Letter from the Publisher

Chronic Wasting Disease (CWD)

Fall means one thing to most gun-owners—hunting season for elk and deer. Outdoorsmen relish the week they take off in the cold with fellow male hunters, spending hours trekking to find their animal often fruitlessly, but occasionally sighting a buck and, if lady luck avails, making the skilled shooting or bow kill. Dressing the downed animal in the field is obligatory especially of a heavy elk or moose. What that means is the hunter is exposed to the animal’s blood, digestive tract and feces, bone and connective tissue, brain and musculature, with meat and blood particulates likely to be inhaled and ingested, and contamination of clothes and truck bed. Messy butchering is easily cleaned up with soap and water, not so easily addressed are tiny organisms known as prions that are infecting a growing number of cervids or reindeer, elk, and deer.

The prion is a poorly understood organism that has been closely associated with causing mad cow disease (bovine spongiform encephalopathy [BSE]) and Creutzfeldt-Jakob disease. In wild cervid herds, the prion causes Chronic Wasting Disease (CWD). Unlike mad cow disease, which is relatively rare, and Creutzfeldt-Jacob disease, which appears sporadically but historically in cultures that eat brain such as in Papua New Guinea, CWD has been spreading in herds throughout the Western US. There have been no clinical reports of humans acquiring CWD, but, in Canada, macaque monkeys fed infected meat did get CWD.¹

Prion organisms build up in brain tissue by an unknown mechanism. The prion changes protein structures in the brain involved in synaptic transmission into an abnormal form; this transformation progresses rapidly converting much of the brain into the abnormal functioning protein. Before the disease progresses, there is a lengthy incubation period during which time the prion is thought to be replicating. Individual genetic variability causes greater or lesser susceptibility to prion infection. Human prion disease is not contagious. However, individuals handling human tissue with prion disease are at high risk for infection. Because prions accumulate in the brain and central nervous system, handling brain tissue poses the greatest risk. Nevertheless, all tissues in an infected animal or human contain prions. Medical sterilization techniques are not capable of destroying all prions; if a medical procedure is carried out on an individual with prion disease, all instrumentation is a bio-hazard and must be disposed.²

Is CWD prion disease a risk for hunters and their families? Venison and other game meat are thought to be much healthier than beef and pork because the animals are wild, not subject to industrialized livestock production. What about the individual who is already compromised immunologically with fibromyalgia, autoimmune disease, or cancer? If they eat prion-infected elk what happens to the prions they ingest?

Jade Teta, ND

When the patient comes into the exam room requesting a prescription for Viagra or Cialis, he is having erectile dysfunction (ED). Not uncommonly the next request is for testosterone or at least to be tested for testosterone deficiency. But what would be a comprehensive approach to assessing erectile dysfunction, and what are the options one should consider from both a naturopathic and functional medicine viewpoint? In this issue, Jade Teta, ND, examines the pathophysiology behind difficulty with erections and recommends appropriate lifestyle and treatment strategies. From a macronutrient viewpoint, zinc, magnesium, and vitamin D must be adequate in the diet. Exercise is definitely an important component in managing erectile dysfunction. Insulin resistance must be corrected, and metabolic syndrome as well as obesity need to be addressed. Of course, testosterone testing is a key component in assessing ED but Teta advises consideration of both hormonal and non-hormonal strategies for increasing deficient testosterone.

Devaki Lindsey Berkson, MA, DC, CAN

As long as we are talking about male erectile dysfunction we should also consider female sexual dysfunctioning at the same time. While Dr. Devaki Lindsey Berkson does not discuss this in this issue, her book, Sexy Brain: 10-Day Hormone Detox Program details “How Sizzling Intimacy & Balanced Hormones Prevent Alzheimer’s, Cancer, Depression and Divorce.” Berkson is an expert on hormones and sexual dysfunction and has participated in research colloquiums because of her knowledge. Earlier books include the Hormone Deception (2000), Natural Answers for Women’s Health Questions (2002), and Safe Hormones, Smart Women (2010). She participated in sharing her research at the Center for Environmental Research at Tulane University as a hormone scholar.

