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Asthma, Nutrition and Drug Alternatives

ASTHMA, NUTRITION AND DRUG ALTERNATIVES

Asthma is a hypersensitivity condition of the lungs associated with spasm of the bronchial tubes, difficulty breathing, shortness of breath, wheezing,, coughing and the excessive production of bronchial mucous. There are basically two types of asthma:

1) Extrinsic/Atopic asthma caused by allergies mediated by the IgE family of antibodies, commonly dust, molds, pollens, animal danders, tobacco smoke and foods.

2) Intrinsic asthma due to cold air, exercise, infection, emotional and other stresses.

Most asthmatics have a mixture of the two types, the extrinsic type being more common. Asthma prescription inhalers (“puffers”) and pills provide temporary relief, but do nothing to halt the progression of the disease and may actually hasten it. Most conventional medical treatments of asthma do not address the underlying cause(s) and are generally aimed at symptom suppression.

Since 1980, the prevalence and incidence of asthma has increased by 80%. It affects at least 5% of the population and is most common in children under the age of 10 with boys affected twice as often as girls. Asthma is now the major cause of school absenteeism for children under 15 years of age in North America and can be a potentially life threatening condition. In fact, the mortality rate from asthma has increased by 300% since 1980.

Why is this happening? Most experts say it’s due to air pollution, increasing chemicals in the diet and the weakening of the immune system by antibiotics, fluoride, chloride, lead, mercury and other toxins. Some of the sources of these toxins include chemical household products, wood preservatives, floor and wall treatments, carpets, rugs, drapes, and synthetic- impregnated furniture.

Less well recognized reasons for the higher incidence are aspartame consumption and vaccines (especially hepatittis B, chickenpox and the flu shot) containing mercury, formaldehyde, aluminum, foreign genetic material and other potential toxins. Still other reasons for the increasing asthma ratesare a relative increase in indoor house mite infestation, indoor natural gas from furnaces, water heaters, and stoves that generate nitric oxide residues. Some authors have also questioned the connection between rising asthma rates and the greater use of the microwave oven, a cooking tool capable of creating never before seen molecules of unknown toxicity. The same can be said for the ever-increasing availability of genetically engineered foods, many containing the DNA of other species of plants and animals.

Natural Treatments

Practical things to start with are to push fluids to loosen bronchial secretions. The average adult should consume at least 2 liters of spring water daily, proportionately more if activity level is higher. Avoid chlorinated or fluoridated tap water. Use a vaporizer with added eucalyptus, thyme, tea tree oil or oil of oregano.

If possible, get food allergy testing done via an elimination – provocation procedure (described in my book,” Childhood Illness and The Allergy Connection” or Dr. William Crook’s “Tracking Down Hidden Food Allergies”). An alternative way of testing for food allergy problems is blood tests that measure antibodies or immune complexes directed at specific foods. Tests that I feel are usually reliable for this purpose are the IgG RAST and various other ELISA tests. Environmental allergies (dust, grasses, trees, pollens, etc.) can best be determined by skin testing done by an allergist. Generally, the younger an asthma patient, the more the allergen triggers are likely to be foods. The older a patient, the more likely the allergens are environmental inhalants.

Asthmatics should avoid sugar and white flour products because of their negative effects on the immune system. Decrease consumption of foods with arachidonic acid (red meat and dairy products) because of their pro- inflammatory, acid-forming effects in the body.

It has been known for over 60 years that at least 80% of asthmatics produce too little hydrochloric acid in their stomachs. In these cases asthma can be improved by supplementing acid (glutamic acid, betaine and pepsin hydrochloride, stomach bitters, other digestive enzyme supplements). Many asthmatics also have poor pancreatic function and inadequate secretion of digestive enzymes. As a result, high protein foods may not be digested completely and, when absorbed into the bloodstream, may evoke an allergic reaction such as wheezing. This is especially the case if the individual suffers from what is called “the leaky gut syndrome” in which there are microscopic sized perforations in the usually intact gut lining. A repair program using supplements such as L-glutamine, gamma oryzanol, bioflavonoids and other potent antioxidants can be implemented.

Also, eliminate food additives like tartrazine, sodium benzoate, sulfur dioxide and all sulfites (sodium bisulfite, potassium metabisulfite, potassium bisulfite).

 

SIDEBAR ASTHMA – NUTRITION CONNECTIONS

Eat foods that reduce inflammation and open up the bronchi: garlic, onions, leeks, turnips, endive, green leafy vegetables, carrots. Celery, spinach, horseradish, daikon apricots. Cherries, elderberries, grapes, pineapple, figs, papaya, mango, lemon and honey high omega-3 and –6 fatty acid foods like salmon, herring, mackarel, sardines, almonds, sunflower and pumpkin seeds., walnuts, flax seed oil, evening primrose oil, black currant seed oil and borage oil, sprouted seeds and grains.

Avoid known food allergies and mucous forming foods: cow’s milk and other dairy productswhite bread, sugar and other refined or processed carbohydrates, chocolates,salty and fried foodsfoods high in arachadonic acid like beef, pork and cold cutscanola oil, corn oil, peanuts, pistachios and margarine

 

Natural Anti-inflammatory Supplements (doses depend on age, tolerance and severity of the condition) all help decrease leukotriene formation and reduce inflammatory compounds.

iNTEGRA RESP FX          INTEGRA LUNG CLEANSE        

Essential Fatty Acids e.g. fish oils (cold water fish like cod and halibut, herring, sardines, salmon and trout), hempseed oil, evening primrose oil, flax seed oil, borage oil, black currant seed oil – all have powerful anti- inflammatory effects and can reduce or eliminate asthma symptoms through their content of omega-3-EPA.

Vitamin B12 injections – Dr. Jonathan Wright has shown that daily vitamin B12 shots will reverse asthma, especially in children. The exact mechanism of how this takes place is unknown.

Vitamin C – asthmatics have been shown to have lower serum levels of vitamin C as well as lower levels in white blood cells.

AOR Pro-bioflavanoids 

Other Anti-inflammatory Supplements:

Carotenoids – anti-oxidant Vitamin E – anti-oxidant Selenium – anti-oxidant N-acetyl-cysteine –precursor to glutathione, a very powerful antioxidant; also has strong mucolytic (dissolving mucous) effect

Coenzyme Q10 – antioxidant especially important for healthy cellular (mitochondrial) respiration and energy Magnesium – relaxes bronchial smooth muscle Molybdenum – a mineral that activates an enzyme capable of neutralizing sulfites.

