Ecstasy and mushrooms are being used by the medical and psychiatric community to help heal depression, anxiety, and PTSD. Both these substances have recently been approved for further studies of their ability, with highly trained support in a controlled setting with active therapy, to help patients who have not found relief elsewhere.
A story in the New York Times today discusses the use of psilocybin, also known as magic mushrooms, in patient’s whose cancer brought them to a desperate place of depression and anxiety. While the researchers are not clear on how this drug works exactly, the trials thus far show it is effective, and after only one dose when administered in a controlled setting by psychiatrist and a social worker in a session lasting 8 hours. There were two small studies and both reported success with patients in whom traditional treatment had not led to improvement. There are also studies being done to look at its role in addiction treatment and non-cancer depression.
A story linked to in this same article discusses the use of ecstacy, or Molly/MDMA, in treating PTSD (post traumatic stress disorder). We think of this in soldiers who have returned from war, but it occurs in civilians with the same triggers- either a single traumatic event or repeated traumas like abuse. It seems that while the brain is under the influence of this medication, it can finally confront the trauma that caused the condition and this trauma can be dealt with during a therapy session much like the one used in the psilocybin trials. The brain and body overreact in an inappropriate way to a given stimulus and can’t stop- to the point where it interrupts the person’s life. This can manifest in nightmares or panic attacks or other reactions that make daily living incredibly difficult.
While psilocybin is a natural substance, and MDMA was created in a lab, both seem to allow the patient to look at themselves and their experiences from a detached perspective and examine thoughts and emotions. Despite a number of treatment approaches including medications and psychotherapy techniques, there is none that hugely effective in treating PTSD and many other mental illnesses. The FDA is allowing these studies to proceed in hopes of offering a cure, in a relatively short course of treatment, for illness that is resistant to conventional therapies. Moving these drugs off the most restrictive DEA schedules is essential to conducting clinical trials, just like what needs to be done for marijuana (which I wrote about last week). I’m looking forward to a day when all medications that have the potential to be medically useful are allowed to be fully investigated in clinical trials.
Our November election offered good news for marijuana. Several states, including California, Nevada, Maine and Massachusetts, voted to legalize recreational marijuana, joining Colorado, Oregon, Alaska, and Washington State. Many more states have legalized marijuana for medical purposes- although the qualifying conditions vary by state. A total of 26 states, plus the District of Columbia, have approved this use and these states have been helpful for studying the effects of marijuana on patients as a group.
Overall the studies show that marijuana legalization decreases the deaths from opioid overdoses. Scientific American wrote a great article summarizing the recent studies on marijuana and opioid use. Marijuana (cannabinoids are the names of the chemical group) has been shown to decrease dependence on prescription opioid pills like Percocet and oxycontin and is a pathway for people to get off the dangerous drugs. As people become accustomed to an opiate, they require a higher dose for the same effect. Since these substances can be lethal, the dose required to relieve pain can near the lethal dose and lead to death. In 2014, 14,000 people died from unintentional overdose of prescribed opiates. Guess how many people died in 2014 from marijuana overdose? Zero, and that’s according to the DEA. Marijuana use does not lead to overdose and it is far less addictive than opiates or even alcohol or cigarettes. This is why so many states have passed legislation to legalize it. The hold up, in terms of wider use of cannabinoids in medicine, is with the DEA (Drug Enforcement Agency) which still classifies it as a drug with no medical use. With the Class I status it is difficult to procure the substance in order perform clinical trials. Since the pharmaceutical companies don’t stand to profit from marijuana there is no financial incentive for funding studies or money for lobbying the DEA. Currently, it is easiest to look backwards at data and plainly see how different symptoms or behaviors changed, how many fewer opioids were prescribed, and how many fewer people died when medical marijuana was available to patients. We are also starting to see the benefits of cannabinoids in treating not just pain or nausea, but also in helping with mental health issues as well, such as PTSD and depression. The use of cannabinoids for pain is so widespread now that the NFL is about to consider allowing their players to use cannabinoids for pain as so many ex-players have found relief from its use and have cut their opiate use.
Here in the District of Columbia, the use of medical marijuana is legal, as well as the recreational use by private citizens if it is not sold. Let’s hope the federal government allows states to keep the laws here in DC and across the nation. Let them also see the wisdom in correcting the DEA classification so that bigger studies can be performed and we can incorporate cannabinoids into everyday evidence-based practice.
What if bright light for 30 min each morning could increase a man’s sexual satisfaction and even boost his testosterone levels? How much less Viagra would be prescribed?
We know that light therapy (using a lamp that that has the right wavelengths and strength) is an effective treatment for SAD (seasonal effective disorder). We are still in the midst of learning about light therapy and all of its potential. But knowing that most babies are conceived in June, when we have the maximum hours of daylight, there is a basis for looking into the effect of light on reproduction. A group in Italy studied a group of 38 sexually unsatisfied men and shared their results with the European Congress of Neuropsychopharmacology in September. This group of men had a mean sexual satisfaction score of 2/10 at the beginning of the study. After just 2 weeks of treatment with 30 minutes of 10000 lux light each morning, the mean score had increased to 6/10. In the control group, who was treated with filtered light, the mean score was 2.7/10. In addition to the subjective satisfaction score, the mens’ testosterone levels almost doubled. The retinohypothalamic tract (sunlight to retina to hypothalamus) is well established as the circadian rhythm pathway. Treating our brains with bright light at various times of day has different effects. Bright morning light helps us wake up, energizes us, and according to this study may improve a man’s sexual satisfaction and testosterone levels. Conversely, bright light at night, or even that from our phones and computers, can cause insomnia, make it hard to get out of bed in the morning, and affect our mood in a negative way. We’ll have another post about that soon, along with information about the types of lights needed.
