Welcome to my blog, where I will share the latest medical and health news and information, posts about cutting-edge treatments, ideas about nutrition, links to research findings, advice on weight loss, supplements, hormonal health, and more. Please feel free to comment, share posts you find interesting, and let us know if there are topics you’d like to see covered.
Fox News recently interviewed Dr. David Borenstein, founder of Manhattan Integrative Medicine, and the New York Stem Cell Treatment Center. Dr. Borenstein shared information about the use of autologous stem cell therapies for treating COPD and other lung diseases, and a patient who has had successful treatment was featured and interviewed. According to Dr. Borenstein, “Two-thirds of patients respond.”
Read more from Dr. David Borenstein in this interview at the Newsmax site, where Dr. Borenstein talks about the benefits of prolotherapy, a natural treatment for arthritis, pain and other degenerative conditions.
Dr. David Borenstein will be a featured speaker this Sunday, October 25th, at the Pillars of Life Personal Planning Symposium at the Islandia Marriott, in Islandia NY. Register in advance for free attendance! Meet professionals, including Dr. Borenstein, who will share knowledge and information to empower you to make the best decisions for your family, regarding health, finances, fitness, technology, and much more!
Did you know that men have hormonal changes in their 40s and beyond too?
I was honored to be featured in this article by Huffington Post Senior Columnist Ann Brenof, talking about male menopause — “andropause” — and the reasons why there is less transparency about this important hormonal change in men.
Diana Naklicki Myers has gone through 20 years, facing misdiagnosed Multiple Sclerosis, worsening symptoms, multiple drug therapies and treatments, and a series of expensive and side effect-laden symptoms that progressively worsened, improved, and worsened.
Deeply discouraged by her medical care, Diana, like many chronic autoimmune disease patients, actively became her own health advocate, exploring options. Pouring through research, Diana found reference to Low-Dose Naltrexone (LDN) treatment as an option for MS.
Pushing further, Diana found research references to Dr. David Borenstein, at the New York Stem Cell Treatment Center. During a telephone consult, Dr. Borenstein and Diana discussed the effects of the drugs she was currently taking. Working with Dr. Borenstein, Diana was weaned off all her medications except for a prescription of LDN.
Within one week, Diana experienced significant improvement, was able to go from her walker back to a cane, and was released by her physical therapist with exercises to do at home. After these improvements, Diana and Dr. Borenstein discussed the potential of experimental autologous stem cell therapy offered through Dr. Borenstein, and wanted to give it a try.
Diana underwent an autologous stem cell treatment with Dr. Borenstein at the New York Stem Cell Treatment Center in May of 2015. On arriving at Dr. Borenstein’s Manhattan office, Diana received a thorough assessment, and a detailed explanation of the treatment from Dr. Borenstein. The next day, Diana and her husband returned to the office for the actual procedure.
Diana describes the procedure as pretty simple. Dr. Borenstein performed a mini-liposuction procedure on the skin just around her waist. During that time, Dr. Borenstein harvested Diana’s own adipose, or fat, cells. While the procedure caused slight bruising, according to Diana, it involved little discomfort.
Processed for approximately 90 minutes, Diana’s own stem cells were then reintroduced into her body. Altogether, Diana said the procedure took about three to four hours. She and her husband were on their way out, and headed off to enjoy dinner with family in New York City.
During the drive to dinner, Diana was surprised to notice immediate changes that she had not expected. Her vision, which had been deteriorating over the past 15 years, began to change. Diana describes it as like “a tunnel just opened up.” Not only did she notice a sharply widened range of vision, Diana began to experience vibrant colors as the couple drove to her mother-in-law’s house.
Though excited, Diana wondered if brushing her teeth that evening would be as painful as always. Happily for Diana—her neuralgia was not triggered again that night, and that debilitating symptom disappeared after treatment.
Now, in July of 2015, Diana is two months post her stem cell process. In the thick of home improvement projects she had been unable to complete for years, Diana recently mowed her lawn for the first time in over a decade.