Potassium iodide liquid – effective mucous expectorant and natural antibiotic: lymphatic stasis and chronically inflamed or enlarged lymph glands are also helped by liquid iodine solutions Querecetin and other bioflavonoids (rutin, grape seed extract, pycnogenols, catechin, hesperidin) are all powerful antioxidants which help stabilize the mast cell membrane and strengthening capillaries and other blood vessels. They help prevent or weaken any allergic reaction to a food or chemical.

 

Herbal and Other natural Remedies

Astragalus – boosts immunity and lung strength; boosts interferon production thereby helping to reduce the number of infectious episodes. Ephedra (Ma Huang) – controversial because of its effects on the heart and blood pressure but used for over 5000 years in Chinese Medicine as an effective bronchodilator. It’s best used in lowest effective doses in combination with herbs and nutrients that support the adrenal glands like licorice root, ginseng, vitamin C, zinc, vitamins B5, B6 and magnesium.

Herbal Expectorants Lobelia, Licorice Root, Grindelia, Euphorbia, Sundew and Senega – help clear irritants from airways.

Chinese Skullcap (Scuttalaria Baicalensis) – an anti-inflammatory herb high in bioflavonoids which stabilize the mast cell membranes and help prevent histamine release caused by allergens.

Angelica Sinensis – prevents the formation of IgE antibodies. Elecampane - effective as a cough remedy but also has anti-microbial properties.

Licorice Root (Glycyrrhiza Glabra) – works to reduce inflammation and asthmatic symptoms due to its ability to prolong the half life of the bodys own cortisone.

Curcumin - the yellow pigment of tumeric (Curcuma longa) is primarily an anti-inflammatory agent comparable to cortisone, ibuprofen and other NSAIDS.

Forskolin - is a derivative of the herb Coleus Forskoli and has been found to be a good natural bronchodilator. It does this by inhibiting the release of pro-inflammatory compounds and inhibiting the smooth muscle contraction in the airways.

Garlic and Onions – high in vitamin C and quercetin inhibit the production of pro-inflammatory chemicals called leukotrienes

Probiotics (lactobacillus acidophilus and bifido bacteria) are friendly bacteria that help prevent colonization of the gastrointestinal tract with unfriendly/pathogenic microbes like candida and parasites.

Mullein – decongestant and antispasmodic

Thyme – antispasmodic and immunity booster. Echinacea – natural antibiotic and immune system modulator.

Other herbs advocated by some herbalists for asthmatics include horehound, colt’s foot, blood root, nettles and eyebright.

Asthma can best be treated by using a combination of conventional and natural therapies as needed. The natural approaches are most applicable in the prevention of wheezing attacks and associated infections while conventional therapies should be reserved for serious, acute situations only. See a natural health care practitioner for a personalized regimen.

 

REFERENCES

Bergmann RL, et al. "Allergen avoidance should be first line treatment for asthma." Eur Resp Rev. 1998;8(53):161-163. Bernard A. et al. Increased intestinal permeability in bronchial asthma. Journal of Allergy and Clinical Immunology 97(6): 1173-78, June, 1996. Bray, GW. The hypochlorhydria of asthma of childhood. Quart. J. Med. 24:181-97, 1931.

Fulwood, R. et al. Asthma - United States, 1980-1987, Morbidity and Mortality Weekly Reports, Vol. 39 No. 29 (July 27, 1990), pgs. 493-497. Gergen, Peter J. et al. National Survey of Prevalence of Asthma Among Children in the United States, 1976 to 1980. Pediatrics, Vol. 81 (Jan., 1988), pgs. 1-7.

Gluck, Joan, Asthma from aspartame, Cortlandt Forum, February 1991;116/36-49. Greene, Lawrence S. Asthma and Oxidant Stress: Nutritional, Environmental and Genetic Risk Factors, Journal of the American College of Nutrition, 1995;14(4):317-324.

Gumowski, Pierre, M.D., et al, "Chronic Asthma and Rhinitis Due to Candida Albicans, Epidermophyton, and Trichophyton,"Annals of Allergy, July, 1987;59:48-51. Platts-Mills TAE, et al. "The relevance of allergen exposure to the development of asthma in childhood." J Allergy Clin Immunol. February,2000;105(2 Part 2):S503-S508.

Rothery, S.P., et al. Hazards of chlorine to asthmatic patients. British Journal of General Practice, Jan, 1991;39. Schwartz J, Weiss ST. "Caffeine intake and asthma symptoms." Annal Epidemiol. 1992;2(5):627-635.

Sicherer SH. "Is food allergy causing your patient's asthma symptoms?" J Respir Dis. February. 2000;21(2):127-136 Waikman, Frank. Assessment of cost-effectiveness of ecological therapy on three asthmatic patients. Presented at the 17th Advanced Annual Meeting of the American Academy of Environmental Medicine in Colorado Springs, 1983.

Warner, J.O., Food Intolerance and Asthma. Clinical and Experimental Allergy 1995; 25 (Suppl.1) : 29-30. Wright JV. "Treatment of childhood asthma with parenteral vitamin B12, gastric re-acidification, and attention to food allergy, magnesium and pyridoxine: three case reports with background and an integrated hypothesis." J Nutr Med. 1990;1:277-282.

Anti-Histamine Alternatives

NATURAL ALTERNATIVES TO ANTI-HISTAMINES

by Dr. Zoltan Rona MD, MSc

One in every three North Americans suffers from hay fever (sneezing, itchy eyes, runny nose, nasal and sinus congestion) every spring (grasses, weeds), late summer or fall (ragweed, goldenrod). Synthetic antihistamines are the mainstay for symptom relief and work by interfering with the binding of histamine to cells after it's release. Antihistamines can cause drowsiness, depression, weight gain and serious cardiac complications when combined with antibiotics or other drugs.

