Surviving the Medical Meltdown (12 page)

For years I cared for a woman in her forties with a multitude of orthopaedic problems. She was pear shaped, looked very pale, had little muscle, and was a strict vegan. When I asked her as politely as I could why she chose to eat this way, she told me that she just could not abide “the thought of hurting animals.” Initially, she came to see me for mid back pain and generalized achiness, and I found that she had become kyphotic – curved forward in the upper spine. Her spine X-rays looked like those of a seventy-five-year-old. Her bone density was terribly low, and there was evidence of small wedge compression fractures of the spine bones due to low bone density. We tested her blood, and she proved to be typical of the vegan patients I see in my orthopaedic practice who are almost universally deficient in vitamin D
₃
and the B vitamins and generally weak of muscle and bone.

Based on this and the characteristic appearance of her X-rays, I am sure – even without a bone biopsy – that her bone density problem was not just osteoporosis (loss of bone volume) but adult rickets – soft abnormal bone – due to vitamin D
₃
deficiency. I placed her on numerous supplements and medicine to improve her bone quality but could never get on top of things. Her energy was low, so exercise was a painful and frustrating experience. She was having frequent diarrhea – probably due to gluten sensitivity – and this added malabsorption to the picture. Her belly fat – another product of her high-carb diet – was distorting her hormonal balance, and she was becoming prediabetic. After she suffered a spontaneous fracture of her foot bone, I had a frank discussion in which I told her she was killing herself with her diet, and although I could keep applying “orthopaedic Band-Aids,” it wasn’t the way to go.
Unfortunately, her emotional commitment to her diet, formed by her worldview, caused her to choose to continue along her path of rapid functional decline.

As reported in a study in the
Annals of Nutrition and Metabolism
, B
₁₂
deficiency ranges from 20 percent in semi-vegetarians to 92 percent in vegans.
²
In other words, the stricter the meatlessness, the more deficient you become in this critical vitamin. B
₁₂
is vital, not only to building the blood, but to nerve and brain health. For example, it was discovered, using sophisticated studies of B
₁₂
blood levels, that 30 percent of men with dementia are B
₁₂
deficient. And in another study, people with low vitamin B
₁₂
levels were at double the risk of developing Alzheimer’s disease (in 370 elderly men and women followed over three years).
³
In my practice I sometimes cure cases of polyneuropathy (dysfunction of the nerves) by giving people sublingual (under the tongue) supplementation of B
₁₂
, even when their labs are reported as “normal.” In sum, B
₁₂
is critical and simply cannot be guaranteed on a vegetarian diet.

Creatine and animal protein in the right ratios likewise are deficient in vegetarians. This leads to weakness and to measurable deficiency in muscle mass.
⁴
Bodybuilders and weight lifters of all kinds (myself included) take creatine to improve muscle gains. And it is my observation, while snowboarding with friends and working on the farm, that vegetarians simply do not have the stamina or strength of those of us who eat meat.

Additionally, vegetarianism leads to deficiencies in vitamin D
₃
.
⁵
Vitamin D is not a vitamin but a hormone that is, in my opinion, the cheapest anti-aging pill we have. Vitamin D
₃
deficiency has been associated with childhood rickets – a bone disorder – for more than a hundred years. And it has been known since the 1970s that those living on the equator, where they get an abundance of vitamin D
₃
from exposure to the sun, regardless of particular locale, have lower rates of multiple sclerosis, colon cancer, and depression. But more recently, many astute observers have discovered that low vitamin D
₃
leads to many other disorders, including adult rickets, cardiac
arrhythmias, breast cancer, adult fractures, dementia, heart attacks, and even diabetes.

Most recently, studies have demonstrated that higher levels of vitamin D
₃
improve longevity and are beneficial at preventing influenza – even better than vaccination.
⁶
Studies showing the beneficial effects of high vitamin D
₃
levels are quite convincing. They not only show a correlation between low vitamin D
₃
blood levels and the medical problem in question, but they also show improvement in the disease or prevention of the condition when levels are raised through supplementation. And I have seen patients feel better in two weeks after starting vitamin D
₃
supplementation. At first I was skeptical that this was a placebo effect, but I have seen it too many times to believe this now. I do not know the mechanism of the sudden improvement, but I suspect these people have critically low initial blood levels because of diet, lack of sunlight and use of sunscreens, northern latitude, and so forth.

