Greetings!

This month’s Pharmaceutical Alert highlights the ongoing problems with PPIs, the Proton Pump Inhibitors. We wrote to you about the problems with these drugs more than a year ago, and finally the FDA is taking action, issuing a Warning Alert. We hope you will read through the following story and then take the appropriate action.

Sincerely,
Felice L. Gersh, M.D.
Medical Director
Integrative Medical Group of Irvine

FDA Warning Alert on Proton Pump Inhibitors

The FDA issued a warning alert yesterday, Wednesday, February 8th, that the risk of serious intestinal infections is increased in persons using the class of drugs known as proton pump inhibitors. These include Nexium, Prevacid, Prilosec (Omeprazole), Aciphex, Protonix, and Dexilant. The increased risk involves the development of diarrhea due to Clostridium difficile. This is particularly worrisome, since new strains of this bacteria are both more virulent and anti-biotic resistant than were previous ones. The bacteria is also more widely dispersed than before, so exposure is far more likely. C. difficileinfection is a potentially life-threatening event.The warning comes after a review of data from the agency’s Adverse Event Reporting System (see below). Medical literature has suggested such a link for quite some time, as indicated by a meta-analysis reported at the 2010 meeting of the American College of Gastroenterology.PPIs block nearly all production of stomach acid. Although stomach acid has been vilified by the pharmaceutical companies, it is actually essential for the proper digestion and absorption of food nutrients. In addition, it protects the body from infections caused by pathogenic bacteria carried on the food we eat.At IMGI, we have been talking about the dangers of PPIs for several years and have successfully weaned many of our patients off these drugs.

FDA Warnings

Less than a year ago, the FDA issued several other warnings concerning this class of pharmaceuticals and declared that fully 70% of patients placed on these medications were done so inappropriately.PPIs are associated with osteoporosis, Vitamin B12 deficiency, severe total body magnesium deficiency, and other nutrient deficiencies. Additionally, they are associated with higher levels of pneumonia and the development of gastrointestinal dysfunctions. Barrett’s Esophagus, considered a significant risk factor for esophageal cancer, is actually not reduced by these drugs, as the elimination of stomach acid does nothing to decrease the reflux problem and the fluids, minus the acid, which continue to reflux can be damaging to the esophagus.

What should you do?

Dr. Yoojin Lee

Dr. Gersh has been extensively trained in all aspects of this important medical condition at her Integrative Fellowship at the University of Arizona. She works closely in this with Dr. Lee, our expert naturopathic doctor, whose training focused in great detail on the function and therapies of the digestive system. In addition, we have teamed with a highly qualified gastroenterologist who will be available to perform upper GI endoscopies when clinically indicated prior to the weaning-off process. Once a patient is off these dangerous drugs, we can offer many natural and safe ways to alleviate, or even eliminate, heartburn, gastritis, and other such conditions.

Please share this information with your many friends and family who are using these medications. And if you are interested in getting off of your drug, please contact the office.

Adverse Event Reporting System

The Adverse Event Reporting System (AERS) is a computerized information database designed to support the FDA’s post-marketing safety surveillance program for all approved drug and therapeutic biologic products. The FDA uses AERS to monitor for new adverse events and medication errors that might occur with these marketed products. Participation in this system is voluntary for doctors, patients and hospitals. For more information on AERS, click here.

Losing weight is one of the easiest things you can do to improve your health and brighten your future.

But it’s also one of the hardest things to do, because the underlying mechanisms are so complex and widely misunderstood.

On February 16, we’re going to change that. We’ll talk about all the different factors that impact weight gain, as well as those that stand in the way of your losing weight and keeping it off. Our speakers will address metabolic changes, hormonal issues, the psychological challenge of emotional eating, the importance of detoxification in weight loss, how stress can derail your efforts, how to prepare nutritious meals you and your family will enjoy, and why physical activity is essential to keeping the pounds off. We’ll provide lots of helpful hints and suggestions you can apply that evening to start you on the way to a slimmer you.

Whether you’re interested in pursuing one of our weight-loss programs or selecting a plan elsewhere, this is the information you will need to succeed. Leaving out a key ingredient will, almost certainly, lead to relapse and regain. Please, don’t make that mistake again!