Natural alternatives

Diet

Avoid dairy, corn, wheat and simple sugars to lessen the body’s allergic load Increase intake of raw fruits and vegetables for their live, anti- inflammatory, enzyme content

Eat more immune system boosting foods: garlic, onions, horseradish, citrus, carrots, greens, cayenne, or other hot peppers as tolerated

Supplements

AOR ALLER QUE

One or a combination of the following are effective in given individuals:

Stinging nettles - 1-2 capsules every 4 hours as needed reduces mucous and nasal congestion Cayenne - 1-2 capsules every 4 hours as needed - a mild stimulant to the beta receptors; enhances the release of adrenalin from the adrenal glands to open breathing passages

Bromelain (pineapple enzyme) - 250 mgs. 3 or more times daily for its anti-inflammatory effects Pantothenic Acid (vitamin B5) - 500 mgs. 3 or more times daily - aids in the formation of hormones deflecting stress and allergic reactions. Vitamin C - bowel tolerance doses (6000 mgs. or more) produce a natural antihistaminic effect

Quercetin (a bioflavonoid) - 500 mgs. 3 or more times daily - stabilizes mast cell membranes and prevents histamine release; reduces pro-inflammatory hormones (prostaglandins) in our bodies. Pycnogenol (pine bark extract) or grape seed extract - 150 -300 mgs. daily prevents histamine release, thereby reducing all the adverse effects of histamine, not just their effects on target cells. N-Acetyl-Cysteine - 1000 mgs. 3 or more times daily - an immune support amino acid that boosts the level of the antioxidant glutathione and dissolves excessive mucous (mucolytic).

AOR PRO QUERCETIN        DOUGLAS QUERCIPLEX

Adrenal Stress and what to do about it

ADRENAL STRESS AND WHAT TO DO ABOUT IT

ZOLTAN P. RONA, M.D., M.Sc.

Stressed out? Chronically tired? Burned out? Allergies getting worse instead of better? Catching one infection after the next despite a good diet? Premature menopause? If you are coping with some or all of these health problems, chances are high that you are suffering from varying degrees of adrenal insufficiency.

How do the adrenals weaken?

Most commonly, different types of stress are involved. While some of these stresses are beyond our immediate control (nasty bosses, postal worker strikes, stock market crashes, unfriendly in-laws, hurricanes, etc.), many stresses weakening the adrenals are dependent on our diet and lifestyle choices. For example, a high caffeine and refined carbohydrate intake, cigarette smoking, heavy alcohol consumption and drugs too numerous to list all stress the adrenals by causing a greater than normal secretion of adrenal hormones leading to eventual depletion of stress hormone reserves. Working long hours under fluorescent lights at a sedentary job and getting little to no exercise also weakens adrenal function. So does long hours of watching television, reading newspapers filled with bad news and staring at computer screens.

DOUGLAS LABS RELORA-PLEX  

Menopause is one major life event strongly connected to adrenal glandular function. In the healthy female, once the ovaries stop producing estrogen and progesterone, the adrenal glands take over production to maintain a comfortable balance. If this transition period does not occur smoothly, women entering the menopause will experience severe and often debilitating hot flashes, vaginal dryness, depression, loss of libido, accelerating osteoporosis, memory disturbances and blood sugar control problems (hypoglycemia). Adrenal insufficiency can cause exaggerated or early menopausal symptoms that create theillusion that prescription hormone replacement therapy is needed.

The ability to deal effectively with physical, chemical, emotional and other environmental stressors such as viruses, ionizing radiation and prolonged physical exertion depends largely on the health of your adrenal response.

The adrenals are a pair of glands shaped like Napoleon's hat that lie just above the kidneys. They secrete more than three dozen hormones derived from cholesterol directly into the bloodstream. Each gland, about one to two inches in length and weighing only a fraction of an ounce each, is composed of two distinct parts, the inner adrenal medulla and the outer adrenal cortex. The outer region secretes hormones known as corticosteroids of which there are three types: mineralocorticoids, glucocorticoids and the 17-ketosteroids (sex hormones).

Adrenal cortical hormones are controlled by ACTH, a pituitary hormone. The inner adrenal medulla secretes epinephrine (adrenalin) and norepinephrine (noradrenaline), the hormones that mediate the “flight-or-flight” alarm response to stress. Adrenal medullary hormones are controlled by the sympathetic nervous system.

The glucocorticoids (cortisol, corticosterone, cortisone) cause blood sugar levels to go higher, reduce inflammation and dampen the allergic response. Abnormal levels of glucocorticoids could be partially responsible for hypoglycemia or diabetes, an exaggerated pain response and poorly controlled allergies. The mineralocorticoids, the most important of which is aldosterone, cause the body to retain sodium while increasing potassium excretion. Abnormal aldosterone levels can therefore create imbalances between sodium and potassium and, consequently, fluid levels in the body. The major sex hormone produced by the adrenal cortex is the androgen, DHEA (dehydroepiandrosterone) which is then converted into other sex hormones (testosterone, estrogens, progesterone).

Shades of Imperfection

Conventional medicine categorizes adrenal function as either normal, low (adrenal insufficiency a.k.a. Addison’s disease) or high (Cushing’s Syndrome, a rare disorder caused by an overactive adrenal cortex). Most individuals affected by suboptimal adrenal function fall between these two extremes and are left without any medical solution to their health problems.

Adrenal weakness is at the bottom of poorly controlled stress conditions ranging from anxiety, allergies and recurrent infections to hypoglycemia, depression, autoimmune disease and chronic fatigue of unknown cause. If the initial screening tests fail to show either low or high levels of various steroids, reductionistic medical thinking, regardless of patient signs and symptoms, is that adrenal function is normal. Studies, however, show that adrenal function can be compromised long before abnormalities start appearing in such laboratory tests and that the use of adrenal glandular support reverses signs and symptoms and replenishes depleted organ reserves.

Signs and Symptoms of Weak Adrenal Function

The many signs and symptoms of adrenal insufficiency are often brushed off by conventional doctors as “nerves” requiring a prescription for anti-depressants, tranquilizers or estrogen. Many of these signs and symptoms, however, should alert both doctor and patient to look deeper into organic sources with the use of special tests (e.g. glucose tolerance test, cortisol, DHEA, hormone challenge tests, etc.). The results of these tests could provide a more definitive diagnosis.

An inability to concentrate, excessive fatigue, nervousness, irritability, depression and anxiety are the commonest symptoms associated with poor blood sugar control (hypoglycemia or diabetes) and ultimately to adrenal glandular weakness. Lightheadedness or dizziness, faintness or fainting as well as insomnia are also common problematic blood sugar control symptoms. So are cold, clammy palms and red palms or fingertips.