It has been shown in the laboratory that heart muscle does not contract well unless adequate vitamin D
₃
is present. An Italian population study showed that low vitamin D
₃
levels were proportional to atherosclerotic plaques (clogging of the arteries).
⁷
Furthermore, a Japanese study of dialysis patients demonstrated that correcting vitamin D
₃
deficiency significantly lowered death rate from heart attacks and heart disease in general.
⁸
This is only a snapshot of the rapidly expanding body of literature supporting the role of vitamin D
₃
in prevention of multiple diseases. But to achieve the positive effects, blood levels of D
₃
need to be in the range of 50 to 100 nanograms per deciliter, not the 20 nanograms per deciliter that laboratories report as the lowest range of “normal.” Specifically in the case of breast cancer, if one achieves blood levels above 50 nanograms per deciliter, the risk of breast cancer is diminished 83 percent.
⁹
This is not surprising, because vitamin D
₃
works at a very basic level keeping telomeres – the ends of our DNA strands – healthy. Studies of equatorial inhabitants demonstrate that some of the longest-lived people on the planet obtain 30,000 to 40,000 international units
of vitamin D (specifically D
₃
) a day from the sunlight – nature’s source of the vitamin. As an orthopaedic surgeon, I deal with bone disorders daily and have long been interested in this topic. Because everyone in our sun-averse society is somewhat low in D
₃
, I just give supplementation then test them in a year after they have stabilized their levels. My vegetarian patients are the only ones I have routinely tested beforehand – just to prove to them how deficient they were. Carnosine (an amino acid) and DHA (an omega-3 fat found only in meats and fish) are also deficient in vegans and vegetarians.
¹⁰

Perhaps most important, vegetarians are short of cholesterol in a usable form. Although cholesterol has gotten a bad rap over the years – more about this later in the chapter – it is critical to most body functions. Specifically, it is crucial to brain mass and brain function because neurotransmitters are made from cholesterol. It is also the precursor to sex hormones and adrenal hormones. Testosterone and cognitive (brain) function are both diminished in vegetarians and vegans.
¹¹
Maybe this loss of testosterone explains why most of my vegetarian and vegan patients are women!

It is well worth reading
The Vegetarian Myth
by a former committed self-proclaimed vegetarian, Lierre Keith. In this well-written and very thorough book, Keith tells her story of being ill and depressed for more than twenty years until she finally could not resist the facts and started eating a diet that included meat. She addresses each argument in favor of a vegetarian lifestyle, including the argument from ecology. For the ecological vegetarians, she points out that returning to the more pastoral mixed agriculture of centuries ago is much more ecologically sound than the monoculture of today that produces the millions of acres of wheat and corn necessary for vegetarianism.

Keith has great sympathy for those who, like my patient, don’t like to kill animals, but points out gently that they are not really keeping death out of the animal world by living a sickly, vegetarian existence. “The vegetarian ethic is still ultimately a variation on the mechanistic model. It simply extends our morality, whether
humanist or religious, to a few animals that are similar to us. The rest of the world – the living, sentient, communicating agents who make oxygen and soil, rain and biomass – those billions of creatures don’t count…. Their ethic is still part of the paradigm that’s destroying the world.”
¹²
As a sarcastic friend of mine has opined, most vegans’ protective umbrella for animals really only extends to fluffy, furry animals with sad eyes – animals that can be anthropomorphized. They couldn’t care less if a cockroach or sewer rat gets exterminated, and they probably swat mosquitoes without thinking.

THE STANDARD WESTERN DIET IS BAD IN A DIFFERENT WAY

It has been known for nearly a century that the standard Western diet produces health problems. In the 1920s Weston A. Price, a dentist and founder of what became the research arm of the American Dental Association, traveled the world, studying aboriginal cultures and the impact of diet on teeth and facial bone formation. In the process he came to believe that not just teeth, but general human health was adversely affected by a Western diet. He noted specifically that peoples as varied as the Maori and isolated Swiss villagers, while eating their traditional diets, had broader faces with straight teeth free of cavities. And they were also healthier in many ways, having less deformity, less tuberculosis, and fewer other diseases of modern civilization. When Dr. Price analyzed the foods eaten by these isolated natives, he discovered they contained at least four times the calcium and other minerals and ten times the fat-soluble vitamins from animal-rich foods. For the rest of his life, he promoted “real food for real people” – the idea that human-processed foods were to be eschewed in favor of natural, aboriginal-type diets including good, natural animal fats.

