The Triple Crown and then some

I was just getting ready to announce that I had achieved the Triple Crown of physician recognition (featured in Hour Detroit’s Top Docs issue, appearing on TV, and the Patients’ Choice Award) when a got a Google alert that I am the runner-up in the Current Reader’s Choice Awards for “Place to get alternate healthcare”. (Yes, half of these spelled my name wrong: Malcolm Sickel and Malcolm Sickles, but it’s not a big deal.)
So let’s recap:
Hour Detroit, an oversized glossy of all things fabulous around Detroit, starts the ball rolling by featuring me as the first holistic physician ever in their magazine.
Fox News Detroit, the big local TV station, has me come in for a spot on their morning news.
3., the main website that scores doctors, gives me the Patients’ Choice award for doctors who have “received near-perfect scores as voted by patients.”
Current, Ann Arbor’s monthly newspaper of events and all things hip, has an annual reader survey and in the category for “best place to get alternate healthcare” (which I didn’t know existed), I get the runner-up position after Castle Remedies, a great retail store for homeopathics and supplements. The fact that I landed first place after a retail shop that gets a lot more traffic than I do is quite flattering.
Of course, I must give credit to the
Crazy Wisdom Journal for featuring me first back in 2006. A nice way to get the ball rolling.
thank you to everyone who has put their faith in me and voted for me. I’m honored. A friend of my brother’s said that I should write a book, but I’m already pretty busy. Maybe if I had a better idea of what people wanted to read...

New wheat-free page

I added a new page on wheat/gluten-free resources around Ann Arbor. So far, it has some links to a few places to get hooked up for good information and some information on local shopping. I’ll be adding more about restaurants and things as well.
wheatfreenia logo2

In addition, this is as good a time as any to announce the website my daughter and I are working on:, a home for people who can’t eat wheat. She has big plans for it, but neither of us has the technical skills to bring all those plans to fruition any time soon. Right now, it’s fairly sparse, but it will grow in time.

The Fosamax facade is starting to crumble

After years of hints that all the bisphosphonates (medications used for osteoporosis) caused jaw osteonecrosis (destruction of the jaw bone after dental work), a new article shows that the risk of jaw osteonecrosis when the person gets dental surgery who has been on Fosamax is one in 23, or around 4%, 1600 times higher than the 0.0005-0.0025% Merk “estimated” in 2007.
While 4% may not seem like a big number, it seems a lot more problematic when realizing how devastating jaw osteonecrosis can be. The jaw bone near the surgery breaks down, leaving a broken jaw, and it can continue to expand. Any attempt to bridge the gap will cause further destruction, as drilling into the bisphosphonate saturated bone will only trigger more breakdown. With no known way to remove the bisphosphonate from the bone once it’s in there, all the dentist can do is watch helplessly as the jaw falls apart.
Hyperbaric oxygen therapy is the only treatment that has shown any promise in stemming the collapse and even that isn’t stunningly effective.
Understandably, dentists are reluctant to operate on people who may be at risk due to the devastating effects on the patient, and are also reluctant to report it happening due to the devastating effects on their reputation and office. So, the condition is dramatically under-reported. Even with less loaded conditions, 90% are never reported.
Of course, this is on top of the risk of erosions and cancer of the esophagus from these medications.
The companies making the bisphosphonates (Fosamax, Actonel, Boniva, Aredia, Zometa and Reclast) have been attempting to portray these medications as safe and effective for the treatment of osteoporosis as well as attempting to expand the market to include the treatment of osteopenia (milder bone loss). Clearly, if one in 23 of people on the oral form of these medications (the IV form is much worse) will have their jaw disintegrate if they get dental surgery, it’s not safe. Whether it’s effective is open to debate.
When trying to prove that putting their new chemical into people is a good idea, drug companies and the researchers that work for them have a lot of tricks to make the chemical that they’ve dumped a pile of money into producing look good enough to produce the serious return on investment they need. Drug companies like to use intermediate markers rather than outcomes since they are easier and cheaper to measure and easier to game than the real outcomes we care about. With cardiac disease, the outcome we’re concerned about is dying or having a hospitalization, while cholesterol or LDL levels are an intermediate marker that may not translate into the outcomes I mentioned. With bone loss, the real outcome is fractures, while an intermediate marker is bone density. By strapping a lead rod behind your leg, it can look denser to the machine, but it won’t do a thing to reduce fractures. While a medication may increase bone density (remember that density is mass per volume, so heavier bones), it may not actually make them stronger (they can be dense and brittle, or lighter but with just enough give to resist breaking: think glass compared to titanium).
While the drug companies have been doing their typical attempt to brush it all under the rug, they also engaged in their typical pastime of trying to get doctors to prescribe it to people for whom it isn’t indicated. As I
discussed 18 months ago, the evidence doesn’t support the idea that this drug is beneficial for osteopenia. Perhaps the only thing that does support the idea is the money the drug companies spend on lunches for physicians so they can whisper these sweet nothings in their ears.

