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DR. MICOZZIS INSIDERS CURES
air pumped into the colon (to inflate it This despite the continual call from
Marc S. Micozzi, M.D., Ph.D., is a for easy examination) escaped into the mainstream medicine for ever more
worldwide leader in nutritional and patients abdominal cavity. It put so randomized, controlled, clinical
complementary/alternative medicine. much pressure on the liver that it cut trialswhich are considered the
He has had a distinguished career as a
off blood supply back to the heart. The gold standard.
researcher and physician executive at
the National Institutes of Health and
patient died from shock. Until the last 10-15 years,
Walter Reed National Military Medical To make matters worse, colonoscopies were only performed
Center in Washington, DC, and the colonoscopies are often prescribed in doctors offices. And only on
College of Physicians in Philadelphia more frequently than medical patients at high risk for colorectal
PA. He has published over 30 medical
guidelines recommend. cancer or who were experiencing
and trade books, and founded and
edited the first scientific journal, and ACOG in the wheel intestinal bleeding.
the first textbook, on complementary/ Ten years ago, apparently having Then doctors reported they
alternative and nutritional medicine, run out of things to say on TV could detect early cancers even in
now going into a 5th edition (2014) and
from one end, Katie Couric had her people who are not at high risk and
continuously in print since 1995.
colonoscopy performed on the other dont have bleeding. But, according
Dr. Micozzis Insiders Cures is published end, live, on national TV. Patients to an article published in the Journal
monthly by OmniVista Health Media, L.L.C., began demanding them like the of the National Cancer Institute,
819 N. Charles St., Baltimore, MD 21201 for latest cosmetic procedure. Then, the there is no compelling evidence that
$74 per year ($6.16 an issue). American College of Gastroenterology colonoscopy offers any additional
POSTMASTER: Send address changes (ACOG) successfully lobbied benefit over the older, cheaper,
to Insiders Cures, 819 N. Charles St., Congress to have the procedure safer tests.4
Baltimore, MD 21201. covered by Medicare (in other words, And the bottom line is no study
Author: Marc S. Micozzi, M.D., Ph.D. us, the taxpayers). has shown that colonoscopy prevents
Publisher: Katherine Wheeler So now, when you become eligible colorectal cancer incidence or
Executive Editor: Amanda Angelini
for Medicare at age 65, with the 15 mortality any more than the other safer,
All material in this publication is year lag time for a polyp to become less expensive screening methods.
provided for information only and may cancerous, this Medicare benefit can And dont forgetcolonoscopies
not be construed as medical advice or help you avoid coming down with
instruction. No action should be taken can miss polyps that are present.
colorectal cancer at age 80 years or In July, I sent out a Daily Dispatch
based solely on the contents of this
publication; readers should consult
older, on average. Just doing the math. reporting on a study which showed
appropriate health professionals on any But I digress that with each passing hour of the
matter relating to their health and well- The fact is, several much less day, gastroenterologists are nearly 5
being. The information provided in this expensive and less dangerous percent less likely to detect a polyp
publication is believed to be accurate
techniques are also effective. Yet during colonoscopy.
and sound, based on the best judgment
specialist medical practitioners
available to the authors, but readers Nonetheless, the ACOG
have (not surprisingly) picked the
who fail to consult with appropriate unilaterally declared colonoscopy as
health authorities assume the risk of any most expensiveand dangerous
the preferred approach to colorectal
injuries. The opinions expressed here do option. Without any scientific data to
cancer prevention. It certainly was
not necessarily reflect the views of the support it. I know it sounds bizarre,
preferred when it came to collecting
publisher. The publisher is not responsible given all the hype and increased
membership dues, apparently.
for errors or omissions. recommendations for colonoscopy
For questions regarding your subscription, but its true. Of course, colonoscopy has also
please call reader services at 443-353-4398 become very lucrative. One analysis
In fact, according to a study
(8 a.m. to 8 p.m. EDT Mon.-Fri.) even reported colonoscopy is the
published earlier this year in the
Copyright 2013 OmniVista Health reason the U.S. leads the world in
American Journal of Gastroenterology,
Media, L.L.C., 819 N. Charles St., Baltimore, health expenditures!
colonoscopy has never even been
MD 21201. Reproduction in whole or
compared to other, much saferand But some primary care doctors
in part is prohibited without written
permission of the publisher. less expensivescreening methods dont realize the costs of the tests and
head-to-head in randomized trials.3 procedures they prescribe.