This is a fascinating area of study. Be prepared to see more chronotherapy (time and light therapies) as they are non-pharmacologic treatments. That means they cost less, and have fewer side effects or interactions with medications, and they are helpful for mental health issues at the very least, if not more. Further, here at any of our Kelly Goodman Group locations we are open to discussing any complementary, integrative, or functional medicine treatment you would like to try.
In addition to its known benefits of improving bone and heart health, adding a natural supplement of Vitamin D may boost our immune system. So, we know that certain groups of people are deficient in D- like darker complexions, higher body fat, and indoorsy types. Fat cells absorb Vitamin D and keep it out of circulation so those of us who have any extra weight (and females have a higher body fat percentage anyways) are likely deficient. Also, if you have a darker complexion or use sunscreen outside it’s really difficult to absorb enough of the sunlight in our skin to make this vitamin. While we are still sorting out the ideal level of Vitamin D in our bodies, there is decades of evidence that this vitamin our bodies produce naturally is essential in achieving and keeping our optimum level of overall health. Our bodies make Vitamin D in our skin when we are exposed to sun. We’ve all been spending less time outside, and people who live in the northern half of the US (or similar latitudes around the world) don’t get enough sunlight.
You know how milk says “Vitamin D” on the label? Well, that’s because we can’t absorb calcium without Vitamin D so the milk producers add it to the milk. We have a tough time using that calcium to build bones without enough D. So while we all know calcium is essential to build and maintain bones and avoid osteoporosis in our later years, that calcium is not useful unless it has its helper- Vitamin D. This means people who follow a vegan diet are also at risk of low D (in addition to B12 and iron).
High blood pressure, heart attacks, strokes, and heart failure are all linked to low levels of Vitamin D as well. Huge clinical trials are being done right now so that we can determine how much of an impact supplementation has on improving heart health.
What we are also realizing is that we have Vitamin D receptors on our immune system cells. People with low D levels are more likely to have auto-immune disorders and increased risk of infection in general. Remember how people with Tuberculosis were sent to sanatoriums to go sit in the sun? And how cod liver oil has been used for centuries for general health? Well sitting in the sun and drinking cod liver oil both increase your Vitamin D level- they were on to something!
Come in and see us at any of our Kelly Goodman Group locations and we can check your Vitamin D level (our Nurse Practitioner draws your blood herself). Once we know your level we can advise you on how best to supplement this essential vitamin and prescribe a prescription strength Vitamin D if needed. Say no to colds and flu this fall and yes to bone and heart health!
Are you experiencing recurrent UTI/bladder infections? Although most women (50% by age 32 according to Cleveland Clinic) experience a urinary tract infection, for some people these become a recurring concern. Studies claim anywhere from 20% to 40% of women who get one UTI will develop another. And of course they seem to come at inopportune times- the day before a big work event, on vacation, or with a new sexual partner. So what do you do when that first stab of pain occurs or the burning starts with urination? First, give us a call to stop by for a quick appointment that same day- even on your way to work! We can check a urine sample in office and start you on a safe antibiotic that has low resistance in our area and very low chances of side effects. We can send out a sample for culture to be sure we know exactly what it is and make any necessary adjustments to treatment to be sure it doesn’t come back. We can also prescribe medication that effectively numbs the urethra and soothes the pain (although it does turn your urine bright orange… can anything be subtle?).
So maybe this is your first UTI. In that case just be sure to use best practices to avoid another one: stay hydrated, empty your bladder regularly (including after sex), and wipe front to back after elimination and/or defecation.
But what if this is your second infection in recent memory? Or even your third or fourth? What then? Well you have some options. Let’s get a culture to determine if the germ is resistant to the medications you’ve been taking and simply was never treated effectively. Depending on the severity and frequency of infections, we can start you on various types of antibiotic regimens. However, many people would prefer to try to avoid the use of antibiotics whenever possible or are looking for more natural alternatives. In this case, please consider the use of two supplements. One is D Mannose and the other is lactobacillus.
We’ll start with the D Mannose– this can be used to treat an active mild infection and to prevent future infections. In fact a controlled study showed that patients treated with D Mannose went much longer (200 days vs 52 days) between repeat infections than those treated with an antibiotic (Bactrim orTMP/SMX- a sulfa type of antibiotic). This substance naturally occurs in fruits like red berries (such as cranberries) and fruits like apples and peaches. But it’s difficult to get enough through food sources alone to have an impact on urinary health. D Mannose helps keep the bacteria from attaching to the side of the bladder and so it can then be flushed out easily.
The other preventive treatment is lactobacillus aka probiotics. We hear so much about the countless benefits of probiotics for our immune system and digestive system. In this case, the lactobacillus family of probiotics (indicated by a lower case “L.” on the ingredient list) has been shown to reduce recurrences of UTIs by half, almost as much as an antibiotic regimen. If you also suffer from vaginal yeast infections this could be a wonderful way to reduce chances of another yeast infection or bladder infection.
Click on our website Kelly Goodman Group or give us a call at any of our locations to make an appointment. Stop going to Urgent Care over and over and come to Promenade Primary for your UTI so we can try to make it your last one!