Alana Cheyne

Feeding our pets kibble may be the cause of not only the obesity epidemic in our pets, but perhaps many of the chronic, degenerative, and inflammatory conditions that are rampant

Andrea Lauridsen watched helplessly as her beloved Shih Tzu, Quincy, suffered for half of his 15 years with skin allergies, itching, welts, and redness. “I tried everything and spent literally thousands of dollars on that poor dog,” she says. “We tried round after round of cortisone, topical ointments, chemical dips, and even Prozac. Nothing worked.”

After discovering Dr. Richard Pitcairn’s book, The Complete Guide to Natural Health for Dogs and Cats, Andrea zeroed in on the possible problem – a lifetime of poor quality dry dog food, otherwise known as kibbles.

To Kibble or Not to Kibble?

While certain dry dog food brands provide better nutrition than others, some veterinarians feel that a processed pellet can’t possibly hit all the nutritional marks. “I believe quite strongly that there is no dry food on the market that is appropriate to feed to dogs or cats as their primary source of nutrition,” says holistic veterinarian Moira Drosdovech.

Not only are kibbles lacking in nutrients, but they also require some kind of starch (often low quality and genetically modified) to hold them together. Even if a product claims to be “grain-free,” it likely still contains another starch, like potato protein, to prevent it from crumbling. “Dogs did not evolve to eat starchy foods,” says Drosdovech. Their digestive systems struggle to process the excess carbs, and which are stored as fat.

(Editor's note: For making a dry food diet less harmful and more useful and effective, pet owners are now turning to natural and probiotic supplements. These supplements are not only rich with vitamins and antioxidants but also probiotics which support natural gut flora and proper digestive function.)

As for what else kibbles might contain, you probably don’t want to know. In her book Food Pets Die For, Ann N. Martin exposes the ingredients used in many processed food brands, like cellulose (a filler not unlike sawdust), meat by-products (the leftover waste from human food production, including diseased and deceased animal materials from rendering plants), and toxic chemical preservatives. Those opting to feed Fido kibbles would be well-advised to read all labels carefully.

Drosdovech concedes that kibbles are convenient, but worries that our dogs may pay the ultimate price. “I feel that these foods are pro-inflammatory,” she says, “and may be the cause of not only the obesity epidemic we are seeing in our pets, but perhaps many of the chronic, degenerative, and inflammatory conditions that are rampant.”

So What Should We Feed our Dogs?

Raw meat and bones: Drosdovech recommends a diet resembling that of a dog’s ancestors. Canine teeth are designed to rip the meat from their prey and chew the bones. Proponents of the raw diet feel that cooking the meat changes it chemically, to a dog’s detriment.

Fruits and vegetables: Fruits and vegetables provide important health benefits – as long as they’re easily digestible. Canine teeth can’t grind vegetable matter down sufficiently for proper digestion, and their small intestinal tract makes absorption difficult. Drosdovech recommends processing or juicing these foods, or using a good “greens” supplement designed for dogs.

Supplements: High quality fish oils provide important nutrients. And your veterinarian can recommend any additional supplementation for specific issues, like glucosamine for joint problems.

A balanced diet comprising each of these elements can go a long way toward ensuring our dogs’ optimal health. Unfortunately, by the time Lauridsen discovered this information, it was too late – Quincy died. “A lifetime of poor quality dry dog food had taken its toll,” she says. “After he died I swore that my next dog would be fed a raw food diet.”

Lauridsen went on to adopt a young puppy, Chico, from a rescue group and did just that. She was delighted to see him thrive, dodging all of the health conditions that had afflicted Quincy. “He was amazingly healthy,” she says. “His coat was shiny, teeth perfectly white and I had never once brushed them. People would ask me if he was a puppy when he was eight and nine years old. I could see the difference completely – it was undeniable.”

The results were so inspirational that Lauridsen and her husband, went on to open their own pet food store, Healthy Spot Pet Nutrition & Supply in Vernon, B.C. Specializing in high quality, natural foods – including pre-packaged raw food – they’ve witnessed how these foods have positively impacted the dogs in their community. Drosdovech can relate, seeing first-hand in her practice how the raw food diet benefits her doggie clients. “Their health and longevity astound me,” she says. “They have fewer chronic degenerative conditions than those pets I see that are on kibble and their energy is wonderful.”

Still, the raw food diet is not without its controversies. Some veterinarians argue that modern domesticated dogs are physiologically different from their wild ancestors, particularly from breed to breed, and therefore do not require the same diet. Also, it can be time-consuming for dog owners to adequately balance this diet, especially if they’re making it from scratch, and cutting corners could lead to nutritional deficiencies.

But the most pressing concern is the fear of bacterial contamination from raw meat. The Canadian Veterinary Medical Association warns on its website that the merits of the raw diet have not been adequately tested, and that positive reports are anecdotal. Along with the Public Health Agency of Canada, they argue that the potential benefits aren’t worth the risks of harmful pathogens like salmonella.

But according to Drosdovech, the risks posed to our dogs are rare because their stomachs are so acidic, generally neutralizing contamination before it develops. Also, a dog’s short intestinal tract provides little time and opportunity for bacteria to thrive.

However, dogs can expose humans to these pathogens, so families with small children or immune-compromised people should be careful. And certain common-sense precautions should always be followed, says Drosdovech. Don’t leave the meat defrosted in the fridge for longer than three days, and wash all dishes carefully. And most importantly, she says, “make an appointment with a qualified professional to gain a clear understanding of all that is involved.”

By taking these risks into consideration, and learning how to mitigate them, you might find that a natural raw food diet is just what Spot needs to live many happy years by your side.