Finally finding the care and concern she had sought in a healthcare specialist, Diana describes Dr. Borenstein as “amazing beyond limits.” Diana and Dr. Borenstein stay in touch on a weekly basis, with phone calls or texts.
In just a few months, Diana has naturally shed 25 pounds because she is able to “do things now.” The walker and rhinestone-decorated cane are in the attic, where Diana hopes they stay for along time.
Grateful to her family and her faith, Diana places her husband first for the unfailing help and support he has given her. After family, Diana credits Dr. Borenstein, because “he is willing to look outside the box to make you feel better, not make you go away.”
As Diana says, in her life, she did everything right. She ate the right foods, took care of herself—and she still got MS. Although she realizes she may not have the life of a perfectly healthy 40-year old woman, she is grateful for some security that, “from here to there, I can do it!”
A recent study suggests women prescribed selective serotonin reuptake inhibitors (SSRIs) could be at higher risk for bone fractures—even years after they stop taking the drugs.
Our Manhattan practice offers holistic options and skilled medical treatment to patients so they can make their best health choices. Part of our mandate is education. For our patients moving through menopause, that means alerting you to information that could affect your health.
In research published online in the June issue of Injury Prevention, study authors compared medical data on more than 235,000 women between 40 and 64 years of age. The study looked for health associations between two groups—those prescribed SSRIs, and those prescribed drugs used to treat indigestion.
The women involved in the study were treated for symptoms related to menopause, not for symptoms of any mental disorder.
What are SSRIs?
SSRIs are antidepressants, and work to address brain chemistry that can lead to depression, and depressive symptoms. In this study, the generic names of the types of SSRIs studied include:
These drugs are marketed under brand names like Zoloft, Prozac, Paxil, and Celexa. Antidepressants are the third most common type of drug prescribed in the U.S., and often for uses that are not psychiatric in nature.
In June, 2013, the Food and Drug Association (FDA) approved paroxetine as the first non-hormone based treatment for hot flashes related to menopause. Antidepressants are sometimes prescribed to treat symptoms of menopause including hot flashes, irritable bowel syndrome, and night sweats.
Reason for Concern if You Take SSRIs
The data collected for this study came from the PharMetrics Claims database, an information resource that tracks drug treatments of more than 60 million patients across the country. Researchers focused on women in the target age range who began SSRI treatment for menopause symptoms between the years 1998 and 2010.
The study was looking to discover if there was an increased risk of bone fracture among women prescribed SSRIs who did not have a mental disorder. Medical literature has previously identified an increased risk of bone fracture among women taking SSRIs for their primary use—depression.
During the study term, researchers learned the following key information:
For women prescribed SSRIs, the risk of bone fracture is 76 percent higher after one year of treatment
After two years, the increased risk dropped to 73 percent
Within five years of taking SSRIs, the risk of bone fracture was still 67 percent higher than women prescribed the drugs for indigestion
The study concludes, “SSRIs appear to increase fracture risk among middle-aged women without psychiatric disorders, an effect sustained over time, suggesting that shorter duration of treatment may decrease fracture risk.”
In their discussion, study authors suggest an association between SSRIs and an increase in osteoclastic behavior. This means SSRIs could increase the rate at which bones replace themselves. The result of altering the cycle of bone renewal could be thins bones, and lower bone mineral density—making patients more susceptible to fracture.
As this was an observational study, the research suggests—but doesn’t prove—an association between taking SSRIs and an increased chance of breaking a bone. More studies will be needed to prove the link.
But at any age, a broken bone is serious. Over 40 years of age, a broken bone could lead to lasting disability, or a shortened life span.
Polycystic Ovary Syndrome (PCOs) affects approximately one in seven women of reproductive age in the United States, PCOS is a common endocrine disorder that owes its name to clusters of pearl-sized, fluid-filled cysts found within the ovaries of women suffering the condition. Learn more about the condition, the signs and symptoms, how it’s diagnosed, and integrative approaches to treat the condition now at our Polycystic Ovary Syndrome page.