Lecture Schedule

• 6:00 Registration and dinner
• 6:30 Felice Gersh, M.D. – Losing Weight Is Tough as Nails – But Not If You’re the Hammer!
• 6:45 Alison Gracom, PA-C – Achieving Permanent Weight Loss with the HCG Diet
• 7:10 Yoojin Lee, ND – Detoxification – Taking Charge of the Ultimate Clean-up Crew
• 7:35 Tammy Occhipinti, MFT – Comfortable, Convenient Junk Food Should Never Be Your BFF
• 8:00 15-minute break
• 8:15 Shannon Clark, CMT – OMG! OMG! I’m too Stressed Out to Lose Weight
• 8:40 Denise Canellos, MS, CNS – Plan to Keep the Pounds Off With Successful Menu Planning
• 9:05 Bob Tygenhof, CPT – Keep Moving and the Fat You Lose Will Never Be Able to Catch Up

If you would like to reserve your place at this event now, just click on the button below or call our office at 949-753-7475 to register. The $15 registration fee will be refunded to anyone purchasing an IMGI weight-loss program in the week following this event. Registration will be $20 at the door, if seating is still available.

Register Now!

Weight loss and weight loss maintenance need not be gloomy, dispiriting affairs. You can live better, live healthier, and enjoy the simple pleasures of being alive and well! We hope to see you there.

Sincerely,

Felice L. Gersh, M.D.
Medical Director
Integrative Medical Group of Irvine
949-753-7475

Greetings!

I certainly hope that you all had a very enjoyable holiday season and that you are now ready to tackle 2012 with optimism, resolve, and a strong dedication to making this new year the happiest and healthiest possible.

In order to help you in these endeavors, we’ve been working on a number of new programs and improving some of our existing ones. I can share with you that those being launched early in the year will include exercise and fitness programs, detoxification programs, plaque reversal cardiovascular programs, and updates to our popular weight loss programs.

As everything in the body is interconnected, there is overlap between the programs. What is good for your musculoskeletal system is good for your digestive system is good for your cardiovascular system is good for . . . well, you get the idea. Just pick the program that addresses your primary concern, and you get all the other healthy side effects for free.

Now, wouldn’t that be a nice way to start the New Year!

Sincerely,

Felice L. Gersh, M.D.
Medical Director
Integrative Medical Group of Irvine

Detoxification – Cleansing the Body From the Inside Out

Detoxification, more accurately known as biotransformation, is the body’s natural, continuous process of eliminating and neutralizing waste products. Flaws in this essential process have now been linked to many neuro-degenerative diseases such as Parkinson’s disease, along with increased risks of cardiovascular disease, autoimmune disease, and cancer.

Under the best of circumstances, detoxification is a demanding task, since the body naturally produces many highly reactive and toxic substances – our own metabolic waste material. As well, our “old” hormones and neurotransmitters must be excreted after being appropriately biotransformed in the liver.

All of these waste products are excreted through the GI tract, the kidneys, lungs, and skin. If any of these organ systems malfunction, toxic materials can accumulate and your health status can be seriously compromised. Add to this our exposures to the many environmental toxins, pesticides, food additives, pharmaceuticals, air pollution, workplace chemicals, cleaning products, personal products, and cosmetics.

Detox programs are geared to optimizing the body’s innate biotransformation mechanisms. At IMGI, detox programs include dietary modifications, scientifically based supplementation and herbals, complemented by additional methods such as hydrotherapy and saunas. We encourage you to minimize ingested chemicals by eating organic, pesticide-free meats, fruits and vegetables, emphasizing foods that provide a wide range of vitamins, nutrients and antioxidants. Pure water is also essential.

The latest research suggests that many of the chemicals we ingest are ultimately deposited in fat cells. These accumulated substances, called the “body burden,” can lead to illness, and have been linked to hormonal imbalance, impaired immune function, nutritional deficiency, and compromised metabolism that leads to weight gain and diabetes.

If you plan on pursuing one of our weight loss programs, we recommend that you precede it with a 10-day detox program. This will ensure that you maximize the benefits obtained from your weight loss efforts. Better yet would be a 28-day detox program, if you have the time and motivation.