IN B.C. - For more information, contact Dr. Moira Drosdovech Pawsitive Veterinary Care, 6-1551 Sutherland Ave., Kelowna, BC 250-862-2727 https://www.pawsitivevetcare.com

IN ONTARIO – Dr. Sasan Haghighat can be reached at NorthEast Newmarket Veterinary Services, a holistic clinic in Newmarket, Ont. at 987 Davis Drive. For appointments call (905) 830-1030; visit his website: https://holistic-vet.ca/dr-sasan-haghighat-hyatt-dvm-cva/

(Updated July 27, 2022)

Are we overmedicating ourselves? During the COVID-19 pandemic, an important fact has not been well reported by the media. That is – a major side effect of commonly used medications is the increased risk of pneumonia. This in turn increases the risk of death.

During the pandemic this risk can certainly become magnified, especially in seniors who are often taking a combination of the drugs most likely to increase pneumonia risk.

Co-factors such as high blood pressure, diabetes, and obesity have often been blamed for the higher risk of death by COVID. However, scientific research has implicated the chronic use of certain drugs as a more likely mitigating factor. And in many cases, the risk can be minimized by reducing doses or discontinuing these drugs. For many of us, alternatives can be used to provide the same benefits as the drugs without all the side effects.

The Key Role of Common Medications

A recent article published by Dr. David Healy, MD and Dr. Joan-Ramon, MD underlined the important role played by common medications in increasing the risk of pneumonia. It is firmly established by numerous scientific studies that the chronic use of the following classes of drugs can make people, especially the elderly, more susceptible to pneumonia, not to mention many other chronic illnesses:

Proton Pump Inhibitors (Heartburn Drugs)

Let’s look at a major class of these drugs. One of the commonest prescriptions seen in the elderly population are the proton pump inhibitors (PPIs). PPIs are the most popular and powerful of all the heartburn drugs, so called because they bind or inhibit an enzyme (hydrogen potassium adenosine triphosphatase), also known as the proton pump. The proton pump causes the parietal cells in the stomach to produce acid.

Through this proton pump inhibition, stomach acidity is reduced or eliminated much more and for much longer periods of time than the histamine H-2 receptor blockers (e.g. cimetidine or ranitidine). The latter are hardly prescribed any more these days. The best-known PPIs are pantoprazole (Tecta), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Losec), pantoprazole (Protonix), and rabeprazole (Pariet).

These drugs are usually well tolerated if used for a few days or weeks but common side effects include constipation (a frequent symptom of excessively low stomach acidity), diarrhea, headache, skin itch and skin rash. There have been reported cases of acute pancreatitis, flu-like illnesses, pneumonia, vomiting, chronic kidney disease, low platelets, hepatitis and autoimmune disorders. The adverse drug reactions are variable from person to person but can be quite devastating when used for extended periods of time.

Both proton pump inhibitors and the histamine H-2 blocking drugs can raise the risk of hip fractures by 44% if taken for longer than a year because, when you block acid production, you make it more difficult for the body to absorb calcium, magnesium, silicon and other minerals found in healthy bones.

When you decrease or eliminate acid production with these drugs, you make it harder for the gastrointestinal tract to digest food and this can cause gas, bloating, and constipation. Sometimes this set of symptoms is labeled as IBS (irritable bowel syndrome) for which further medication is often prescribed. By the way, ginger and/or enteric-coated peppermint oil might be a reasonable alternative to the drugs commonly used for IBS.

When either proton pump inhibitors or the histamine H-2 receptor blockers are used, stomach acidity can become so reduced that the body fails to absorb vital nutrients like iron, calcium, zinc, magnesium and numerous others. You also reduce your primary defense against bugs in food (bacteria, parasites and fungi like Candida). This then can lead to both acute and chronic gastrointestinal infections and often sets one up for a lifetime of IBS, Candidiasis, and food sensitivity syndromes. Essentially, you are increasing your risk of food poisoning every time you use these “remedies”.

PPIs have also recently been associated with a much higher risk of acute kidney injury and chronic kidney disease. It’s no wonder that the use of PPIs is generally associated with greater risks of death and shortened lifespans.

Clostridium difficile bacteria can cause life-threatening colitis. A 2005 study in the Journal of the American Medical Association discovered that people taking proton pump inhibitors were almost three times more likely to have a C-difficile infection than non-users. Those taking H2 receptor antagonists were twice as likely to have the infection.

A 2004 study reported in The Journal of the American Medical Association concluded that the risk of pneumonia was 89% higher for those using proton pump inhibitors and 63% higher for those using H2-receptor antagonists. Acid-suppressive drug users were four times more likely to have pneumonia than non-users.   This underlines the importance of stomach acid as a systemic immune-boosting substance. Suppressing it will have its infectious disease consequences, especially if this is done on a long-term basis.

In 2000, the histamine H-2 receptor blocker, Propulsid, was taken off the market due to associated cardiac deaths.   While it seems to me that only cardiac deaths are the sole reason the HPB and the FDA takes drugs off the market, perhaps increasing rates of life-threatening pneumonias and C. difficile infections ought to be considered for drug removal as well. Proton pump inhibitors and the histamine H-2 receptor blockers should be used sparingly, if at all. Certainly, the natural alternatives are a better option here.

Alternatives to Heartburn Medication

Much like antibiotics, heartburn drugs of all kinds are grossly over-prescribed. According to most health care professionals, perhaps one in a hundred people actually need these drugs, while 99 out of 100 really need to change their diets and/or use harmless alternatives.

Drink more water: In my practice, I have found that many people who suffer from heartburn or reflux symptoms can control their symptoms simply by drinking more water that helps neutralize acid excess symptoms. So, if you get heartburn, drink an extra glass of water and watch the symptoms just disappear. It is a well-known fact that many patients living in long-term health facilities are dehydrated and this itself predisposes one to an early death.

There are probably as many natural remedies for hyperacidity as there are prescription drugs, so one has many choices. If you are not sure what to do, a natural health care practitioner will be able to help.

Since stress, or poor lifestyle choices such as cigarette smoking and physical inactivity can cause hyperacidity as well as just about any disorder, efforts should definitely be made to make major changes in these areas.