What Berkson details in Sexy Brain is how the hormone activity in men and women overlap but differ to a major degree. She explains that the major difference is how testosterone and estrogen alter our thinking and emotions. While estrogen makes women multi-task, it is their testosterone that grounds their thinking. Berkson argues that women acquire optimal levels of testosterone through heterosexual intercourse—the semen delivers testosterone that ultimately activates receptors far away in the brain’s hippocampus. However, many women have unfulfilling sex because their hormone levels are deficient and imbalanced. She advises the need for bio-identical hormone replacement as well as non-hormonal approaches to balance hormone status. Once hormones are optimized, sexual functioning may still be impaired. Berkson provides a down-to-earth, Karma Sutra, for Western patients and doctors explaining how the man should engage sexually—the foreplay, the touching, stimulating all the right spots, and achieving ultimate orgasms.

For those couples who are sexually dissatisfied, for those doctors who are dissatisfied, Berkson’s Sexy Brain deserves a read. It would be a good one for the holidays.

Jean-Ronel Corbier, MD

If you are like me, the neurologists you refer to do a standard neurology workup, order CT scan or MRI (with contrast, please), nerve conduction studies, EEG, and rarely a spinal tap, then make a diagnosis. Medication and treatment is generally palliative, not restorative, and patients and caregivers now deal with managing their illness with the limited tools at hand. But what if there could be a restorative approach? What if the neurologist could move beyond the textbook diagnosis and the palliatives and consider restoration to optimal health? Of course, “the cure” for a disease is the objective of most neurologic societies, research associations, and patient advocacy groups, but until that cure is here, what next?

Jean-Ronel Corbier, MD, claims that we can “return optimal health” to many of these individuals through a “Restoration Model.” Underlying restoration is a history of having sustained “physical, emotional, psychogenic, and spiritual” injury. Corbier argues that one must take the time to address each of these insults comprehensively, fastidiously uncovering each of them. And some insults may be very difficult to uncover and address, but Corbier emphasizes that the doctor and patient must be persistent in examining each of insults despite their complexity. In the article in this issue Corbier explains how he uses the restoration model when he treats a youngster with autism, but he thinks it can be used in adult or child for all chronic disorders.

Dr. Corbier just presented at the International College of Integrative Medicine’s October meeting in Grand Rapids, Michigan; for more information see icimed.com/conferences.

Dugald Seely, ND, MSc

This past September, Dr. Dugald Seely was awarded the Rogers Prize in Vancouver, British Columbia. It’s not the Nobel Prize, but it’s as prestigious an award for integrative and natural medicine. The prize is $250,000.00 but it is open only to Canadian physicians. Why don’t we have a comparable integrative medicine prize in the US?

Our medical curmudgeon and Fellow of the American Board of Naturopathic Oncology (FABNO), Dr. Jacob Schor, offers an accolade of Dr. Seely and spells out why he richly deserves the award. Dr. Seely is a clinician and clinical researcher—he usually approaches his research in that order, first, clinical observation, and then evidence-based research. Dr. Seely’s research has focused on oncology, but he has researched naturopathic treatment and cardiovascular disease, mental health, musculoskeletal disorders, and infectious disease. Just do a search of Dugald Seely on PubMed to get a sense of his research. To the medical nay-sayers who claim that naturopathic medicine is not evidence-based, Seely offers a potent dismissal of the skeptics’ belittlement.

Dr. Seely and his MD brother were awarded a $3.85 million grant to study the adjunctive role of naturopathic medicine in the conventional treatment for lung, gastric, and esophageal cancer. The Thoracic-POISE study, “Thoracic Peri-Operative Integrative Surgical Care Evaluation,” was started in 2014. As Dr. Schor reports, the study seeks to understand the role of naturopathic care before and after cancer surgery and also seeks to determine if such care reduces surgical adverse events and extends disease-free survival. The planned 11-year study will take place at multiple Canadian cancer centers coordinating with ND physicians.

Seely is the executive director of the Ottawa Integrative Cancer Centre; the clinic of 26 seeks to provide only evidenced-based complementary medicine. The Townsend Letter is very pleased to keynote Dugald Seely for his outstanding clinical work and research.

1. Davidson, A. The financial page: Pissed off. The New Yorker. 2017 Sept. 25; p. 41.

2. PDF Information about Prion disease, National Prion Clinic, University College London, Prion Clinic, prion.ucl.ac.uk