower in pesticide residues.

Children Have a Higher Risk with Exposure

Unfortunately, the effects and risks of combining pesticides are unknown and untested, according to Dr. Rangan, a toxicologist and executive director of the Food Safety and Sustainability Center. Almost a third of the produce the U.S.D.A. tested had two or more pesticides. There are studies suggesting chemical toxins can adversely impact neurodevelopment and behavior in children while their brains and nervous systems are growing. In addition, children eat more food relative to their body weight than adults. I would also be concerned about pregnant mothers exposing their babies in utero as toxins are concentrated in the placenta and cord blood, but can transfer to the baby.

Glyphosate Risks

One special area of concern brought up in several Consumer Reports® articles and in other publications is the herbicide glyphosate, better known as Roundup.  It is the most commonly used pesticide in agriculture in the USA because it kills the weeds but not the crops.  It is also used to kill weeds in lawns.  The government doesn’t regularly test foods for it so we have no idea how much is in the food supply or our bodies.   About 100 million pounds of glyphosate are applied to farms and lawns annually according to the EPA.  Monsanto, the company that manufactures Roundup, claims this product is safe in humans. The World Health Organization (WHO) however, recently classified glyphosate as “possibly causing cancer.”  There are French studies which looked not only at glyphosate but at the so-called inert ingredients that are mixed with it (solvents, surfactants and others). These ingredients were toxic and killed human cells in culture in dilutions well below the levels used in agriculture.  In 2005, ecologists at the University of Pittsburg added Roundup using the manufacturer’s recommended dose to ponds filled with frog and toad tadpoles. When they returned two weeks later, they found that 50 to 100 percent of the populations of several species of tadpoles had been killed.  In my opinion, the health effects of this product needs to be better researched given its widespread use.  The EPA on its website states the cancer risk is “unknown” for chronic exposure to glyphosate in drinking water.

Monsanto has genetically modified (GMO) corn and soy plants to be resistant to Roundup.  Currently, producers are not required to label GMOs in the grocery store in the USA, but they are in Europe so consumers know what they are buying.

Action to Take

The bottom line is wash your produce thoroughly in water. There are non-toxic vegetable sprays that may help somewhat. Buy organic for the high-risk category fruits and vegetables, even though it costs more. There are a variety of supplements that we carry that provide general support for the detoxification pathways, including UltraClear Plus PH, Phoschol, Essential GSH Pro, non-corn derived vitamin C in both powder and 1000mg capsules, and Silymarin Forte (contains milk thistle).  If you do not have hypertension or cardiovascular disease, going into a sauna, especially a far infrared sauna, for 30 minutes once or twice a week is also very helpful and healthy in helping the body rid itself of toxic chemicals.


Is Too Much Vitamin D Toxic?

Vitamin D, known as the sunshine vitamin, is needed for bone health and immune function.  As increasing numbers of patients take vitamin D supplements on their own or receive a prescription from a doctor for vitamin D.  Concern arises among physicians that taking “too much” vitamin D can be dangerous.  But is there scientific evidence to support this?  I recently reviewed a 10 year Mayo Clinic study that was published in the May 2015 issue of the journal of Mayo Clinic Proceedings. The study basically showed that people rarely experience harmful side effects when taking large amounts of vitamin D. In most reference labs a vitamin D level below 30ng/mL is considered either a deficiency or insufficiency and any level above 100ng/dL is considered “elevated.” In the 20,000 patients followed in the Mayo Clinic Study, about 8% had “high” levels of vitamin D as defined by a blood level over 50ng/mL.  One concern in taking “too much” vitamin D is that it might result in elevated levels of serum calcium which can lead to conditions such as kidney stones.  What the Mayo doctors found was that levels of vitamin D over 50ng/mL did not result in elevated serum calcium levels.  In fact, the study identified just 4 cases out of 20,000 of hypercalcemia associated with high vitamin D levels as found on a blood test.  Three of the four patients had no symptoms.  The fourth patient was a 51 year old woman who was taking 50,000 IU of vitamin D a day for three months and whose vitamin D level was 364 ng/mL.  This woman had kidney disease, weight loss, confusion and vomiting.

In 2011 the Institute of Medicine increased its recommendation of taking 400 IU of vitamin D a day to 600 IU a day for persons age 1 to 70.  Since that recommendation was given a number of reports have surfaced stating the Institute of Medicine’s recommendations were based on flawed statistics and that the daily allowance should be closer to 1800 IU or even greater.  Vitamin D requirements may vary based upon age, sex, body weight (heavy people will require higher doses due to fat sequestration), and genetics.  At the Center we take a functional medicine approach “where one size does not fit all.” We monitor and adjust dosing of vitamin D intake based upon blood levels rather than government recommended daily allowances.


Chelation Therapy for Diabetes

In the May 2015 issue of the Townsend Letter, an article was published entitled “Complete Diabetes Care Now that We Have TACT.” One of the authors was L. Terry Chappell, M.D., an integrative physician with years of experience in functional medicine and an expert in chelation therapy.  In this article he discusses conventional approaches with drugs and diet in the treatment of diabetes as well as complementary treatment options and lifestyle measures. The article is too extensive to summarize in this newsletter, but I wanted to share his viewpoint on the place chelation therapy has in the treatment of diabetes.