Get Tested for Bacterial Infections: Helicobacter pylori bacterial infections are thought to be the cause of peptic ulcer disease and this triggers doctors to prescribe either proton pump inhibitors or other drugs. There are a variety of tests your doctor can order for you to make the diagnosis. These include blood tests, breath tests, x-rays, ultrasounds, scopes and even biopsies. Medical doctors treat the H. pylori infection with antibiotics and a variety of antacids and/or acid suppressing drugs.

Try a Therapeutic Diet: With respect to diet, the best thing to do is eat frequent small meals throughout the day instead of the usual 3 large meals. Drink more spring or purified water to help dilute acid excess. Therapeutic vegetable juices include carrot, spinach, beet, cucumber, parsley, celery, cabbage and potato. These should be used liberally throughout the day (2 litres daily). Raw potato juice just before breakfast can help with acid regurgitation. Avoid red meat, alcohol, hot sauces, spicy and fried foods, added salt, caffeine products, sugar and refined carbohydrate products.

Remove aspirin; check your food allergies: If you use aspirin, replace it with white willow bark capsules. At least this will not further aggravate the discomfort. A large number of people suffer from hyperacidity because of an allergy to milk protein (casein) or gluten found in most grains. Food allergy or sensitivity testing might be a good idea in the more stubborn cases failing to respond to other diet and supplement changes.

Take supplements to relieve inflammation: Supplements that have a healing effect against H. pylori include garlic, wild mountain oregano oil, berberine, lactobacillus acidophilus and other probiotics, L-glutamine, bovine colostrum, essential fatty acids (flax seed oil, cod liver oil, salmon oil, evening primrose oil, borage oil), licorice root tincture or herbal tea, choline, lecithin, PABA, bismuth, bentonite, goldenseal, slippery elm, burdock, manuka honey, ginger root, mastic gum and aloe vera juice.

The use of proteolytic digestive enzyme supplements is by itself often very effective against any gastrointestinal infection.

Caution: The long-term use of licorice could elevate blood pressure in some sensitive individuals. The glycyrrhetinic acid component of licorice is what is responsible for this potential side effect. The best way of getting around this problem and still take advantage of licorice’s ability to protect the gastrointestinal lining from acid irritation is to use deglycyrrhizinated licorice (DGL). Many herbal brands manufacture DGL, a supplement widely available at most health food stores and pharmacies specializing in natural remedies.

The four-herb combination of burdock, slippery elm, Turkish rhubarb and sheep sorrel (a.k.a. Essiac) is effective for a wide range of gut problems including hiatal hernia, duodenal ulcers, gastritis, colitis, Crohn’s disease, non-specific indigestion, irritable bowel syndrome, hemorrhoids and bowel infections. It can be used alone or in combination with DGL, aloe vera juice or prescription medications in more resistant cases. Check with your doctor or naturopath for a personalized treatment regime.

Conclusion

“As geriatricians, we’re trained to take off medications first before we put more on. But often once medications are on, unless there’s a blatant problem, they don’t come off.” Dr. Elizabeth Landsverk, Geriatrician, Berlingame, California, 2019

One of the first scientist’s work I studied in the expanding subject of natural medicine was that of Dr. Carl Pfeiffer. His contribution to this field made him one of its all-time greats. The statement of his that I most remembered was:

“For every drug that benefits a patient, there is a natural substance that can achieve the same effect.” — Pfeiffer’s Law

Although I have mainly focused this article on PPIs and its safer alternatives, there exist safe and effective natural alternatives to all the drugs listed earlier that are most frequently prescribed for seniors in long-term care facilities. If only more of these were used, the incidence of pneumonias that include COVID-19 infections would likely be significantly reduced. There is much scientific evidence for this but it has been largely ignored. There is definitely a place for prescription drugs in the treatment of chronically ill seniors, but it is unfortunately an overused way of dealing with health concerns. It’s time to listen to and apply the alternatives.

[Editor's note: This article is not meant to replace the advice of your doctor. Please consult with your personal physician before making adjustments to your health care routine.]

REFERENCES

BITTER TASTING DANDELION LEAVES WORK TO STIMULATE THE LIVER AND GALLBLADDER, THEREBY IMPROVING DIGESTION

There are many ways to detoxify the body, and for a herbalist the favourite strategy involves medicinal plants. From my perspective, weeds and wild herbs are the best. With the snow gone and winter finally over, the green starting to appear isn’t just grass, but includes all those plants bursting with energy and waiting to help us. When I speak to gardening groups, I always warn them that after they learn how beneficial their weeds are, they won’t be able to look at them the same way again, and may even have difficulty throwing them into the compost.

Weeds, despised by gardeners and ignored by commercial interests, grow unnoticed beneath our feet, in the flower bed and through cracks in the concrete. We just can’t get rid of them. This is good because they provide us with effective medicine, and the place to start is with herbal teas.

Spring is the traditional time to clear the body of accumulated stagnation from winter foods and residual congestion from colds, although some form of cleansing can be done any time of the year.

A good detox should be balanced to support all the organs of elimination – liver, kidneys, bladder, skin, lymphatic system, and lungs. If all these organs are working in harmony, the waste metabolites that they clear will leave the body as intended – and will not come out through the skin as hives, pimples or boils, or produce headaches, nausea, and even diarrhea.

Dandelion (Taraxacum officinale)

This entire plant – flowers, leaves and root – supports the body. The flowers with their bright yellow colour indicate flavonoid content and its resulting antioxidant activity. If the spring flowers are picked early in the morning before the bees collect the pollen, then covered with boiling water to make a tea, a pleasant, sweet tasting beverage results.

Dandelion leaves are an important part of a detox because of their diuretic action, and unique because they do not leach out potassium. The nutritious leaves are a good source of potassium, as well as vitamins A, B, C and zinc. The bitter taste of these leaves stimulates the liver and gallbladder, thereby improving digestion.

