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From the Townsend Letter
November 2012

Letter from the Publisher
by Jonathan Collin, MD

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Super Sad True Love Story
My letter does not usually focus on fiction, but this was one of those books that has made an impression on me, so I thought I might pass it on. Yes, there is a love story between two people – so what does this have to do with alternative medicine? Not much, really. However, the man works for a company that that is involved in anti-aging medicine and cosmetic surgery. There is ample discussion in the text of using various nutraceuticals, alkaline water, detoxifying, and metabolic therapies that are not the typical work activities for a book's main character. That was the hook for me. The story itself is not quite 1984, Animal Farm, or Brave New World, but it is a scary look into our future.

Super Sad True Love Story, by Gary Shteyngart, takes place in 2030 or 2040. It is a time when China largely owns and operates the US. The dollar is pegged to the yuan and nonpegged dollars are worthless. There is a "Restoration Authority" that pumps out patriotic feel-good messages to assuage the public, who are living restricted lives with barely the daily essentials. Manufacturing is nonexistent and the only work is in retail or the bureaucracy. Everyone has a device that is like a vastly upgraded iPhone called an apparata. This device holds the owner's identifying information in full: medical history, financial and credit records, even personal and social capabilities. In public, each individual’s information is made instantly available to everyone else within proximity through their apparata. There is no privacy and no private information.

Super Sad True Love Story is fiction, our bureaucracy in 2012 is gearing up to make our health information universally available. The UK National Health Service has already engineered the change. In the US, not only Medicare but private insurance companies are now requiring doctors and dentists to maintain electronic medical records and billing. It is only a matter of time before one's medical records will be available instantly through the medical system for insurance companies and government agencies. Who will prevent these records from being available on private devices like Shteyngart's apparata? Welcome to our future of destitution and no privacy.

60 Minutes Exposes Doctor's Dubious Stem Cell Therapy
A physician who lost his license to practice medicine in Alabama currently operates a company in Ecuador putatively offering stem cell therapies. Dan Ecklund offers stem cells from his website, Stem Tech Labs, for treatment of 70 medical conditions, including cerebral palsy. His operation was exposed on a recent episode of 60 Minutes and it was not a banner day for the treatment.1 His website offered interested parties stem cells for purchase to be shipped directly to the buyer in the US. 60 Minutes purchased stem cells for $5000 and did receive a shipment. The product was shipped under dry ice after it was received in the US to the laboratory of Dr. Joanne Kurtzberg of Duke University, a renowned researcher of stem cells. Kurtzberg analyzed the product and found that it contained only 100 live stem cells of the 20 million umbilical blood stem cells purchased. The majority of the product was cellular debris. Kurtzberg indicated that injection of this material would have a high likelihood of causing an adverse reaction and would not have any possibility of treating a medical condition.

60 Minutes set up a sting operation and arranged for the parents of a youngster with cerebral palsy to consult with Ecklund about stem cell therapy for their child. The parents were not willing to travel to Ecuador but agreed to initiate treatment if Ecklund would treat the child in the US. Ecklund travelled to Florida and arranged to meet at a hotel to administer the treatment. Instead of meeting the family, Ecklund was met by producers of 60 Minutes. Ecklund was asked to explain stem cell treatment. His response was vague and without substance as to what stem cell therapy is and why it would benefit cerebral palsy. He claimed that there were studies supporting its benefit for cerebral palsy and that there was a 70% likelihood that the child would benefit. When he was informed of the results of the analysis by Kurtzberg, Ecklund argued that the cells had been fully viable when shipped.

Stem cell therapies may offer effective treatment for chronic disease. However, it is unclear what conditions stem cells effectively treat. It is also uncertain how effective such treatment is when there is no standardization of stem cell production. With no direct oversight and licensing, numerous companies exist producing stem cells of questionable quality. Given the very high cost of these therapies, there is a need for standardization, laboratory quality control, regulation, and clinical studies. Until that comes about, physicians and consumers should undertake such therapies only with rigorous investigation.

The Fatty Liver
We are all concerned with the obesity epidemic and our patients’ health risks with increased weight. Metabolic syndrome, elevated lipids, hypertension, blood sugar dysfunction, and hyperinsulinism are among the many issues at risk in an overweight patient. The worry that an obese patient may develop diabetes is sufficient reason to focus on diet and exercise. What we often overlook is the fatty liver. As much as 30% of the US population has nonalcoholic fatty liver disease (NAFLD), and a significant number of these patients progress to nonalcoholic steatohepatitis (NASH). In this issue, Dr. Mona Morstein examines the fatty inflamed liver, reviewing its pathophysiology, diagnosis, and treatment.

Prevention of NASH is important, as liver fibrosis is accompanied by liver cell degeneration and death (apoptosis). As fibrosis progresses, the liver may develop cirrhosis and liver failure, hepatitis, or cancer. Hence there are compelling reasons to look for evidence of fatty liver disease in the overweight patient. Interestingly, NASH may be exacerbated by rapid weight loss of greater than 3 pounds weekly – a good reason to check liver enzymes before starting a diet.

Treating the Diseased Liver
Burk Berkson, PhD, MD, has developed a renowned reputation for treating liver disease. Berkson is interviewed in this issue by Nancy Faass, MSW, MPH. Berkson originated the use of alpha-lipoic acid (ALA) in treating acute hepatic necrosis during his medical residency. He had been advised that an agent known as ALA would have the ability to regenerate liver. When he was confronted with a patient facing imminent liver failure, he elected to administer ALA intravenously. After this treatment, the patient's liver regenerated. According to Berkson, he treated 79 patients who had terminal hepatic necrosis, administering ALA to them intravenously. 75 of the 79 patients survived. Berkson has continued to study ALA and has found it to be very successful in managing a wide array of liver disorders. Berkson discusses how he manages patients with liver diseases and related conditions.

Thomas Abshier, ND, reviews a new protocol developed to reverse fibrosis caused by hepatitis C. This condition is now treated primarily with medication designed to reduce viral load, such as interferon. In addition to its great expense, interferon is highly taxing to the body, leading to generalized debility through the treatment period. Additionally, while the viral load is reduced, the fibrosis process frequently proceeds in many patients with hepatitis C. Preliminary clinical reports have demonstrated a reversal in the fibrosis process by patients who have employed the HepTech antifibrotic formula. Studies carried out in chimeric mice that have had human liver tissue replace their native mouse liver have demonstrated resistance to HCV fibrosis when given the antifibrotic formula. As the formulation is based on antioxidants, botanicals, and polyenylphosphatidylcholine, there are no significant adverse effects. Having a successful approach to managing fibrosis may offer a treatment approach for diverse liver disorders.

Jonathan Collin, MD

1.   "60 Minutes" investigates online stem cell fraud [online article].




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