There are many benefits to be gained from a detox program, including improved energy, clearer skin, regular bowel movements, improved digestion, increased concentration, and clarity of thinking. At IMGI, we encourage most patients to undergo a 10-day, though preferably a 28-day, detox on an annual basis. If you schedule a detox appointment in January with Dr. Lee, our expert Naturopathic Doctor, you will receive a free canister of Thorne Research’s premier detox product, MediClear Plus at NO CHARGE! This is a ($75) gift from us to you to help you on your path towards optimal health.

February 16 – Save the Date!

On Thursday evening, February 16, we will be hosting an evening program on “Attaining the Ideal Body Weight for a Healthier You.” This event will be held in Irvine at the new headquarters of the Orange County Medical Association.

A light, nutritious dinner will be served starting at 6:00 PM, followed by a series of talks on the subject of successful weight loss and the reversal of cardio-metabolic problems. A formal schedule of activities and lecture topics will be sent to you soon.

There will be a nominal charge of $15 per person to attend this event for those registering in advance. The cost at the door will be $20. Space is limited, so if you know you can attend, now is the time to call (949-753-7475) and reserve your spot.

12 Great Ways to Get the Body You’ve Always Wanted

Here are a dozen suggestions to help you lose fat, feel better, and look the way you should:

1. Slow down your eating. Set a timer, if necessary, to help pace your eating. Make each meal last at least 20 minutes, preferably 30 minutes or more. You will enjoy your food more, and your brain will have the time it needs to tell you when you have eaten enough and should stop.
2. Sleep more. If you get less than 7 hours of sleep at night, add an hour in bed to discourage night eating and to allow your body to heal and de-stress. Lack of sleep stimulates the adrenal gland to produce more cortisol, which, in turn, increases appetite and slows your metabolic rate.
3. Substitute vegetables for starches at all, or most, meals. Use a wide variety of vegetables – try to include 3 different ones with dinner.
4. Start dinner with a big salad topped with a dressing of yummy vinegar or lemon juice, along with a touch of organic olive oil. On occasion, replace the salad with a vegetable soup made with broth.
5. Just say no to sugar, manufactured food, chemical food, and food with high fructose corn syrup. They never help your body and always hurt it. Honestly, it’s time to say good-bye to these faithless friends.
6. Drink green tea often. It has wonderful phytonutrients and anti-oxidants, and has been shown to trigger fat burning.
7. Eat at home. Studies show you’ll eat half the calories and consume a small fraction of the sodium you otherwise get when eating out. Get friendly with your food and explore new places to shop, such as farmers markets.
8. When you must eat out, don’t be shy. Order your food to be prepared in a healthy manner, usually baked or broiled with any sauce on-the-side. Substitute vegetables or salad for the starchy carb dish.
9. Learn some form of meditation, breathwork, self-hypnosis, or guided imagery. Lowering stress (which lowers the adrenal hormone Cortisol) has a major impact on your ability to lose weight and keep it off.
10. Measure your food portions until the sizes become automatic. “Supersizing” of portions has become the norm, a leading cause of the obesity epidemic.



11. Get moving!! A sedentary lifestyle – sitting for hours in front of a computer, TV, smart phone, or even a book – is as detrimental to your health as being overweight or hypertensive.
12. Celebrate festive occasions with interesting activities and loved ones, while trying to de-emphasize food, especially unhealthy items. Good food is wonderful and should be appropriately enjoyed – make every item you eat something which adds to your well-being, as well as to your pleasure.

As the year comes quickly to a close, we find ourselves looking back over our shoulder at where we’ve been, while glancing ahead to see where we’ll likely be going next. We hope you have, as we do, both warm memories and exciting opportunities to occupy your thoughts.

While we do this in our personal lives, at IMGI we do the same thing in our professional capacities. Accepting the past as prologue to the present, we see the greatest concerns for our community’s health coming from the overweight/obesity epidemic, which has been picking up speed for the past 25 years.

For the past several months we’ve been asking ourselves: what can we do to help our patients successfully address all the different issues involved in losing excess weight? We’ve come up with some different ideas and will be unveiling a number of new programs early in 2012. Here’s a quick peak at the new and revised programs we’ll be offering:

HCG Diet Comprehensive Weight-Loss Program

HCG Diet Comprehensive Weight-Loss Program – 3 new programs to choose from!