The taste of the dandelion root in spring is also bitter because the sweet-tasting carbohydrate, inulin, which the plant produces and stores all through the summer, has been used for the plant’s survival under the snow through the autumn, winter, and early spring. This bitterness has a tonic effect on all the digestive organs which works to stimulate enzymes, hormones, and hydrochloric acid needed for good digestion. For the liver, the bitter taste of dandelion root increases the production of bile to flush and restore liver cells.

One of the liver’s lesser known attributes is the ability to break down hormones. If the body is producing excessive amounts of any hormone, and the liver is too congested or exhausted to do its job, this hormonal excess can cause unpleasant symptoms (as seen in PMS or menopause).

Harvested in the spring, dried and ground into powder, dandelion root works to draw wastes from the cells. The effect is noticed in the lungs as it helps to clear congestion, and in the joints as it alleviates the inflammation of arthritis.

Because the action of dandelion root on the liver is gentle, it is the best herb with which to begin a detox. Caution should be taken not to over-stimulate the liver initially because, if waste metabolites and/or toxins stored there are dumped too quickly into the bloodstream, and can’t be cleared efficiently through the kidneys, the result is skin irritation and other unpleasant side effects mentioned earlier.

If the waste matter cleared out from the liver stays in the bloodstream, it will circulate all over the body until it can be removed, either through the skin, or by passing through the kidneys, or with red blood cells being broken down in the spleen. Two particular herbs make the removal of waste from the blood more efficient.

Yarrow (Achillea millefolium)

Yarrow is a plant traditionally thought of as a vulnerary because of its ability to heal wounds of any kind, but this plant also has many additional benefits. Important for the detox process is the ability of yarrow leaves and flowers to help clear waste from the bloodstream by carrying worn-out red blood cells to the spleen for recycling, as well as stimulating the production of mast cells in the bone marrow.

Yarrow’s bitter taste works to stimulate the liver and general digestion, and the herb also has a tonic effect on the lungs and skin. Furthermore, its diuretic action assists with clearing metabolic waste from the body.

Red Clover (Trifolium pratense)

Red clover flowers share with yarrow the ability to carry waste out of the bloodstream, and so are a valuable part of a spring detoxification regime. Red clover is also considered a phytoestrogen for its ability to fill the same cellular receptor sites as natural estrogen. The phytoestrogenic effect is weaker than natural estrogen, making it a good choice when hormonal issues are caused by too much estrogen. Those who suffer from PMS can thus benefit from this phytoestrogenic effect of clover, as well as the liver’s ability to break down excessive hormones, as these two actions combined can lessen unpleasant symptoms. During menopause, the gentler phytoestrogenic effect also helps to fill empty receptors when estrogen is low.

Red clover also performs a tonic action on the lymphatic system, and its expectorant properties are useful for individuals needing a lung tonic.

Stinging Nettle (Urtica dioica)

To assist the body in clearing waste, support for the kidneys is provided by stinging nettle leaves. This is another wild plant that tends to be unwelcome in any area, not just the garden. Yet herbalists consider nettles as essential components of kidney-supportive protocols that are part of a spring detox.  If you encounter them in the wild, you can be sure of their identity by brushing your hand against them – the leaves and stalks will impart a nasty sting. So wear gloves when harvesting nettles. The leaves can be collected and steamed to be eaten as a vegetable, or chopped and added to a salad (blanch the leaves first). When the leaves are used in a detox combination (as part of a tea or tincture), their supportive action on the kidneys is concentrated to help clear waste from the blood that passes through them.

And nettles have other ways to help us feel better. The antihistamine content can relieve allergy symptoms. Anti- inflammatory action is also part of reducing allergies and can benefit anyone suffering from arthritis. Nettles are also considered to be nutritive because of the chlorophyll and micromineral (particularly boron) content, making them useful in a formula for strong bones, nails, and teeth.

Ground Ivy (Glechoma hederacea)

This weed has other names, including ‘Gill over the ground’ and ‘Creeping Charlie’– and is considered a menace by anyone who wants a perfect lawn of grass. A member of the mint family, ground ivy has a strong, earthy scent and taste, and can perform valuable medicinal actions.

As a choleretic supporting liver function, the aerial parts of ground ivy are a good choice in a detox formula. The plant’s ability to remove lead and other heavy metals is particularly valuable for spring cleansing. Its expectorant action can be helpful if sinuses and lungs need clearing. Ground ivy also has a stimulating effect on the thyroid, making it helpful for those who are hypothyroid, but contraindicated for anyone whose thyroid is overactive.

The diuretic action of ground ivy may not be noticed when the herb is used alone, but in a detox combination it will augment clearance through the urinary tract.

Cleavers (Galium aparine)

Cleavers is another plant with more than one name. Sometimes spelled ‘clivers,’ the fine prickles on the stems and seed heads inspire another name: ‘Sticky Willie.’

Regardless of what you choose to call it, the aerial parts of this plant work to stimulate the production and circulation of lymph fluid by  clearing congestion in the lymph nodes and reducing lymphatic inflammation. At the same time, cleavers has a diuretic effect, which helps the detox process.

For those needing a longer detox with stronger herbs, the next step is to replace dandelion root with yellow dock.

Yellow Dock (Rumex crispus)

Named for the bright yellow-orange colour of the inner root, yellow dock root has a noticeable laxative action, which may be needed to aid the detoxification process. As well, the root and seeds of yellow dock are an easily absorbed source of iron.

If, after using yellow dock, congestion in the liver hasn’t cleared sufficiently, it is time to change from yellow dock to burdock root as the liver stimulant part of a detox plan.

Burdock (Arctium lappa)

It is never wise to begin a first detox using burdock root, particularly if the liver is extremely congested. Burdock acts so strongly on the liver that years of accumulated waste can be released into the bloodstream faster than the other eliminative organs can process it out of the body, resulting in the symptoms referred to earlier.

Once an individual has gone through a few months of detox with dandelion root and yellow dock to clear out accumulated toxins, the body is ready for burdock to complete the process, and will benefit from the many other beneficial actions this root offers. These include adrenal support, antimicrobial activity, and the ability to lower blood sugar.