Progesterone is one of the most important hormones secreted by the adrenal gland. Progesterone has a major role to play in healthy menstruation, bone building and fertility. Many women who suffer from hot flashes, vaginal dryness, mood swings and premenstrual syndrome symptoms (fluid retention, depression, food cravings, breast pain and tenderness) are often suffering from relatively low progesterone levels which can often be corrected by normalizing adrenal function.

The adrenal glands are responsible for blood pressure control. If you have access to a blood pressure measuring device there is a simple self test you can use if you suspect low adrenal function. Take or have someone take your blood pressure several times both reclining and standing. If your blood pressure is usually somewhat on the low side (postural hypotension) on standing (105/60) but elevated to (120 or 130/70 or 80) on reclining, chances are high that your adrenals are malfunctioning. There should be very little difference between standing and reclining blood pressures if adrenal function is optimal.

Other, lesser known signs of adrenal weakness or insufficiency are:

Skin thin, dry or scaly Skin pigmentation of temples Exaggerated reflexes Angular appearance with long arms and legs (span is greater than the height) Inflammation of lymph glands of the neck (swelling, pain, or tenderness) Thin-muscle type (asthenic habitus) Sparse hair on body, but usually a full head of fine and abundant hair. Typically blond and blue eyed, or red headed with skin allergies Crowded lower teeth - with a high palatal arch (roof of mouth) Pain and tenderness over adrenal area when pressure is applied.

(Positive Rogoff's sign). Scanty perspiration (except under arms or hands and feet).

The Adrenal Insufficiency Connection

A long list of suboptimal health conditions and diseases are stress-related and stem from a weak or an exaggerated adrenal response. The following is just a partial list of conditions requiring adrenal glandular support:

Anxiety/Panic attacks        Asthma          Autoimmune diseases  (e.g. fibromyalgia & chronic fatigue syndrome,  Graves’ disease,  multiple sclerosis,  rheumatoid arthritis, etc.)       Cancer           Diabetes Mellitus (Type II)         Depression   Headaches (tension, migraine)         Hypoglycemia        Infertility           Premature menopause         Menstrual problems (premenstrual syndrome, dysmenorrhea, menorrhagia, amenorrhea)      Multiple chemical hypersensitivity / allergies            Recurrent flus, colds and other infections

Adrenal Glandular Support

The vast majority of cases requiring adrenal glandular support programs can help themselves without prescription hormones. A combination of diet and lifestyle changes with or without nutritional supplements is usually all that’s required.

Diet: avoid foods and beverages that unnecessarily stress the adrenals, especially alcohol, caffeine, tobacco, fried foods, processed foods, pork, sugar and refined carbohydrates. A high percentage of symptomatic individuals are allergic to gluten (wheat, spelt, rye, barley, oats) and casein (dairy products) and should avoid these foods altogether. Unless allergic to them, eat more deep water ocean fish, salmon, tuna, trout, fresh fruits and green leafy vegetables, garlic, onions, shiitake or maitake mushrooms, olives and legumes.

Lifestyle: regular moderate exercise, meditation, biofeedback or other relaxation techniques to reduce stress; in more severe cases, consultation with a health care provider is required.

Nutritional and Herbal Supplements (dosages are dependent on severity of symptoms and individual tolerances):

AOR ORTHO ADAPT          SEQUEL  MACASURE 120               AOR  PANTETHINE

 

Multiple vitamin and mineral supplement Green drink (spirulina, chlorella, barley, kamut, etc.) Bee pollen B complex vitamins with extra vitamin B5 (pantothenic acid) or royal jelly Vitamin C and bioflavonoids Raw adrenal extract Raw liver extract Coenzyme Q10 Astragalus Echinacea Licorice root (can raise blood pressure if used excessively) Milk thistle Siberian ginseng.

Hormone replacement: In more severe cases that fail to respond adequately to the natural approach, low dose adrenal hormones could be prescribed for short periods of time. These include:

DHEA Pregnenolone Cortisol Testosterone Progesterone Estrogens

The use of steroid drugs (e.g. prednisone) for extended periods of time can cause the shrinking (atrophy) of the adrenal glands and should be monitored regularly to prevent long term side effects. This is far less likely to occur when one takes low dose DHEA, pregnenolone or other natural steroids but should not be ignored as a remote possibility. For more information on reversing adrenal woes, see the references below and consult a natural health care practitioner for an individualized adrenal enhancement regime.

REFERENCES

Cleare, Anthony, J. and Wessely, Simon, C., Chronic Fatigue Syndrome: A Stress Disorder?British Journal of Hospital Medicine, 1996;55(9):571-574.

Freeman, Roy, M.D. and Komaroff, Anthony L., M.D., Does the Chronic Fatigue Syndrome Involve the Autonomic Nervous System?" American Journal of Medicine, 1997;102:357-364.

Goldberg, Samuel, M.D., et al. Adrenal Suppression Among Asthmatic Children Receiving Chronic Therapy With Inhaled Corticosteroid With and Without Spacer Device, Annals of Allergy, Asthma and Immunology, March, 1996;76:234-238.

Rubin, Robert T., et al. Adrenal Gland Volume in Major Depression: Relationship to Basal and Stimulated Pituitary- Adrenal Cortical Axis Function," Biological Psychiatry, 1996;40:89-97.

Selye, H. Stress in Health and Disease. Buttersworth, London, UK, 1976.

Tintera, John W. HYPOADRENOCORTICISM, 1969; the Adrenal Metabolic Research Society of the Hypoglycemia Foundation, Inc., 153 Pawling Avenue, Troy, New York, USA 12180.

Tintera, John W. The Hypoadrenocortical State and Its

Management,: N.Y. State J. of Med., Vol. 55, No. 13, 7/1/55.

Wilder, Ronald, L. Adrenal and Gonadal Steroid Hormone Deficiency in the Etiopathogenesis of Rheumatoid Arthritis, Journal of Rheumatology, 1996;23(suppl 44):10-12

My Top 10 Immune Boosting Supplements

Emotional Health and Well-Being - HEALTH MATTERS - Dr. Rona interviewed by Dr. Lana Marconi

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Diverticulitis

DIVERTICULOSIS

Zoltan Rona MD MSc

A diverticulum is a small, pouch-like area in the large intestine. The appendix can be considered to be a particularly large diverticulum. When stool gets stuck in it, inflammation develops (appendicitis). Diverticula (more than one diverticulum) come about as a result of increased pressure needed to force hard, dry stool through the bowel when constipated. They do not cause symptoms unless waste matter becomes trapped in them. The diverticula can then get infected and inflamed (diverticulitis). Conventional doctors usually prescribe antibiotics for diverticulitis attacks in addition to pharmaceutical brands of psyllium seed products (e.g. Metamucil). This approach works for the majority of cases.