APO E Genetic Analysis

APO E Genetic Analysis to determine the types of food your body is genetically programmed to use most efficiently.

FirstLine Therapy

FirstLine Therapy: an evidence-based program to improve metabolic status and promote weight loss.

Comprehensive Detoxification Program

Comprehensive Detoxification Program to better enable your liver to handle the toxins released from fat cells during healthy weight loss.

Hormonal Balancing

Hormonal Balancing with bioidentical hormones to ensure proper metabolism, as well as physical and emotional well-being.

We will be hosting an evening program on Thursday, February 16 at the Orange County Medical Association headquarters, beginning at 6 PM to fully explain and publicly introduce all of our new programs. Additionally, we will be offering tips and techniques that you can use immediately at home, including healthy recipes, simple relaxation techniques, home exercises, and foods and herbals which promote weight loss. We will also be providing a light and nutritious dinner to all attendees.

In the near future we will be sending out email newsletters that will give you all the details and costs of these programs. If, however, you are anxious to move forward with your health right now, just give the office a call to set-up an appointment with Alison Gracom, PA, our endocrinology and bariatric specialist. Let’s get started making 2012 the best year of your life!

Sincerely,

Felice L. Gersh, M.D.
Medical Director
Integrative Medical Group of Irvine

Holiday Schedules at IMGI

During the holiday season you make plans with friends and family. Sometimes you visit them, and sometimes they visit you. It’s the same for us, though we try to make sure that your medical needs are accommodated throughout the entire period.

So that you can plan your schedule and make appointments at your convenience, please be aware of our office’s following vacation schedule:

• Friday, December 23 – the office is OPEN
• Saturday, December 24 – the office is CLOSED
• Monday, December 26 – the office is CLOSED
• Tuesday, December 27 – Friday, December 30 – the office is OPEN
• Saturday, December 31- Dr. Gersh will be in the office from 8:00 AM to noon
• Monday, January 2 – the office is CLOSED
• Tuesday, January 3 – the office is OPEN and our normal schedule resumes

Free Educational Program:

Solutions to the Chronic Problems of Metabolic Dysfunction, Diabetes, and Obesity

Tuesday, November 29, 2011
6:00 PM in our office lobby area
For reservations please call 949-753-7475 or request an appointment online

American Diabetes Month

November is American Diabetes Month, and, with the holidays fast approaching, it is essential for all of us that we protect our bodies by establishing healthy lifestyle habits. In fact, an important study in a recent issue of the “Annals of Internal Medicine” suggests that a combination of five healthy lifestyle factors may help reduce the risk of type 2 diabetes, even when there is a positive family history and an overweight status. This is important new information because an estimated 25.8 million Americans – over 8% of the entire US population – now has diabetes.

Though previous research had linked several healthy lifestyle factors to a lowered risk for type 2 diabetes, these narrowly focused studies typically looked at the impact of just one risk factor at a time. This time, a research team for the National Heart, Lung and Blood Institute compiled data that considered the combined effects of five risk factors: healthful eating, maintaining an optimal body weight, engaging in recommended amounts of physical activity, not smoking, and keeping alcohol use to no more than one drink per day for women and two for men.

Data from more than 200,000 healthy adults between the ages of 50 and 71 was compiled. Each person completed extensive surveys for three years during the mid-1990s about their diets, lifestyles, medical conditions, and other issues. They were then followed for 11 years to see if they developed diabetes.

Reduce diabetes risk by up to 84%

The results suggest that if Americans were to adopt multiple healthy lifestyle factors, they could reduce their diabetes risk by up to 84%!

During the course of the study, 9.6% of men and 7.5% of women developed new-onset diabetes. Among men and women who were overweight, the odds of developing diabetes were 31% lower for men and 39% lower for women for each additional healthy lifestyle factor incorporated by the individual.

For overweight persons whose diet score, physical activity level, smoking status, and alcohol consumption were considered low-risk, the odds for getting diabetes were 39% lower for men and 57% lower for women. Maintaining a healthy weight led to the greatest protection – at a standard, healthy weight, men were 72% less likely to develop diabetes and women were 84% less likely to be at risk. Similar associations were observed among participants with and without a family history of diabetes.