Conclusion

I recommend that the herbs in a detox combination be taken as a tincture for a month (1 tsp. or 5 mls in a glass of water on empty stomach, 3 times per day). Depending on the individual’s state of health, a longer detox period may be required. Alternately, you may prefer to switch to a tea (one teaspoon of dry herb in one cup of boiling water; cover and steep until cool enough to drink) rather than continue taking an alcohol-based tincture long term. The action of a tea will be gentler, and so will take longer to complete, but it is still effective.

These are all safe herbs. However, they should be used with caution by anyone who is pregnant or taking prescription medications, and only if they are under the supervision of a qualified herbalist or other natural health practitioner who is experienced with the use of herbs.

By choosing the herbs mentioned, you can achieve a balanced detox with no unwanted symptoms, giving only the energy that results from a body working as it was meant to.

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Dear Dr. Rona,

I'd very much appreciate it if you could address the issue of bladder stones (not kidney stones, not gallstones).
I'd like your take on what causes them to occur; what foods/drinks to avoid; what natural remedies are best to reduce and/or eliminate them.
Similarly, re: BPH and high PSA reading - 8.4. Many thanks in advance and keep up your great work.  Howard F.

Dear Howard,

Bladder stones are basically hard masses (the size of tiny pebbles) that form from minerals that crystallize inside the bladder, mostly in men over the age of 50. They usually start to form just as men begin to have problems completely emptying their bladders. This allows for the urine to become more concentrated and, in time, stones start to develop.

If the urinary bladder is completely drained, minerals do not have enough time to form into stones. Most of the smaller bladder stones usually pass without treatment but occasionally they require medications or surgery. Left untreated, bladder stones can result in infections and possible blood loss or urinary tract blockages.

Infections can cause bladder stones as well as the presence of any foreign materials in the bladder. Prostate gland enlargement (Benign Prostatic Hypertrophy or BPH) can cause bladder stones in men because it can interfere with urinary flow preventing the bladder from emptying completely. Damaged nerves to the bladder (a.k.a. neurogenic bladder) from a stroke, spinal cord injury, or other health problem can also prevent the bladder from emptying completely.

Bladder inflammation caused by radiation damage or infection can also lead to bladder stones. Medical devices such as urinary catheters may cause bladder stones. In women, some contraceptive devices or a urinary stent could be the cause. Finally, some kidney stones formed in a completely different way could travel down the ureters and end up in the bladder. If not expelled they can grow into bladder stones.

Prevention & Treatment

Early diagnosis and treatment of BPH could reduce the risk of developing bladder stones. A medical doctor could diagnose BPH through a rectal exam or ultrasound test.

Drink more water to help dilute the concentration of minerals that could form bladder stones. Most adults with normal cardiovascular systems and kidney function should be able to drink at least 2 liters of pure water every day. If a person tends to sweat more than the average, or is exposed to higher summer-like temperatures, make sure theydrink even more than the 2 liters daily.

Practice what’s called “double voiding.” This means that you try urinating 10 – 20 seconds after the first attempt. This can help more fully empty the bladder. Men with enlarged prostates can more completely empty their bladders by sitting down to urinate. Combining this with double voiding can help prevent bladder stones.

Horsetail, dandelion leaf, corn silk and goldenseal are herbs with mild diuretic properties that can make urination somewhat easier. Experiment with dosages and use as teas whenever possible. Men with prostate problems will also often benefit from herbs such as stinging nettle and saw palmetto. Beta sitosterol is the active ingredient of herbs such as saw palmetto and can help prevent prostate enlargement. A variety of combination prostate health formulas are available from your local health food store.

If you supplement with vitamin D, make sure it’s combined with vitamin K2. Take at least 120 mcg of K2 with each 1000 IU of vitamin D3. This prevents calcium from being deposited in soft tissues like the kidneys or bladder. Do not take any calcium supplements.

As far as diet is concerned, avoid foods high in sugar and low in fiber. Try to follow a Mediterranean diet as much as possible, and avoid caffeine and alcohol that tends to dehydrate the bladder. Better still, plant-based diets are naturally lower in sodium and higher in water concentration, making them more likely to prevent bladder stones. Plant-based diets tend to make the body more alkaline – making it easier to pass stones. So try using plant burgers instead of the regular meat ones. They are also higher in both potassium and magnesium, two minerals important in balancing higher calcium concentrations that can lead to bladder stone formation.

Lemon and apple cider vinegar are acidic to start with, but in the body they become alkaline-forming and make stone passage easier. Avoid un-sprouted or refined grains as they tend to work as stone formers. Avoid foods high in oxalic acid (oxalates) as this can stimulate more stone formation. High oxalate foods include spinach, rhubarb, tomatoes, collards, eggplant, beets, celery, summer squash, grapefruit/grapefruit juice, sweet potatoes, peanuts, almonds, blueberries, blackberries, strawberries, parsley and cocoa.

Avoid calcium supplements but not vitamin C. It is untrue that vitamin C causes stones. In fact, vitamin C may actually help dissolve them by pushing uric acid out of the body in those suffering from high levels causing gout and stones in various parts of the body.

These same principles will help any man with an enlarged prostate. In cases where the PSA reading is high, doctors will have to rule out prostate cancer which is something that requires somewhat of a different approach.

REFERENCE

https://www.mayoclinic.org/diseases-conditions/bladder-stones/symptoms-causes/syc-20354339

"Sufficient doses of vitamin C and other nutrients such as vitamin D3, zinc, magnesium, and selenium lower the risk of developing viral infections, and can protect patients in the initial stages of infection from progressing to more serious disease." – Dr. Richard Cheng, MD, PhD

Due to their lengthy development of at least 2 years, vaccines are not an effective tool for stopping or controlling new epidemics. Group immunity (as the term "herd" generally implies animals other than humans) may be the only way to stop an ongoing new epidemic. However, unprotected exposure of the public to new pathogens (viruses) may result in high morbidity, mortality and economic losses.