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DR. MICOZZIS INSIDERS CURES
The most expensive hour youll For anesthesia during one surgical Anesthesiologists lobbies strongly to
ever spend procedure, for the exact same service, keep in place, of course).
A colleague of mine in Hartford, one anesthesia group practice charges So all of this leads us to the $1
CT recently called the local hospital $6,970 from a large private health billion question
in order to price a colonoscopy. And insurer, $5,208 from Blue Cross Blue
Shield, $1,605 from Medicare, and What are the alternatives?
even he couldnt get an answer.
$797 from Medicaid.5 What is the real Here we have yet another situation
Because this routine screening where the most expensive, most
cost of providing this service? Who
procedure can cost anywhere from dangerous screening procedure has
knows!
$6,000 to nearly $20,000. For an simply never been proven to be better
outpatient procedure requiring less A better question is: Why are
than less expensive, safer procedures.
than an hour. anesthesiologists involved in
colonoscopies at all? Three proven alternatives to
Again, they are the most expensive colonoscopy are:
screening tests that otherwise Colonoscopy does not require
healthy Americans undergo. In general anesthesia. Moderate 1.) The long-established hemoccult
fact, colonoscopies in the U.S. sedationa drug like Valium, test detects blood in the stool as a
often cost more than childbirth or or another intravenous medicine sign of intestinal bleeding. When
an appendectomy in most other that takes effect and wears off there is bleeding in the lower
developed countries.5 quicklyis all you really need. intestinal tract it can be seen as
Both of which could technically be bright red blood in the stool. But
But colonoscopies represent such a administered by any nurse in any when the bleeding is higher up, the
large financial burden because, unlike doctors office. There is no clinical blood breaks down and becomes
hip replacements, c-sections, or even benefit whatsoever from having invisible, or occult. Fecal occult
nose spray, everybody gets themor anesthesiologists involved in this blood testing can decrease the risk
is supposed to, whether they need it procedure. But it adds a further cost of death from colorectal cancer
or not. of $1.1 billon per year.7, 8 by 33 percent.9 Not bad for a test
The final knock-out blow So, who is keeping the that is cheap, completely safe,
And on top of all this, there is anesthesiologists where they dont non-invasive, and that you can
the wild west of administering belong? Our friends at the FDA. administer yourself in the privacy
anesthesia during colonoscopies. They refuse to modify the drug of your own bathroom.
Not only does anesthesia add to the labels advising that moderate 2.) To get an actual look inside
procedures risk, but this service is sedation must be performed in the the lower intestine, opt for
billed separatelyand is all over presence of an anesthesiologist (a a sigmoidoscopy. Unlike
the map. policy that the American Society of Continued on page 4...
colonoscopy, which examines the out several more specific guidelines job of reducing mortality from this
entire colon, sigmoidoscopy only for individual casesincluding disease.
enters the lower large intestine, instances of positive fecal occult If you have your doubts about
which is where most cancers occur. blood tests (FOBT), and to deal getting a colonoscopy, make sure
Several recent studies have shown with the frequent problem of an to consult with your primary care
that this screening method is as incomplete colonoscopy. physician regarding your family
effective as colonoscopyif not Please dont misunderstand my history, personal medical history,
more so.10,11 In fact, according to intention. In no way am I downplaying and any current health problems
one of these studies, getting just the importance of colorectal cancer or symptoms, to find out whether
ONE sigmoidoscopy between the and effective screening for this starting with safer, less expensive
ages of 55-64 can reduce incidence potentially deadly disease. However, optionsa hemoccult test, a
of colorectal cancer by 31 percent Iand many othersdo take issue sigmoidoscopy, or the new CT
and colorectal cancer mortality with the medical subspecialists colonography scanmay be right for
by 38 percent.12 A sigmoidoscopy carte blanche recommendation of you for colorectal cancer screening
can be done right in your doctors colonoscopy. The available science and prevention.