Diverticulitis is a completely preventable problem through natural means alone.

It is the end result of poor North American diets, the overuse of drugs (antibiotics, codeine, etc.) and alcohol and stress. Avoid sugar, white flour products, all animal products including milk and cheese, fried foods, coffee, tea, alcohol and processed foods. High in animal protein (dairy, fish, meat, etc.) diets are to be avoided. Cheese in particular is a poor choice for anyone suffering from diverticular disease. Get yourself food allergy tested to see which foods specifically cause you problems. Both temporal arteritis and high blood pressure can be linked to excessive consumption of animal products, salt in dairy, meat, cheese and food allergies. Tests to consider include the CDSA (Comprehensive Stool and Digestive Analysis) and the ELISA/Act blood test for food allergies.

If you tolerate grains, seeds and nuts well, leave them in your diet. If these give you problems in any way (bloating, gas, constipation, cramps, etc.), stay with only well cooked brown rice, fruits, vegetables, legumes and juices. Oat bran, psyllium seed powder, glucomannan, guar gum, prune juice, aloe vera juice and green drinks such as Barley Green, Green Magma or cabbage juice are good things to take on a regular basis. Periodic juice fasting is a very good idea, particularly when attacks occur. Follow the guidelines discussed in Klaus Kaufmann’s excellent book, The Joy of Juice Fasting available from Alive Books.

Herbal remedies that may be very effective for diverticulitis include alfalfa, cayenne, chamomile, echinacea, pau d’arco, goldenseal, garlic, red clover and yarrow. Essiac or Flor-Essence is a herbal combination which could help diverticular disease. The combination herbal digestive supplement, Swedish Bitters, also has remarkable soothing effects. Dairy free acidophilus supplements should be taken on a daily basis to prevent bacterial or yeast (candida) infections of the large bowel. These same herbal remedies are effective for the prevention and treatment of bladder infections. Consider also the use of buffered vitamin C or ester C as well as the amino acid, L-glutamine (6000 - 12000 mg. daily). Trapped gas and symptoms related to it can be absorbed/eliminated by charcoal tablets (e.g. Eucarbon). Have these on hand to prevent and treat embarrassing gas attacks if you are forced to follow a less than optimal diet at various social functions.

Reversing diverticulitis requires an unshakable commitment to healthy eating and lifestyle habits. Aside from a vegetarian, high complex carbohydrate, high fiber diet, supplements that promote healing include digestive enzymes (pancreatin, etc.), vitamin A, B complex vitamins, buffered vitamin C (ester C is best), vitamin E and essential fatty acids (flax seed oil, oil of borage, evening primrose oil or Efamol), high fiber supplement. A naturopath or doctor familiar with nutritional remedies can help you with a personalized program.

 

Products Dr. Rona has recommended to his patients

Ultimate Fiber Plus      Dipan 9      Intenzyme Forte 500      Super Digestive Aid

THE NATURAL APPROACH TO ADHD

THE NATURAL APPROACH TO ADHD

By Dr. Zoltan P. Rona

 

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioural disorder of childhood. It affects thousands of infants, children, adolescents, and adults. Some reports claim that 1 in 10 children suffer from some degree of ADHD but US government statistics claim that it affects about 3 – 5% of school aged children.

 

It shows up as abnormalities in behavior like excessive, uncontrollable, physical activity, learning disorders and communication problems in early childhood with some remission occurring during puberty. In the past two decades there has been a growing diagnosis of the disorder in adults.

 

It is thought that children are usually affected by ADHD before birth and that, left untreated, continue to suffer from the condition into adulthood. ADHD affects more boys than girls with a ratio of 3:1. A high percentage of hyperactive children have blond hair and blue eyes and suffer from what appear to be allergic signs and symptoms.

 

In the history of an ADHD child, the mother often describes that, during pregnancy, there was a great deal of fetal movement and very hard kicking.  As infants, hyperactive babies are often colicky, sleep poorly or very little and cry or scream a lot.  In childhood, they look restless and fidgety and eat poorly.  In the more severe cases they may be “rockers” or “head bangers” rejecting affection and mothering.

 

As the child becomes older, there is a very noticeable rushing from one thing to the next, a shortened attention span and easy distractibility.  Behaviour can become destructive with poor coordination and general clumsiness.  Some hyperactive children have trouble integrating what they see and hear due to visual perception abnormalities which, in turn, leads to inabilities to understand basic concepts.

 

Other conditions that have been documented to occur in many ADD children are eczema, asthma, chronic infections, hay fever, headaches, stomach aches and fungal infections of the scalp, skin and nails. Some believe that ADHD is a condition that runs in families but there is no consensus amongst various medical and psychological authorities on the causer of the condition. Based on imaging studies, it is now becoming more accepted that the brains of ADHD children and different from those of children who do not suffer from the condition. Most children with ADHD have at least one other behavioural or developmental problem. They may also have a psychiatric problem such as depression or bipolar disorder.

 

SYMPTOMS IN INFANTS AND YOUNG CHILDREN 

•  crying inconsolably
• screaming
• restlessness
• poor or little sleep
• difficult feeding
• refuses affection and cuddles
• head banging or rocking
• fits or temper tantrums

         

SYMPTOMS IN OLDER CHILDREN

• impulsiveness
• clumsiness
• constantly moving
• destructive or disruptive behaviour
• accident proneness
• bouts of fatigue, weakness and listlessness
• aggressiveness
• poor concentration ability
• vocal repetition and loudness
• withdrawn behaviour
• restlessness
• school failure despite normal or high IQ
• poor sleep with nightmares         
• poor appetite and erratic eating habits
• poor coordination        
• irritable, uncooperative, disobedient, self-injurious         
• nervous, very moody or depressed
• hypersensitive to odors, lights, sound, heat and cold
• nose and skin picking or hair pulling
• bed wetting (enuresis)
• dark circles or puffiness below the eyes
• red earlobes or red cheeks
• swollen neck glands or fluid behind ear drums

 

CAUSES OF ADHD

genetic abnormalities

birth injuries

hormonal imbalances

psychological or emotional problems

biochemical imbalances caused by toxic heavy metals (lead or cadmium excesses), food allergies, vitamin and mineral deficiencies, amino acid deficiencies

toxins from chronic infections with bacteria, fungi (e.g. candida overgrowth) and parasites

digestive enzyme or stomach acid deficiencies

environmental hypersensitivities, especially to food dyes, chemicals and additives

multiple food cravings and delayed (Type II-IV) allergies/food intolerances

dyes, chemicals, inhalants, and other irritants

hypoglycemia or sugar hypersensitivity

 

ADD children should be thoroughly tested and treated by diet changes and nutritional supplements before resorting to amphetamine-like drugs like methylphenidate (Ritalin®).