It may also seem irresponsible or unethical for governments not to offer any protection to its citizens. Early and sufficient use of vitamin C (along with vitamin D3, zinc, magnesium and other nutrients) is able to offer a high level of protection. A strategy of combining supplements of vitamin C and other nutrients with traditional herd immunity to form the basis of the "Protected Group Immunity" is worth further study and may become a better preventive measure to stop Covid-19 and future epidemics.

Epidemics/Pandemics are on the Rise

In a short period of only 4 months, Covid-19 pandemic has caused more than 200,000 fatalities, with 2.7 million confirmed cases of SARS-Cov-2 infections, and economic losses in the trillions of USD worldwide.

An article in the Wall Street Journal's Economy section on March 6, 2020, read "Global viral outbreaks like Coronavirus, once rare, will become more common." [1] BBC also reported on March 25, 2020 (Covid-19: the history of pandemics) that the rate of new epidemics like SARS, MERS and Covid-19 has increased 4-fold over the past century. The annual outbreak of epidemics in the last 40 years has doubled. [2]

In the short 20 years of the 21st century, there has been over 60 epidemics compared to the less than 100 epidemics in the entire 19th and 20th centuries combined. This is about a 650% annual increase in the number of epidemics in the last 20 years compared to the 200 years prior! Moreover, there have been 11 epidemics in the 21st century that caused more than 1,000 fatalities, compared to the 14 epidemics in the 200 years prior. If we use fatality of 1,000 as a marker for severity, there has been an increase of 785%. [3]

What's the plan of our governments, the World Health Organization (WHO), the pharmaceutical industry, and the leading medical institutions to deal with the disturbing trend of increasing epidemics?

Probably the most common term used to describe prevention of epidemics is "vaccine." International agencies like WHO, sovereign governments, major foundations, pharmaceutical industry, as well as leaders in major medical institutions all appear to be focused on vaccine and vaccine only.

We wish we would have a Covid-19 vaccine today. We wish we had a Covid-19 vaccine 4 months ago. But unfortunately, we didn't and we don't. The best estimate of a vaccine is at least 18-24 months away, if possible at all.

Vaccine is Not an Ideal Answer to New Epidemics

The nature of vaccine development makes the vaccine strategy against new epidemics a less than ideal one. Let's look at the process of how a vaccine is developed.

First, a new pathogen (e.g., SARS-Cov-2 virus that has caused the Covid-19 pandemic) appears and causes a local infectious disease outbreak. This eventually catches the attention of the local medical agencies and governments. Scientists then begin to study the new infectious disease, identify the new pathogen, develop a vaccine, which needs to go through clinical trials to demonstrate its safety and effectiveness. If the clinical trial is successful, an application for approval by the FDA is then submitted. If a vaccine is finally approved by the FDA, it is then mass produced and distributed for clinical use. This is a lengthy process, with at least 2 years after a new epidemic breaks out. To make things worse, due the frequent mutations of viruses, especially for RNA viruses, and due to the delay in finally mass-producing a vaccine, the virus has likely mutated to lower the vaccine's efficacy.

Covid-19 has already caused trillions of dollars in economic damage in a short period of four months. Likely many more lives and much more economic damage will occur in the next 18 to 24 months while we are waiting and expecting a vaccine. What if we will never see an effective vaccine? In the history of medicine, there has never been a vaccine developed in a timely manner to stop an ongoing new epidemic. Successful vaccines today are only effective against an existing infectious disease or recurrent epidemic, not a new epidemic. Even so, for most of the many recent epidemics like SARS, MERS, Ebola, Marburg, Zika, and Dengue, to name just a few, there is no vaccine.

Further, vaccines can only prevent an infection. Vaccines are not treatment for infections.

Ideal Preventive and Treatment Measures Against all Epidemics are Urgently Needed

We clearly need better preventive and treatment measures to deal with the disturbingly increasing trend of epidemics. Ideally good preventive and treatment measures for new epidemics should have the following characteristics:

  1. Nonpathogen specific and universal: treatments that can lower the risk of infection from a virus or other pathogens, or can reduce the severity of the infection. This characteristic would allow us to prevent and treat any epidemic when it occurs, without any unnecessary delay.
  2. Effective and safe.
  3. Readily available: when an epidemic breaks out, we need to have it available right away to stop an epidemic.
  4. Affordable: this is yet another key characteristic for large scale application to stop an ongoing epidemic.

For new epidemics, vaccines clearly don't meet the above criteria.

Our natural defense mechanisms including nutrients like vitamin C are among the few options that meet the above characteristics. They can defend us from catching diseases, and can prevent the disease from progression. Other such nutrients include vitamin D3, zinc, magnesium, selenium etc.

Vitamin C has pleiotropic biological effects including – but not limited to – its antiviral and antimicrobial effects, immune-boosting effects, as well as antioxidant effects.

  1. Vitamin C has potent antiviral effects through virucidal and immune modulating effects. [4-13]
  2. Vitamin C is a prototypical potent antioxidant that plays a critical role in the prevention and treatment of the marked inflammatory response to viruses and other pathogens. Clinically vitamin C is effective in preventing and treating pneumonia [12], multi-organ failure [14], and acute respiratory distress syndrome (ARDS). [14-18] Another related antioxidant that has shown promise for acute cases of pneumonia is glutathione. [19]
  3. Preliminary clinical evidence from China and elsewhere seems to show high-dose IV vitamin C is effective in treating Covid-19 patients. [20,21]
  4. Out of the few treatments being tried for Covid-19, high-dose intravenous vitamin C (HDIVC) shows very promising results in treating critical cases of Covid-19 with reduced fatalities, reduced ICU or hospital stays [22-25] and is very safe, without significant side effects (caveat, G6PD deficiency). [22,26] HDIVC's effectiveness in treating infectious (including viral) diseases and its high safety profile is based on solid science with decades of basic and clinical research reflected in tens of thousands of research papers in the world's largest biomedical library, the United States National Library of Medicine, hosted at the NIH (pubmed.gov).
  5. Given the lack of proven and widely accepted effective treatments of Covid-19, the high safety profile of HDIVC and promising effectiveness of HDIVC makes the compassionate use of HDIVC very reasonable. In my opinion, not to give HDIVC to critically ill Covid-19 patients seems unthinkable, even unethical.