office and doesnt require any simply doesnt support it as the be-all, And remember, you can lower
sedation. Which makes it much less end-all of colorectal cancer screening. your risk of colorectal cancer in
expensiveand also much safer And, as always, when it comes to your the first place (and any other form
than colonoscopy. health, its absolutely critical to follow of cancer, as well as many other
3.) A relatively recent development the science. chronic diseases, for that matter)
has been CT colonography, The fact is, there are serious risks by following the diet, exercise,
which involves doing CT scans to associated with colonoscopyand and supplement recommendations
detect colon polyps. In general, CT its superiority is unproven. But there youll find throughout your issues of
colonography is done every five ARE alternatives. Safer ones. That do Insiders Cures. IC
years, but radiologists have worked a better (or, at the very least, safer) Citations available online at www.DrMicozzi.com
NEWS BRIEF
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DR. MICOZZIS INSIDERS CURES
into the diseased eye using very fine maintain the peripheral nerves of the A healthy dose of B12
syringes. body. So it stands to reason they can (cyanocobalamin) is 20-40 mcgs per
As I pointed out recently, preparing benefit the highly specialized nervous day, and 800-1,600 mcgs of folate
drugs for injections is a risky tissues of the eye and retina. per day. You can also ask your doctor
business. The extra handling and Previous studies have noted about getting periodic B12 injections.
exposure greatly increases the risk of statistical associations between The second study, called LUTEGA,
contamination. serum homocysteine levels, vitamin is evaluating the benefits of
Indeed, earlier this year, a B12, folate, and age-related macular carotenoids, omega-3 fatty acids,
compounding pharmacy in Georgia and antioxidants for AMD.
recalled 40 lots of vials. Turns out, Fortunately, you can skip One group of patients was given
several AMD patients developed the dangerous injections 10 mg of lutein, 1 mg of zeaxanthin,
bacterial endophthalmitis after 100 mg of the omega-3 fatty acid
receiving Avastin injections. and the pricey drugs too. DHA, and 30 mg of the omega-3 fatty
And that wasnt the first time You dont need drugs acid EPA per day. A second group
Avastin caused problems. was given double these daily doses.
at all to treat macular And a third group didnt take any
In 2011, 16 people in Florida and degeneration. Two new supplements.
Tennessee lost their eyesight following
Avastin injections. In those cases, studies show that a few key After one year, researchers found
patients brought malpractice lawsuits that vision had improved among
nutrients may be all you all the patients taking supplements.
against doctors, clinics and hospitals.
need to save your vision. Improvements were the same with
A study published last year in the both the lower dose and higher dose
American Journal of Ophthalmology of these supplements. However, vision
investigated the problems with degeneration (AMD). But this new
study investigated how intake and deteriorated in the control group.
Avastin.1 The researchers found that
the drug itself wasnt the problem. blood levels of B12 and folate affect Lutein and zeaxanthin are two of
But rather, the compounding incidence of AMD over 10 years. the carotenoids my colleagues and
procedures used to prepare the tiny Blood levels were measured in I discovered during the 1980s when
ophthalmic syringes. samples drawn during 1997-1999 we examined the nutrient content of
from a cohort of study participants foods that protect against cancer. No
Essentially, this is the same kind of one had ever heard of them before
thing we saw back in 2012 with steroid 55 years and older. Dietary intake of
B12 and folate were assessed using then. When I was interviewed on
injections for neck and back pain. As NIH Radio about our findings, the
youll recall, contaminated steroids a food frequency questionnaire. And
the presence of AMD was assessed by commentator said it was too bad
caused dozens of deaths and hundreds these particular carotenoids were not
of debilitating neurological illnesses. taking retinal photographs.
(then) available in supplement form.
Fortunately, you can skip the Higher homocysteine levels showed I said not to worry because they are
dangerous Avastin injections. And the a linear, dose-response increased risk available in every grocery storein
pricey AMD drugs too. You dont need of AMD. leafy green, and yellow-orange fruits
drugs at all to treat AMD. Patients with lower serum B12 had and vegetables.
a 1.58 times higher risk of developing Of course, these carotenoids are
New vision cure from age-old
nutrients early AMD and a 2.56 times higher available in supplement form now
risk of later AMD. both alone and in combination. But
Two new studies show that a few
key nutrients may be all you need to Lower folate levels were associated even if you do choose a supplement,
save your vision. with a 75 percent increased risk of I always recommend following a diet
early and 89 percent increased risk of high in fruits, vegetables, and fish.
The first study, published in May
later AMD. In addition to helping preserve your
in the American Journal of Clinical vision, eating in this healthy way has
Nutrition found that vitamin B12 and Patients who took B12 supplements
had a 47 percent reduced risk of many other benefits as well. IC
folate decrease the risk of macular
degeneration.2 These B vitamins help AMD.3 Citations available online at www.DrMicozzi.com
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DR. MICOZZIS INSIDERS CURES
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