 

TESTS TO CONSIDER

routine blood and urine tests

hormonal tests for thyroid, adrenal, pancreas (enzymes, insulin, glucagon)

insulin and glucose tolerance tests

vitamin and mineral testing via blood, urine and hair

livecell microscopy

CDSA and Comprehensive Parasitology

gut permeability testing

food allergy testing

amino acid analysis

 

DRUGSTORE CHILDREN

In the early 1990s the production of Ritalin and other amphetamines used to treat ADHD increased by over 500%.  The vast majority of the medication is given to boys between 5 and 12 years of age. IMS America, a marketing research firm in Plymouth Meeting, PA., reported that the number of prescriptions written for the 3 main stimulant drugs used to treat attention-deficit hyperactivity disorder (ADHD)-Ritalin, Dexedrine, and Cylert tripled from 1990 to 1994.  Ritalin's increasing popularity lead to a shortage of the drug last year.  That, in turn, caused the Drug Enforcement Administration to increase the production quota for Ciba-Geigy, the manufacturer of Ritalin, to 8,189 kilograms, 4 times the allotment 4 years earlier.

 

One of the reasons for the increased use of  Ritalin is because it is being used as a diagnostic tool for attention-deficit hyperactivity disorder (ADHD) by too many primary care physicians.  This often results in misdiagnosis and inappropriate treatment.  If a child responds to a stimulant, it does not necessarily mean that the child has attention-deficit disorder.

 

Certain allergy medications have been reported to have adverse side effects on learning and behavior because they affect the central nervous system.  For example, the use of the anti-asthma drug, theophylline has been significantly correlated with reports of inattentiveness, hyperactivity, irritability, drowsiness and withdrawal behavior, these negative side effects being directly proportional to the length of use. The use of this medication may also cause learning disabilities.

 

Corticosteroids are other drugs used to treat asthma, allergic rhinitis and other allergic conditions.  Unfortunately, these drugs, whether swallowed or inhaled, have a direct and indirect impact on the central nervous system. They have been documented to cause a change in brain electrical activity, mood changes, changes in sleep patterns, increased irritability and even psychotic reactions.  Children on continuous steroids for at least a year have been reported to have lower performance on standardized academic achievement tests for reading, verbal memory and mathematics.

 

Commonly used prescription and over the counter antihistamines have been reported to cause slower reaction time on visual-motor tasks, worsened attention and cerebral processing speed and drowsiness.  Antihistamines can cause sedation, dry mouth, and irritability.  There is also some suggestion that antihistamines are associated with a greater cancer risk.  Decongestants have been associated with visual hallucinations in some children.  While spokespersons for the medical profession tend to minimize such side effects, they can be of significant concern to parents of children with ADHD or learning disabilities (LD).

 

NUTRIENT DEPRIVED CHILDREN

Micronutrient deficiencies or dependencies (e.g. zinc) can have deleterious effects on both short and long term memory.  White spots on the nails could be a sign of zinc deficiency even when blood tests for zinc are normal. The expression, “No zinc, no think” is not without merit.  Many studies have shown that zinc supplementation is helpful with memory, thinking and I.Q.  The best way of getting zinc is to optimize the diet.  The most recently published RDA (Recommended Dietary Allowance) for adults is 15 mgs. per day.  The richest sources of zinc are generally the high protein foods such as organ meats, seafood (especially shellfish), oysters, whole grains and legumes (beans and peas).

 

Studies show that cognitive development can be impaired when there are low iron blood levels.  Deficiencies in B vitamins, particularly vitamin B 1 and choline may also be involved.  Toxic heavy metals such as cadmium and lead can accumulate in the body and cause both hyperactive behavior and learning disabilities in some susceptible children.  A hair mineral analysis can reveal whether or not these toxic heavy metals are building up in the body.  The good news is that, with a natural program of vitamins and minerals, accumulations of lead and cadmium can be removed from the system.

 

Since amino acids are the precursors to the neurotransmitters, low levels can lead to neurotransmitter deficiency.  Higher than accepted levels may lead to neurotransmitter excess. One example of amino acid excess causing hyperactive behaviour occurs with the artificial sweetener, aspartame.  Some children are highly sensitive to aspartame and scrupulous attention should be aimed at keeping this potential neurotoxin out of the child’s diet.  In children who consume large amounts of aspartame in soft drinks or other processed foods, amino acids can be significantly abnormal.  Once the amino acid levels are determined, treatment can be aimed at balancing brain chemicals more accurately.

 

A history of allergies has been reported by many authors for behavioral problems like being overtalkative, irritable, inattentive/distractible, hyperactive, impulsive, difficult to handle, drowsy/sleepy, mean, withdrawn, and euphoric. ADHD has been particularly connected with food allergies, chemical allergies and salicylates. Food allergy testing via a blood test known as the IgG- RAST is now available in Canada through Gamma Dynacare to test the immune system reaction to as many as 200 different foods. Any doctor in Ontario can order this test at a patient cost between $250 and $325. Other blood based food allergy tests are available from assorted labs in the United States but the costs are considerably higher.

 

Conventional medicine, in particular conventional psychiatry, treats ADHD children with Ritalin® and similar amphetamine-like drugs. These stimulant medications work fairly quickly and, for many kids, this is effective treatment, especially in the case of the child about to be expelled from school or causing the family to fall apart. On the negative side, amphetamine-like drugs are only effective in about 70-75% of cases. In many cases, increased hyperactivity occurs after the last dose of the day has worn off. The child may have trouble going to sleep, difficulty getting up the next morning and experience a loss of appetite. The risk of marginal deficiencies in iron, zinc, calcium, B vitamins, protein, etc. increases.