Do gastrointestinal symptoms and a lack of diagnosis have your stomach in knots? The answer may be a leaky gut. What exactly is leaky gut syndrome?
Spanning the space between your mouth and anus, the human gastrointestinal tract (GIT), or gut, is an extraordinary system that absorbs and digests nutrients, and eliminates waste. The GIT is the biggest mucosal organ in your body, routinely exposed and responding to foreign matter passing through.
The gut does not stand alone, but is home to trillions of microorganisms called microbiota. The number of microbiota in the gut is far greater than the number of cells that compose our bodies. While there are commonalities across the microbiome (another word for the rich ecosystem of microorganisms), each of us harbors microbiota as unique as our fingerprints.
The small intestine is located in the lower gastrointestinal tract. As food passes from the stomach to the small intestine, consumable nutrients, like proteins, carbohydrates and lipids, are broken down by microbiota, enzymes, hormones, and other chemicals.
When decomposed, nutrients are absorbed through the surface area of the small intestine. Once absorbed, nutrients are transported by blood vessels throughout the body. Undigested material passes into the large intestine.
At least, that is how it is supposed to work.
Leaky gut syndrome is a broad term that describes the theory that the small intestine, under certain conditions, becomes inflamed and allows undigested matter, allergens, and potential toxins to leak into the bloodstream.
The mechanism of the leak is increased permeability of the surface area of the small intestine, allowing larger, undigested particles or materials to pass into the bloodstream that otherwise would have been excreted.
Ailments linked to leaky gut syndrome include:
Autoimmune disorders — like rheumatoid arthritis, Hashimoto’s thyroiditis, Graves’ disease, and others
Chronic fatigue syndrome
Eczema and other skin conditions
Irritahble bowel syndrome
Immune system disorder and dysfunction
How do you know if you have leaky gut syndrome?
While we know that the small intestine is permeable, how that affects disease and physical disorder is still being explored.
There is also a gap between the mainstream medical approach, and integrative medicine’s ideas about and acceptance of leaky gut. Factors known to damage the lining, and affect permeability, include:
Inflammatory bowel diseases
Non-steroidal anti-inflammatory drugs (NSAIDS)
Food sensitivities and allergens
Research into intestinal permeability is ongoing. Here are a few interesting studies :
Newly discovered protein could increase permeability: In 2012, research published in the Journal of Gastroenterology and Hepatology describes a protein that regulates intercellular junctions and permeability in the lining of the GIT. Study authors theorize dysfunction of the protein in susceptible individuals may lead to “immune-mediated diseases.”
MS may cause intestinal permeability: A study published in PLOS ONE in 2014 suggests Multiple Sclerosis (MS) disrupts the permeability of the intestinal lining. While leaky gut syndrome is linked to MS, the study is one of the first to propose increased intestinal porosity is a result of the immune-mediated event of MS.
Diet affects intestinal inflammation: Attention to diet and nutrition has long been advocated by physicians who believe their patients suffer from leaky gut syndrome. In a 2014 study published in Gastroenterology, researchers note modification of diet and nutrients can reduce intestinal inflammation—a trigger of increased intestinal permeability.
What are your options if you suspect leaky gut syndrome?
My clinical practice is focused on integrative medicine. We look at causes and all potential treatments of digestive related issues, and often look for and correct underlying digestive and leaky gut-related issues as a core of other conditions.
Resolution of underlying infections, i.e., yeast overgrowth/candidiasis
Change of diet, elimination of food allergens
Supplements, including probiotics and digestive enzymes, among others
In working with my patients, I know the importance of understanding the underlying cause of their disease and symptoms. If you are concerned about digestive issues, and live in New York City, contact my office.
Sublingual immunotherapy is an increasingly popular treatment for seasonal and other allergies. How does it work?