Contact form changes

I made some changes to the contact forms, and you will now have to enter a security word to submit a message. While it has benefits for you and me (you get your message read sooner since we don’t have to wade through spam to find it, and we don’t have to pick the real messages out of the pile of spam), it also helps humanity by helping convert old books into machine-readable form. This video explains how it all fit together. It’s enough to make you look forward to filling in those forms.
I’m also cleaning out old pages, so if you can’t find a page, I’ve probably changed the location. Follow the links to get to it.

Where did the testosterone go?

Back when I was giving talks on men’s health, I would talk about testosterone and how it goes down with age and that there is also a decline from one generation to the next: the testosterone levels in a 60-year-old in 1988 were higher than a 60-year-old in 1996, which were higher than one in 2003. Understandably, the men were shocked and demanded to know why. At that point, all I could say is that no one knows for sure, but it’s probably some chemical we’ve been adding to the environment and mentioned the feminized male alligators in Florida where PCBs had been dumped in the lake years earlier.
Well, we finally do have a candidate for a cause of the lower hormone levels in men: phthalates, specifically DEHP. The
Journal of Andrology published a study showing that higher levels of the DEHP metabolite MEHP consistently accompanied lower levels of testosterone and estrogen. This also implies that it will cause similar hormone disruption in women (earlier studies have shown an association between phthalates and genital defects in infants), making it a good thing to avoid.
These phthalates are mostly used in making flexible vinyl for flooring, wall coverings, “food contact applications” (food packaging, though this is illegal in Europe), and medical devices. Other, lighter, phthalates (DEP and DBP) are used in lotions, perfumes, cosmetics, lacquers, coating, varnishes, acetate, and in some time release medications.
Interestingly, DEHP is relatively insoluble in water, so little will migrate from the plastic (DEHP doesn’t become a permanent part of the plastic) into a mainly water containing liquid. Because of this, US law permits DEHP in packaging of food that is primarily water. However, since DEHP accumulates in fat over your entire lifespan and persists in the environment it is likely the only safe level of it is none.
One this stuff gets in you, how do you get it out? Well, there’s no good answer for that right now. Sadly, the only sure way to be sure to move it out of a human is to have a baby: some of those phthalates will leave inside the baby. There have been some attempts to do it with Olestra (the non-absorbed fat in Wow chips), but it didn’t work (though it might work if you have just been exposed to the fat-soluable chemicals before they have gotten into your fat).
I had switched to phthalate-free medical supplies (mostly IV tubing) long ago, so applying the precautionary principle in my office has paid off. I wonder when the government will put the health of its citizens over corporate profit. Right now, they hear more from the corporations’ lobbyists (paid for out of the money we pay for their stuff) than from us, so as long as we sit on our hands and keep quiet it won’t change.

In case you need another reason to avoid corn syrup

High fructose corn syrup (HFCS), a very pervasive ingredient in american foods, may well be the lynchpin of our obesity epidemic. It doesn’t trigger satiety (feeling full) like regular sugar, so people eat more of it (and its empty calories), and it’s processed differently that normal sugar leading to higher triglycerides and fatty liver disease (also known as NASH or non-alcoholic steatohepatitis). In addition, it’s sweeter than sugar, so normally sweet things taste less sweet in comparison, triggering the dietary arms race of adding sweeteners to foods just so they taste sweet compared with everything else (have you noticed that “no-added sugar” fruit juice popsicles now have aspartame in them?). That the corn it’s made from is grown from frequently genetically modified stock and uses large amounts of fertilizers (mostly petroleum based) to grow just adds to the reasons to avoid it. Now, news just came out that adds another reason to the pile.
Environmental Health published an article (as did the Institute for Agriculture and Trade Policy) showing that 30% of the foods they tested with large amounts of HFCS had detectable levels of mercury in them. Mercury is, of course, a potent neurotoxin and not something you want in your diet, especially when you’re not exposing yourself to it for any good reason (since there’s no benefit to eating HFCS).
Why is there mercury in HFCS? Making HFCS uses numerous chemicals including chlor-alkali based sodium hypochlorite, hydrochloric acid, and caustic soda, all of which have mercury involved in their manufacture. Every year the plants that make these report that they end up with less mercury than they started with (including mercury from plant emissions) and that a substantial amount is “missing”: escaping the plant in the products they produce. So, when these chemicals with mercury are used in the manufacture of other products (like HFCS), some of the mercury ends up in them.
As usual, the industry trade group (the Corn Refiners Association) tried to muddy the waters about the article, claiming that the methods of making hydrochloric acid and caustic soda (notice they didn’t mention sodium hypochlorite) that involve mercury are outdated and mostly not used in the US any more. However, some is still produced in the US with mercury today and some is imported from countries with even less stringent laws than ours. So, despite the Corn Refiners Association’s protestations, this is still very much a current issue.

Web problems

Between our web host changing server locations and our wholesaler redesigning their website, there’s been some problems. It took me a bit to figure out how to fix things, but the website shouldn’t have any problems now and the link to the wholesaler is functional now. You’ll need to get an access code to order. Please let me know if there are any other problems.