Others have written along these lines, including Gary Taubes in his book
Good Calories, Bad Calories
. Taubes notes that in Africa, before the introduction of the Western diet, diseases of modern civilization (heart disease, diabetes, and cancer) were rare. His excellent
book, which focuses on obesity and the cycle of disease, reveals that diseases of modern civilization show up in an aboriginal culture, on average, seventeen years after the introduction of a Western diet. He ascribes the ill effects to four foods – white processed flour, white rice, sugar, and beer.
¹³
(Like it or not, he is probably right. Regarding the last one, note that we don’t talk about martini gut, just “beer gut.”)

Since the time of Weston A. Price, in spite of various food fads and the nonsense propagated by outmoded “official” food agencies, we have been drilling down closer to the truth. Recently, Dr. David Perlmutter, a neurologist, published
Grain Brain
, and Dr. William Davis, a cardiologist, published
Wheat Belly
, probably two of the most eye-opening and best books on the issue. In short, the major culprit in the Western diet responsible for the majority of the problems we see today is wheat or wheat gluten – a major staple estimated to comprise nearly 75 percent of the average American’s intake.

WHAT’S WRONG WITH WHEAT?

“What’s wrong with wheat?” you ask. Well, in a nutshell, everything. Wheat (after digestion) is the only food to cross the blood-brain barrier and bind with opiate (morphine-like) receptors. Wonder why you have food cravings? Wheat is an addictive substance. It gives you a craving to eat constantly. And it is an unnatural substance that we were not genetically designed to ingest and metabolize. Besides being nutrient poor in its own right, it has the unusual property of damaging the tight junctions between cells in the gut, thereby disturbing the body’s ability to properly absorb nutrients from other foods. This effect is most obvious in people with so-called celiac disease, who develop overt diarrhea with wheat. But to a certain degree, many if not most people have a degree of digestive disruption.

And wheat in its modern form contains a substance called amylopectin-A, which produces autoimmune disease. Want to get rid of psoriasis? Stop eating all wheat. Stop wheat and stop the progression of rheumatoid arthritis and lupus. Now, you cannot just go
halfway on this one. To be effective you have to eliminate all wheat from your diet, and I mean
all wheat
. It is not dose related, per se. Wheat is an immune trigger. Imagine turning on a football stadium’s vast lighting with a single switch. A
small
switch – the trigger – can produce the
big result
of bright lights all over the stadium. So too, wheat is a trigger. Eating even a morsel can, in people with autoimmune disease, trigger a reaction in our immune system that lasts for months. I have had several patients with Crohn’s disease (a problem that includes bloody diarrhea, gastric pain, and ultimately poor health from malabsorption of nutrients). The gastroenterologists – specialists in gut disorders – do not know what causes Crohn’s disease, but they will swear that diet makes no difference. I am an orthopaedic surgeon. I do not pretend to be a gastrointestinal specialist. But I take health histories, and knowing what I know, I tell my patients about the emerging science of wheat/gluten sensitivity. In one case, an old friend from high school told me about his twenty-four-year-old son. This young man had developed all the symptoms of Crohn’s disease – weight loss, bloody stools, diarrhea after eating, and abdominal pain. In general he just felt bad, with loss of energy and vitality. I told his dad, “Try taking him completely off wheat. What have you got to lose?” At the time his son was on about seven hundred dollars a month of IV medications, which, in spite of the high price, had failed to relieve his symptoms very much. Within three days of going wheat-free, however, all his symptoms resolved. Three days! I helped him wean slowly off his medication just in case symptoms would recur. But they never did. He remains well and committed to a strict wheat-free diet. As further confirmation of the cause of his problem – diagnosed by gastrointestinal (GI) docs as classic Crohn’s disease – he accidentally ingested some wheat months later, and for a day or so the symptoms returned, including diarrhea. As of this writing, he has been asymptomatic for a year. Now, I call that a test of the theory. But sadly, his GI doctors still say diet doesn’t matter. And in a self-fulfilling prophecy, they say if it was solved with diet, then it couldn’t have been Crohn’s disease.
What?! Well, I have two other such patients, and with time, perhaps others will believe in the wheat connection. And in time, after much needless patient suffering, the truth will out, as they say.