Our Take On This:

This research provides an important incentive for people to adopt a more healthful lifestyle. The health care team at IMGI continues to work hard to develop cutting-edge programs to help each patient develop optimal health. Currently, we offer the FDA-certified lifestyle program, FirstLine Therapy; the more aggressive HCG diet program; as well as individually tailored programs designed with our master’s degree nutritionist. We have incorporated state-of-the art cardiovascular laboratory testing through the prestigious Cleveland HeartLab, including several new and critically important genetic tests. We also provide cardiovascular imaging tests, including carotid artery ultrasounds, carotid intima media thickness, evaluation of leg artery health, ultrasounds checking for aortic aneurysms, and echocardiograms.

In January we plan to add another essential component – fitness evaluation and exercise programs – developed for each unique individual. We also emphasize the mind-body connection to metabolic wellness by offering meditation, cognitive behavioral therapy, homeopathy, naturopathy, acupuncture and Chinese herbs, massage, and Reiki energy healing.

To assist you in making the choice best suited to your unique situation, we are offering a free get-together to introduce you to our programs. Join us in our office lobby on November 29th at 6:00 PM. You’ll have an opportunity to ask all of your questions.

Turn this holiday season into a joyous and healthy one, supporting your wishes to have many, many more holiday celebrations with the ones you love.

Sincerely,
Felice L. Gersh, M.D.
Medical Director
Integrative Medical Group of Irvine

Approximately two weeks ago, we were all shocked by a story appearing in the national news media warning that women taking vitamins had a higher mortality than women not taking vitamins. Subsequent to this, many patients called our office, concerned that their use of vitamins and supplements might be dangerous. In response to these concerns, we are forwarding one of the many well-reasoned rebuttals that appeared after this story was published.

Our take on this matter is no different from the position we have always held. We believe that good lifestyle choices – based on sound principles of good nutrition, exercise, stress reduction, minimizing exposure to environmental toxins, adequate amounts of sleep, and an upbeat emotional attitude – are the mainstays of a long, healthy, and happy life.

Nevertheless, obtaining adequate vitamins and minerals on a daily basis is a challenge for many people. Fast foods, processed foods, and our continued exposure to high levels of environmental toxins combine to make high-quality vitamin/mineral supplements a good idea.

Of course, all vitamins and supplements should be of the highest quality – low quality, hard-pressed vitamin tablets filled with suspect binders and synthetic (not bio-identical) vitamins are not a good choice. Although the study could not appropriately draw any conclusions due to its poor design, the best conclusion one could draw from this flare-up of silly science and media headline mongering would be that it is best to avoid substandard quality in supplements.

Below is an excerpt from the rebuttal written by an expert on supplements, Dr. Alan Miller, Director of Medical Education and Research at Thorne Research, Inc.

Sincerely,
Felice L. Gersh, M.D.
Medical Director
Integrative Medical Group of Irvine

A recent study, “Dietary Supplements and Mortality Rate in Older Women,” published in the Archives of Internal Medicine, 2011, Volume 171(18):1625-1633, has caused some concern among the public about the safety of dietary supplements. We have thoroughly reviewed this study and share the following analysis in order to help you better understand the study’s design and its findings, and to help allay any concerns you may have.

The Study’s Design

This study is an analysis of data gleaned from 38,772 postmenopausal Caucasian women enrolled in the then-ongoing Iowa Women’s Health Study. The data for the study is based on the responses obtained through a self-administered questionnaire initially distributed in 1986, with two follow-up questionnaires distributed over the next 18 years, in 1997 and 2004. The questionnaires inquired about lifestyle practices, food intake, dietary supplement use, weight, smoking status, hormone replacement therapy, and the presence of diabetes or heart disease.

Although study participants were asked about their intake of dietary supplements, the study did not report how much of any specific nutrient was consumed. Nor was information elicited from the women regarding the chemical form of the supplement (e.g., picolinate versus sulfate) or the quality of the supplements that were taken. Furthermore, although the women were asked whether they took a “multivitamin,” the study does not define this term; i.e., the mineral, vitamin, and botanical content of the study’s universal “multivitamin” cannot be determined.