 

Amphetamine-like drugs do not address the cause of ADD/Hyperactivity. It's akin to taking an aspirin for recurrent headaches. The pain temporarily goes away but the reasons for the headaches remain a mystery. The majority of parents do not like the idea of medicating their children. Some parents reluctantly medicate their children only because they are pressured by teachers, schools and dogmatic physicians to use stimulant drugs.  Further, there are no long term studies showing that medicated children do better in the long run academically, emotionally and otherwise compared to the children of parents who say no to drugs.

 

According to recent scientific research, Ritalin, the deceptive quick fix for hyperactivity/attention deficit disorder (ADHD) interferes with blood flow to the brain and routinely causes gross malfunctions in the developing brain of the child. 

 

Some of its damaging effects include:

* Decreased blood flow to the brain associated with impaired thinking ability and memory loss.

* Disruption of growth hormone, leading to suppression of growth in the body and brain of the child

* Permanent neurological tics, including Tourette’s Syndrome

* Addiction and abuse, including withdrawal reactions

* Psychosis (mania), depression, insomnia, agitation, and social withdrawal

* Possible shrinkage (atrophy) or other permanent physical abnormalities in the brain

* Worsening of the very symptoms the drug is supposed to improve (hyperactivity and inattention)

* Decreased ability to learn

 

According to American psychiatrist, Dr. Peter Breggin, Ritalin and similar drugs "work" by producing robotic or zombie-like behavior in children, enforcing docility and obedience.  This can produce a few weeks of subdued behavior but has no positive effect on academic achievement and no positive long-term effects.  There is no scientific evidence that giving Ritalin to a child helps prevent future problems such as school failure or delinquency.  In his is book, “Talking Back to Ritalin” he documents how Ritalin brain damage suppresses creative, spontaneous and autonomous activity in children while producing no benefit for a child's psychology, academic performance or achievement.

 

While weaning a child off Ritalin, it is very important to optimize nutritional status.  Tests for food allergies, toxic heavy metal excesses (especially lead and cadmium), hidden parasites and candidiasis as well as the levels of amino acids (protein), vitamins and minerals should be done to individualize diet and nutritional supplements as much as possible. 

My book, “Childhood Illness and The Allergy Connection” (Prima Publishing, 1997) goes into this in detail.  Irrespective of lab testing, any child on Ritalin and drugs like it can take the following nutritional supplements and antioxidants at individualized levels to minimize the brain damaging effects of the drug and its withdrawal symptoms:

• Free amino acids (multiple) - provides neurotransmitter precursors
• L-Theanine
• GABA
• Bee pollen - offsets food and chemical allergies
• Flax seed, fish oils (omega-3 fatty acids) and evening primrose oil - for optimal brain levels of essential fatty acids
• Green food supplement (e.g. barley, kamut, spirulina, etc.) - antioxidant and phytonutrient source
• Vitamin B complex - supports neurological function
• Vitamin B12 and folic acid injections - speeds repair of damaged DNA in cases of malabsorption
• Phosphatidyl choline (lecithin) - enhances memory by boosting acetylcholine levels in the brain
• Vitamin C - antioxidant and repair of nervous tissue
• Vitamin E - antioxidant protecting nerve cell membranes and their polyunsaturated fatty acids
• Vitamin D
• Octacosanol - antioxidant and brain function enhancement
• Ginkgo biloba extract - brain and nervous system antioxidant; enhances cerebral circulation
• Calcium - natural calming effect
• Magnesium glycinate - anti-spasmodic, anti-tic effect
• Multiple minerals - balances calcium and magnesium
• Digestive enzymes - enhances nutrient absorption; fights parasites, fungi and bacteria

 

Omega-3 fatty acids are also often referred to as essential fatty acids (EFAs) or polyunsaturated fatty acids (PUFA). EFA’s make up at least 60% of the mass of our brains. These are called essential because our bodies cannot produce these from other nutrients. They must therefore be obtained from either diet or supplements. They are needed as basic elements of our cell membranes. They control the inflammatory response and, hence pain and the spread of disease. They also mediate the immune response, control hormone production and regulate nerve transmission.

 

The ideal ratio of omega-6 to omega-3 fatty acids is 1:1. The standard North American diet, due to the over consumption of breads, cereals, eggs, poultry, nuts, vegetable oils such safflower, corn, soy and sunflower from processed foods has a ratio of between 20:1 and 30:1. This relative omega-3 deficiency is what is believed to be the cause of numerous health problems.

 

Omega-3 fatty acids are critical to the structure and function of neuronal membranes. The communication between various nerves could not occur in a normal way without omega-3 fatty acids. As a result, just about every brain condition would benefit from optimal levels of DHA and EPA.

 

Depression is one of many common conditions that could benefit from omega-3 fatty acids. They influence something called the cytokine system in the brain. These cytokines are known as interleukin-1 -2 and -6, interferon-gamma, and tumor necrosis factor alpha. They can directly and indirectly influence the severity and outcome of depression.

Cognitive health promotion is another area of proven benefit of omega-3 fatty acids. The incidence of ADHD (Attention deficit Hyperactivity Disorder) is rapidly escalating with a greater and greater dependency on drugs such as Ritalin (an amphetamine). In fact, at one time in the 1990s, so much Ritalin was being prescribed that the drug companies manufacturing it ran out of stock and could not keep pace with the demand.

The good news is that there are now numerous studies supporting the use of EPA and DHA in the treatment of ADHD. EPA and DHA are crucial in proper retinal and brain development.  They improve school performance, learning, focusing on tasks and behaviour in children.

One study from Australia published in 2007 by Sinn and Bryan concluded that a 30 week treatment of children with ADHD with fatty acid capsules (providing 560 mg/day of EPA, 175 mg/day of DHA, 60 mg/day of gamma-linolenic acid, and 10 mg/day of vitamin E) plus a multivitamin tablet containing low (RDA) amounts of vitamin and minerals yielded slightly better results than seen in children who used Ritalin. These fish oils reduce ADHD symptoms whether or not a child is on Ritalin.

For those wanting an official seal of approval, Health Canada’s Natural Health Product Directorate (NHPD) requires a minimum of 1.5 – 3.0 g of EPA and DHA per day including at least 1.0g of EPA per day (at a ratio of 2:1) to support mood balance. As we all know, if Health Canada says so, it must be true.

Omega-3 fatty acids preserve the blood levels of vitamin D, now universally acknowledged as being one of the most important nutrients for the prevention of cancer, heart disease, inflammation of any kind, diabetes and all auto-immune diseases. Most scientists now believe that the reason why omega-3 is so important is that it supports the many functions of vitamin D. If you want to read more about vitamin D but do not want to spend weeks doing that, read my new book, “Vitamin D, The Sunshine Vitamin”.