Dr. Chappell states “perhaps the most promising advance in the treat of diabetes since insulin came from the Trial to Assess Chelation Therapy (TACT).”  This trial was funded by the National Institutes of Health and was designed to determine if future cardiac events could be reduced for patients at least 50 years old who had already suffered at least one heart attack.   The TACT trial was a randomized, double-blind, clinical trial involving 1708 patients, who were given more than 55,000 intravenous treatments. Half the patients were given disodium EDTA chelation (some with and some without vitamins) and half were given placebo IVs.  All patients were also given conventional medical care for their coronary artery disease. A little over a third of the patients had diabetes, and within this subgroup there was an astonishing 41% reduction in cardiac events, a 52% drop in recurrent heart attacks, and a 43% reduction in deaths.  Chelation was shown to be extremely safe when given according to the protocol.


How Does EDTA Chelation Work?

EDTA works by removing toxic heavy metals such as lead, arsenic and to a lesser extent cadmium from the body.  It is thought that toxic metals bind to proteins in the body’s tissues including the lining of blood vessels in the heart and other organs. This causes inflammation, oxidizes cholesterol, allowing cholesterol deposition within the blood vessels. Removal of toxic metals reduces the oxidative stress in the body, increases the production of nitric oxide, and allows the blood vessels to become more pliable. EDTA may have other beneficial effects that we are not yet aware of.

Dr. Chappell’s position is that disodium EDTA chelation should be used as a part of a diabetic patients medical treatment. The authors of the TACT trial stated given the magnitude of benefit for diabetic patients, a TACT-2 study to include only diabetic patients should be run to replicate the original study.  At the same time, other forms of vascular disease, specifically peripheral vascular disease could be studied.


Success Story -  Patient with Autoimmune Thyroiditis and Severe Fatigue

Ms. J is a 55 y.o. rancher who has known autoimmune thyroiditis and a goiter. She has multiple other medical problems including kidney stones.  For the past 4 or 5 months she has been experiencing severe, unremitting fatigue without symptoms of fever, chills, stomach issues or urinary symptoms. In spite of the fatigue, she worked outdoors, in the heat, on her ranch caring for her horses.

Physical examination was unremarkable for age except for an enlarged, irregular thyroid gland. Extensive lab work within the reference range, including euthyroid replacement on Levothyroxin 50mcg daily, a normal blood count, chemistry panel, and vitamin D3 levels.  On kinesthetic testing her adrenal, liver and ileocecal meridian reflexes were positive.  A series of two IV Glutathione treatments with B vitamins were given over a two week period with dramatic improvement in her fatigue and malaise. In addition, oral GSH PRO (glutathione) and Phoschol were continued to support her liver and detoxification pathways.  Ms. J was given the option of receiving IV Glutathione on an elective basis twice monthly as a preventive therapy.

Glutathione is manufactured within the cells of the body, primarily within the liver.  Because it is a protein that can be broken down by stomach acid, the IV form of glutathione is most effective.  Glutathione is the body’s main antioxidant and it also supports immune and brain function.  As a person ages, glutathione production drops off and fatigue can be one of the symptoms of low glutathione reserves.  Glutathione is needed for DNA synthesis, which is critical for maintaining normal physiological function and reducing cancer risk.


Success Story – Diabetic Patient Who Underwent EDTA Chelation

Mr. M is a 59 year old karate instructor and musician who had an increased retention of lead.  Bioaccumulation of lead takes place over a period of time (sometimes years) when a person is exposed to even small amounts of environmental sources of lead.  This is not apparent on a blood test but may be seen on hair analysis or provocative urine testing, which are non-traditional lab tests.  Mr. M began having a slow increase in fasting blood sugar levels over a number of years in spite of being trim and fit.  He was in what was considered a “pre-diabetic” state, where his fasting sugars were mildly elevated but below 125mg/dL and his hemoglobin A1c values were below 6.4%.  His initial treatment was avoiding concentrated carbohydrates, sugars, and alcohol in the diet and maintaining his active lifestyle and exercise program.  When Mr. M’s fasting sugars went above 125mg/dL, his fasting insulin and C peptide levels were measured and were paradoxically found to be low, indicating his pancreas was producing a low amount of insulin.

In type 2 diabetes, insulin production is elevated.  It was thought Mr. M had type 1.5 diabetes. Type 1.5 diabetes is a relatively new classification and is an autoimmune disorder where the body’s immune system attacks the pancreas. Eventually, patients with type 1.5 diabetes may need to go on insulin therapy.  During Mr. M’s last 15 EDTA chelations we added IV Glutathione as this anti-oxidant goes into the cells and helps pull out toxins, including lead.  Lab testing showed a 63% reduction in lead excretion from his baseline. His fasting insulin returned to normal as did his C-peptide level, indicating an improvement in pancreatic function. His fasting glucose dropped 117mg/dL, which is in a pre-diabetic range.