Protected Group Immunity

With vaccines against Covid-19 not anywhere near, the only other hope to stop the Covid-19 pandemic seems to be group immunity: when enough members of a population develop immunity. Yet to leave the public without any protection from the risk of a SARS-Cov-2 infection seems cruel, unethical and may even cause a public outcry.

However, sufficient doses of vitamin C (3000 mg/d in divided doses), and other nutrients such as vitamin D3 (2000-5000 IU/d), zinc (20 mg/d), magnesium (400 mg/d), and selenium (100 mcg/d), lower the risk of the public developing the infection, and can protect patients in the initial stages of infection from progressing to more serious disease. [22]

Vitamins C and D are known to assist and empower the immune system to prevent viral infection, [22-31] and vitamin C in high oral doses to bowel tolerance [32,33] can denature viruses and prevent damage to the body from oxidative stress. Supplemental high-dose oral or intravenous vitamin C is indicated in severe infections and oxidative stress because they cause the vitamin C level to drop to zero. [27]

Zinc, magnesium, and selenium are known anti-viral agents. [30,31] With such a treatment that has worked to prevent serious infection of a variety of other viruses, further research is clearly indicated here. Moreover, the WHO currently recommends research on vitamin C as a promising treatment for COVID-19. [34] When proven, this strategy not only can help stop Covid-19 pandemic, it will also protect us in the future epidemics.

Acknowledgment: thanks to the members of the editorial board of the Orthomolecular Medicine News Service who reviewed and critiqued this manuscript, including the choice of "group immunity" over "herd immunity."

[Editor's note: This article is not meant to replace the advice of your doctor. Please consult with your personal physician before making adjustments to your health care routine.]

REFERENCES

1. Hilsenrath, J. Global viral outbreaks like coronavirus, once rare, will become more common. Wall Street Journal (2020). https://www.wsj.com/articles/viral-outbreaks-once-rare-become-part-of-the-global-landscape-11583455309

2. Walsh, B. Covid-19: The history of pandemics. (2020). https://www.bbc.com/future/article/20200325-covid-19-the-history-of-pandemics

3. Timeline: Major Epidemics in the U.S. (2020) https://www.infoplease.com/math-science/health/diseases/major-us-epidemics#timeline

4. Pauling, L. (1971) The Significance of the Evidence about Ascorbic Acid and the Common Cold. Proc Natl Acad Sci USA 68:2678-2681. https://www.ncbi.nlm.nih.gov/pubmed/4941984

5. Chen Q, Espey MG, Krishna MC et al. (2005) Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Proc. Natl. Acad. Sci. USA 102:13604-13609. https://www.ncbi.nlm.nih.gov/pubmed/16157892

6. Chen Q, Espey MG, Sun AY et al. (2007) Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proc. Natl. Acad. Sci. USA 104:8749-8754. https://www.ncbi.nlm.nih.gov/pubmed/17502596

7. Du J, Martin SM, Levine M et al. (2010) Mechanisms of ascorbate-induced cytotoxicity in pancreatic cancer. Clin. Cancer Res. 16:509-520. https://www.ncbi.nlm.nih.gov/pubmed/20068072

8. Sestili P, Brandi G, Brambilla L et al. (1996) Hydrogen peroxide mediates the killing of U937 tumor cells elicited by pharmacologically attainable concentrations of ascorbic acid: cell death prevention by extracellular catalase or catalase from cocultured erythrocytes or fibroblasts. J. Pharmacol. Exp. Ther. 277:719-1725. https://www.ncbi.nlm.nih.gov/pubmed/8667243

9. Verrax J, Calderon, PB. (2009) Pharmacologic concentrations of ascorbate are achieved by parenteral administration and exhibit antitumoral effects. Free Radic. Biol. Med. 47:32-40 . https://www.ncbi.nlm.nih.gov/pubmed/19254759

10. Hemilä H, Chalker E. (2013) Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev CD000980. https://www.ncbi.nlm.nih.gov/pubmed/23440782

11. Nabzdyk CS, Bittner EA. (2018) Vitamin C in the critically ill - indications and controversies. World J Crit Care Med 7:52-61. https://www.ncbi.nlm.nih.gov/pubmed/30370227

12. Hemilä, H. (2017) Vitamin C and Infections. Nutrients 9(4). pii: E339. https://www.ncbi.nlm.nih.gov/pubmed/28353648

13. Colunga Biancatelli RML, Berrill M, Marik PE. (2020) The antiviral properties of vitamin C. Expert Rev Anti Infect Ther. 18:99-101. https://www.ncbi.nlm.nih.gov/pubmed/31852327

14. Vincent JL, Moreno R, Takala J et al. (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 22:707-710. https://www.ncbi.nlm.nih.gov/pubmed/8844239

15. Kashiouris MG, L'Heureux M, Cable CA et al. (2020) The Emerging Role of Vitamin C as a Treatment for Sepsis. Nutrients. 12(2). pii: E292. https://www.ncbi.nlm.nih.gov/pubmed/31978969

16. Sawyer, M., Mike, J. & Chavin, K. (1989) Antioxidant therapy and survival in ARDS (abstract). Crit Care Med. 17:S153.