Fortunately, many of these can be combined into one supplement.  Frequent follow up visits for supervision by a natural health care practitioner are important to ensure compliance and optimal results.

 

THE REAL CAUSES

Like the other chronic diseases of our times like multiple sclerosis (MS), lupus, cancer, asthma and autoimmune disease, ADHD is at epidemic levels in the post-industrial revolution era.  Childhood learning problems are also on the rise.  Some argue that this is because of better recognition and objective testing but respected authors like William Crook and Lendon Smith strongly disagree. Learning disability (LD) was not a major problem for children growing up in the the early 1800's and as late as 1950, there was only one child in each classroom with LD or ADHD.  Today, it is more like five or six.  Ritalin, other amphetamine like drugs or intense psychotherapy have done nothing to change the dramatic rise in incidence of these diagnoses because they do not address the source of the problem.  The answers to why a child develops LD or ADHD lie in the field of genetics, environmental toxicology and nutrition.

 

Although genetics, infections and brain damage (trauma) have been cited as causes of ADHD and LD, these cases are quite rare compared to causes like a dysfunctional home, heavy metal toxicities, nutritional deficiencies, and food and chemical allergies.The majority of cases are caused by an immune defect and allergies to food additives, preservatives, chemicals, or inhalants.  To deal adequately with this illness, we must address all these potential imbalances.  Some of the nutritional deficiencies that correlate with LD or ADHD are calcium, magnesium, iodine, iron and zinc.  On the other hand, high copper, lead, cadmium and aluminum levels have also been seen in learning disabled children.

 

Aside from diet changes excluding food and chemical (food additives, dyes, preservatives) allergies, there are many natural treatments including a long list of vitamins, minerals, herbs, amino acids, essential fatty acids and enzymes. The treatments all depend on the case history, physical examination and the results of biochemical tests. 

 

Evening primrose oil is a common remedy recommended for ADD children.  It and numerous herbs have anti-inflammatory and anti-allergy properties through their ability to modulate prostaglandin levels, the hormones responsible for inflammation, pain, allergic reactions and other aspects of the immune system.  Based on the findings of biochemical tests, a personalized nutritional program of diet and supplements can be recommended. 

 

Dr. Zoltan P. Rona practices Complementary Medicine in Toronto and is the medical editor of “The Encyclopedia of Natural Healing.” He has also published several Canadian best-selling books, including “Return to The Joy of Health.” For more of his articles, see http://www.highlevelwellness.ca , http://mydoctor.ca/drzoltanrona, and  http://www.tristarnaturals.com/home.html 

 

REFERENCES

 

US Government Publication. PubMed Health. ADHD. March 25, 2012; http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002518/

Batoosingh, Karen. Ritalin Prescriptions Triple Over Last Four Years. Family Practice News, June 1, 1995;4.

Boris, M. Foods and food additives are common causes of the attention deficit hyperactivity disorder in children. Annals Allergy 72, 1994, pp. 462-68.

Breggin, Peter. Talking Back to Ritalin, Revised: What Doctors Aren’t Telling You About Stimulants and ADHD. Perseus Books, 2001.

Breggin, Peter. Brain-Disabling Treatments in Psychiatry. Springer Publishing Compamy: New York, 2008.

Breggi, Peter. Psychiatric Drug Facts. http://breggin.com/index.php?option=com_content&task=view&id=24&Itemid=42

Carter, C.M. Effects of a few foods diets in Attention Deficit Disorder. Archives of Diseases of Childhood . 69, 1993, pp. 564-568.

Crook, William G. Solving the Puzzle of Your Hard-to-Raise Child, Jackson, Tennessee:Professional Books, 1987.

Crook, William G.  Detecting Your Hidden Allergies, Jackson, Tennessee:Professional Books, 1988.

Crook, William G. The Yeast Connection Handbook, Jackson, Tennessee:Professional Books, 1996.

Egger et al. Effect of diet treatment on enuresis in children with migraine or hyperkinetic behavior. Clinical Pediatrics, pp. 302-307, 1992.

Goldman, Erik, L., Ritalin Wrongly Used to Diagnose Attention Deficit. Family Practice News, November 1, 1995;33.

Hagerman, R.J. and Falkenstein, M.A., An association between recurrent otitis media in infancy and later hyperactivity.  Clinical Pediatrics, 1987; Vol.26, No.5

Kahn, Cynthia, A.", M.D., et al.  Lead Screening Children With Attention Deficit Hyperactivity Disorder and Developmental Delay. Clinical Pediatrics, September 1995;498-501.

Kahn, Cynthia, A., M.D., et al, Lead Screening Children With Attention Deficit Hyperactivity Disorder and Developmental Delay. Clinical Pediatrics, September 1995;498-501.

Kaplan, B.J. Dietary replacement in preschool-aged hyperactive boys. Pediatrics 83, 1989, pp.7-17.

Needleman, H.L. Bone lead levels and delinquent behavior. Journal of the American Medical Association Vol. 275, Feb. 7, 1996, pp. 363-369.

Rapp, Doris J. Allergies and the Hyperactive Child., New York, New York: Cornerstone Library, (Simon & Schuster), 1979.

Rapp, Doris J. Allergies and Your Family. New York, New York: Sterling Publishing, 1980.Stevens, Laura J., et al. Essential Fatty Acid Metabolism in Boys With Attention-Deficit Hyperactivity Disorder",  American Journal of Clinical Nutrition, 1995;62:761-8.

Rona, Zoltan P. Vitamin D, The Sunshine Vitamin. Tennessee, USA: Alive Books, 2010 http://www.amazon.com/Vitamin-D- Sunshine-Zoltan-Rona/dp/0920470823Rona, Zoltan. Childhood Illness and the Allergy Connection. Prima Publishing 1997.Smith, L.  1983.  Feed Yourself Right.  New York: McGraw-Hill.Stevens, Laura J., et al, Essential Fatty Acid Metabolism in Boys With Attention-Deficit Hyperactivity Disorder.  American Journal of Clinical Nutrition, 1995;62:761-8.Tuthill, R.W. Hair lead levels related to children's classroom Attention-Deficit behavior. Archives of Environmental Health Vol. 51, May/June 1996, pp.214-220.