Finally, no attempt was made to verify the accuracy of the answers provided in the questionnaires, nor were any of the participating women asked why they were taking supplements, and no attempt was made to determine the impact of taking-or not taking-supplements on any specific individual.

One possible flaw to consider: it is well known that when an individual is diagnosed with a serious disease, such as cardiovascular disease or cancer, beginning or increasing the use of dietary supplements occurs commonly. If the new or increased supplement use were reported on a questionnaire and then subsequent mortality resulted because of the underlying disease, the situation could very possibly exist such that the individual’s death, while properly attributed to the disease, would also be “associated” with the use of a dietary supplement. Such an erroneous scenario is a highly likely flaw in the study’s design.

The Study’s Findings

The results of the study’s analysis claim to show a slightly higher risk of all-cause mortality associated with the use of multivitamins, iron, and copper. In weighing the study’s findings, however, it must be emphasized that the Iowa Women’s Health Study is a retrospective study of already collected data. It is not a prospective, controlled intervention study, i.e., it is not a “clinical trial,” in which participants would be given a specific dietary supplement or a placebo and then followed closely over time to observe not only the specific outcomes but also the factors possibly contributing to those outcomes.

As can only be surmised retrospectively, individual circumstances change over time, and a significant number of the women participants likely either changed or began new dietary supplement regimens over the course of the 18 years they were studied. And since there was no direct contact with the participants outside of the mailed questionnaires, general information surrounding individual deaths had to be obtained from public records; it was not ascertained by direct medical investigation.

With regard to iron and copper, it has been known for decades that both metals can be potentially toxic, as exemplified by the multi-system disease states that can result from hemochromatosis and Wilson’s disease, respectively. For this reason, many postmenopausal women, like men, probably should not take an iron supplement in the absence of anemia or a documented deficiency. At the very least, iron and copper supplements should be taken concurrently with antioxidants and/or antioxidant-rich foods to prevent a potential increase in oxidative stress. Each of these circumstances points to the merits of dietary supplements being recommended and overseen by medical professionals.

With regard to multivitamins, there is simply insufficient data that can be gleaned from the study to make any serious conclusion about the impact of multivitamins on mortality. This is due to the fact that there are literally thousands of different combinations of vitamins, minerals, and botanicals that can be considered a “multivitamin,” as well as a whole host of considerations such as quality, potency, dosage, protocol, and indications for use, among others.

Practitioner and Patient Concerns

We believe there are serious flaws in the methodology, analysis, and findings on which this study is based. Retrospective surveys such as this-in which people are asked to recall years of dietary habits or supplement use-are notoriously inaccurate. The only conclusion that can realistically be drawn is that a slight statistical association was found based on a limited data set of questionable reliability-and a simple association does not reflect causation. The study’s authors do not disagree, stating the following in their commentary to the study: “It is not advisable to make a causal statement of excess risk based on these observational data…” We heartily agree with this advice.

When made by a quality manufacturer, when recommended by a knowledgeable health-care practitioner, and when taken for the appropriate indication, dietary supplements promote, enhance, support, and help maintain overall good health and well-being. The “results” of the recent study do not diminish this conclusion.

Additional commentaries on this study are available at:

The Alliance for Natural Health

The Council for Responsible Nutrition

Women were extremely frightened nine years ago by the many news stories regarding the risk of breast cancer and hormonal replacement therapy in menopause. A great deal of new data has come to light and all menopausal women should come to this seminar to get up-to-date information on this subject.

This seminar will be held in the IMGI office reception room, starting at 6:00 PM. There will be no charge and all are welcome!

Please reserve your spot by calling 949-753-7475.

This program will review the scientific evidence on the use of pharmaceuticals, hormones, lifestyle choices, energy medicine, herbals, and supplements to lower your chances of developing breast cancer. The effects of early life exposures, environmental toxins, and genetics will also be covered. Don’t miss this important educational program.

This seminar will be held in the IMGI office reception room, starting at 6:00 PM. There will be no charge and all are welcome!

Please reserve your spot by calling 949-753-7475.