Intended to prevent and treat disease or allergen-caused conditions, immunotherapy introduces material (like a germ or an allergen) to the human immune system to provoke an ultimately helpful response. It functions similarly to vaccines, which can protect you against certain viruses or bacterial infections.
In an earlier post, we discussed types of allergen-specific immunotherapy (ASI) like subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT).
For those who suffer chronic seasonal allergies, or mild asthma, ASI has numerous advantages that include:
Better, more comfortable quality of life
Reduction of symptoms related to allergic rhinitis and allergic asthma
Decreased reliance on medications like antihistamines, decongestants, and nasal sprays
How does immunotherapy work?
Allergen-specific immunotherapy works by desensitizing your system to the allergens that causes your symptoms and discomfort.
As part of the immunotherapy process, you undergo testing, using skin-prick tests or lab work, to identify the specific allergens causing your allergic response. Unlike medications aimed at managing general allergy symptoms, testing focuses on finding the cause.
Creating a clinical history is part of ASI, to ensure you are a good candidate for treatment. Talk to your doctor about the advisability and safety of allergen immunotherapy under conditions such as:
A patient under five years of age
Pregnancy, or potential pregnancy
Presence of severe allergies, strong allergic reactions, or average to severe asthma
Underlying medical conditions, or taking certain medications
What about sublingual immunotherapy?
Once specific allergens are identified, you have a choice of treatments including lifestyle changes, medication, allergen avoidance, SLIT, or SCIT.
SLIT and SCIT are therapies developed to address the problem, not mask the cause. By desensitizing your immune system to specified allergens, your symptoms are reduced.
Whether you receive injections, or take tablets or drops, you receive small amounts of the allergens causing your symptoms. It may sound backward, but it works. Here is the process with SLIT:
After placing a tablet or drops under your tongue, the extract dissolves and is absorbed through the mucous membrane in your mouth, with few side effects. Any residue of a tablet is swallowed and makes its way to the small intestine.
Throughout the duration of treatment, the daily dose of allergens causes changes in cellular activity to reduce local inflammatory reaction to the allergen, and blunt the build-up of symptoms during active exposure (allergy season).
SLIT and SCIT work similarly to achieve the same goal. Because the delivery mechanisms are different, so is your experience. Consider these differences:
Delivery: Subcutaneous injections – allergy shots — are usually given weekly, at the office of your physician for the first year. The initial dose of a sublingual extract is given at the doctor’s office, thereafter, once a day at home. Over time, the amount of allergen in each dose is increased to reach a target or maintenance level dose.
Duration: Treatment by injection or extract is generally given over a three to five-year period. Improvement in symptoms may occur within, or after the first year of treatment. Many patients drop out of treatment before it is concluded. With the relatively convenient, painless delivery of SLIT, busy patients can maintain their health—and their schedule.
Side effects and safety: Side effects of SCIT may be similar to the allergy itself—coughing, headache, fatigue, sneezing, and redness, pain, or itch at the site of injection. SLIT can cause throat irritation or mild itching or swelling in the mouth. Though rare, both modalities can trigger anaphylaxis, a life-threatening allergic response.
Effect and benefits: Both SLIT and SCIT are considered effective. At present, research studies do not find either treatment more effective than the other. Long term benefits of allergen-specific immunotherapy include cessation or reduction of symptoms, potential avoidance of onset of allergic asthma, or more serious allergic reactions.
Cost: Currently, many health insurance companies reimburse for the cost of SCIT for allergy relief, excluding co-pays. Because approval of sublingual extract tablets was not approved by the U.S. Food and Drug Administration (FDA) until 2014, some insurance companies do not yet reimburse for SLIT.
Already in use in European countries, expanded use of sublingual extracts and tablets offers Americans an effective, easy alternative to improve their health—and quality of life.
If you have questions about sublingual immunotherapy in the New York metro area, contact my office for more information.
If you suffer the misery of seasonal and other allergies, here is some good news you can use. A novel form of treatment may save you time—and the pain of allergy injections.
In April of 2014, the U.S. Food and Drug Administration (FDA) approved the first extract for use with sublingual immunotherapy (SLIT). How is SLIT different from regular allergy shots and what could this mean for you?
Are you allergic?
Allergies occur when your immune system comes in contact with a substance it identifies as a harmful intruder. Most allergens are harmless, but allergic reactions can be serious, even deadly. Food, drinks, and the environment are common sources of allergens.
According to the Agency for Healthcare Research and Quality (AHRQ), between 20 and 40 percent of adults in North American suffer allergic rhinitis, or hay fever. Globally, allergic rhinitis affects about 400 million people. Allergic rhinitis is considered a risk factor for asthma, a chronic inflammatory condition of the lower airways. For children and adults, effective treatment of hay fever often reduces the severity of asthma.
There are a variety of common triggers for hay fever and asthma, including:
Household allergens: Dust, mold, pet dander, and dust mites
Situational substances: Air pollutants like tobacco smoke, off-gassing carpets, varnishes, cleaners, and other products
Environmental allergens: Botanical allergens like pollen from grass, plants, and trees
Symptoms commonly associated with hay fever include:
Itchy eyes, nose, or mouth
Watering, red, or swollen eyes
Head and ear pressure, often with pain
Runny and congested nose, sneezing, and sinus pressure
General malaise and fatigue
Each year, allergic rhinitis, and asthma have a significant impact on the health of those who suffer these symptoms, and those who care for them. Those burdens include:
Reduced quality of life
Lost productivity and work days
Increased medical expenses, doctor, and emergency department visits
Decreased learning ability
Greater difficulty in social situations
Higher incidence of sleep disorders
If you suffer allergies, understanding your treatment options is essential.
Allergy management in the United States
In the United States, a prominent form of medical management of allergies, and allergic asthma, is subcutaneous immunotherapy (SCIT), or the injection of small doses of specific allergens under the skin of affected patients. Other types of treatment include:
Identifying and avoiding allergens
Making lifestyle changes to manage allergens
Prescriptive use of antihistamines, decongestant, and nasal steroid sprays
Used in European countries for years, sublingual immunotherapy uses small doses of specific extracts to provoke an immune response in a patient. The word “sublingual,” simply refers to where the dosage is administered—under your tongue—where it painlessly dissolves.
While available in the United States as an off-label treatment prior to approval by the FDA, the acceptance of a sublingual allergen extract by that regulatory agency is a positive step for millions of allergy sufferers.
Understanding sublingual immunotherapy
Immunotherapy is a broad term used to describe stimulation of an immune response to manage or prevent a disease. When you receive an influenza (flu), or tetanus vaccination, you are triggering your immune system to more effectively fight invading germs.
The focus of allergy immunotherapy is the reduction of symptoms through the administration of small doses of allergens. As we discussed, two forms of allergen specific immunotherapy (ASI) include SCIT and SLIT. Points about these treatments include the following:
Both treatments are considered effective for allergic rhinitis and minor asthma. The management of these conditions reduces long-term use of medication, associated costs, and the potential worsening of symptoms.
SCIT is administered through injection, usually in the upper arm. SLIT is given in tablet or droplet form under the tongue, where it dissolves.
Injections may be administered weekly. Allergy drops are administered daily.
Allergen specific immunotherapy works by increasing the dosage, and your tolerance, to a specific allergen. Over time, a target or maintenance dose is reached. The time to reach that target dose is different for SCIT and SLIT. SCIT may take longer to reach the target dose than SLIT
Subcutaneous injections are given in a physician’s office until the maintenance dose is reached. Allergy drops are administered the first time in a physician’s office, thereafter, they are taken at home.
Currently, SLIT is not covered by most insurance providers. SCIT is commonly covered by health insurance.
Chronic and seasonal allergies are nothing to sneeze at. If you have questions about SCIT or SLIT, contact my office in New York or a qualified physician in your area.