17. Marik PE, Khangoora V, Rivera R et al. (2017) Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest 151:1229-1238. https://www.ncbi.nlm.nih.gov/pubmed/27940189

18. Boretti A, Banik BK. (2020) Intravenous Vitamin C for reduction of cytokines storm in Acute Respiratory Distress Syndrome. PharmaNutrition. 12:100190. https://www.ncbi.nlm.nih.gov/pubmed/32322486

19. Horowitz RI, Freeman PR, Bruzzese J. (2020) Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases. Respir Med Case Rep. 30:101063. https://www.ncbi.nlm.nih.gov/pubmed/32322478

20. Video conference with Dr. ZY Peng, of the world's first high-dose IVC trial. (2020) Cheng Integrative Health Center Blog. http://www.drwlc.com/blog/2020/04/16/video-conference-with-dr-zy-peng-of-the-worlds-first-high-dose-ivc-trial

21. Cheng RZ (2020) Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)? Medicine in Drug Discovery 5, 100028. https://www.ncbi.nlm.nih.gov/pubmed/32328576

22. Orthomolecular Medicine News Service Editorial Review Board (2020) Rationale for Vitamin C Treatment of COVID-19 and Other Viruses. http://orthomolecular.org/resources/omns/v16n21.shtml

23. Player G, Saul AW, Downing D, Schuitemaker G. (2020) Published Research and Articles on Vitamin C as a Consideration for Pneumonia, Lung Infections, and the Novel Coronavirus (SARS-CoV-2/COVID-19) Orthomolecular Medicine News Service. http://orthomolecular.org/resources/omns/v16n20.shtml

24. Front Line COVID Critical Care Group (2020) Early Intervention Protocol for COVID-19 Can Save Lives. April 15, 2020. https://covid19criticalcare.com

25. Carr AC, Maggini S. (2017) Vitamin C and Immune Function. Nutrients 9(11) pii: E1211. https://www.ncbi.nlm.nih.gov/pubmed/29099763

26. Prier M, Carr A, Baillie N. (2018) No reported renal stones with intravenous vitamin C administration: a prospective case series study. Antioxidants (Basel) 7: 68. https://www.ncbi.nlm.nih.gov/pubmed/29883396

27. Berger MM. (2009) Vitamin C Requirements in Parenteral Nutrition. Gastroenterology 137:S70-78. https://www.ncbi.nlm.nih.gov/pubmed/19874953.

28. Grant WB, Baggerly CA (2020) Vitamin D Supplements Could Reduce Risk of Influenza and COVID-19 Infection and Death. Orthomolecular Medicine News Service. http://orthomolecular.org/resources/omns/v16n23.shtml

29. Grant WB, Lahore H, McDonnell SL, et al. (2020) Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 12(4). pii: E988. https://www.ncbi.nlm.nih.gov/pubmed/32252338

30. Gombart AF, Pierre A, Maggini S. (2020) A review of micronutrients and the immune system-working in harmony to reduce the risk of infection. Nutrients 12(1). pii: E236. https://www.ncbi.nlm.nih.gov/pubmed/31963293

31. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. (2020) Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients 12: 1181. https://www.ncbi.nlm.nih.gov/pubmed/32340216 https://doi.org/10.3390/nu12041181

32. Cathcart RF. (1981) Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy. Medical hypotheses 7:1359-1376. https://vitamincfoundation.org/www.orthomed.com/titrate.htm

33. Hickey S, Roberts HJ, Cathcart RF. (2005) Dynamic Flow: A New Model for Ascorbate. J Orthomol Med. 20:237-244. http://orthomolecular.org/library/jom/2005/pdf/2005-v20n04-p237.pdf

34. World Health Organization (2020) A Coordinated Global Research Roadmap: 2019 Novel Coronavirus. March, 2020, p 36-37. https://www.who.int/blueprint/priority-diseases/key-action/Coronavirus_Roadmap_V9.pdf

Nutritional Medicine is Orthomolecular Medicine

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"In the torrent of information about COVID, one aspect of the crisis is conspicuously missing – the manner in which the medication burden people are already under may compromise their response to the infection.  RxISK has published the only paper dealing with this, in downloadable English and Spanish PDFs: https://rxisk.org/medications-compromising-covid-infections/" – Dr. David Healy, MD

"During the present COVID-19 pandemia, all medications should be critically reviewed and where possible de-prescribed, in order to decrease not only the risk of pneumonia and its complications, but also other adverse effects which frequently lead to hospital admission (e.g., fractures)." Dr. Joan-Ramon Laporte, MD

In the present situation of pandemia by SARS-CoV-2, it is imperative to avoid pneumonia and related risk factors as much as possible. The consumption of various commonly used medicines increases the risk of – and complications from – pneumonia. Prescription medications can increase the risk of pneumonia by depressing immunity and other protective mechanisms. Such medicines can also increase pneumonia risk by causing sedation, which may increase the risk of aspiration by depressing pulmonary ventilation, or by a combination of these mechanisms.

The impact of the association between exposure to certain drugs and infection or pneumonia depends on the prevalence of use of the concerned drug, the magnitude of the relative risk, and the baseline incidence of the condition (i.e., infection, pneumonia).

Drugs Which Increase the Risk of Pneumonia

Antipsychotic Drugs (APs)

Antipsychotic agents (aripiprazole, olanzapine, quetiapine, risperidone, haloperidol, among others) are associated with a 1.7 to 3-fold risk of hospitalization for pneumonia,[1],[2],[3],[4],[5],[6] and of mortality by pneumonia. According to the Journal of the American Geriatric Society, "Current use of antipsychotics was associated with an almost 60% increase in the risk of pneumonia."[3] These drugs can also cause a respiratory dyskinesia that may be mistaken for asthma or other lung conditions and lead to inappropriate treatment.

In view of the harms induced by the use of antipsychotic agents (APs) for the symptomatic treatment of aggression and psychotic symptoms in elderly patients in residential facilities,[7],[8] in 2008 the European national regulatory agencies recommended limiting their use to patients not responding to other interventions, and to reconsider their prescription at every follow up visit, with close patient follow up.[9] In spite of these warnings, APs are widely prescribed off-label to the elderly[10] at inappropriate doses and for too long periods.[11],[12],[13] In these situations, the harms caused are considerable.[14]International variability in their use[15],[16],[17],[18] is more likely related to variability in off-label use than to variability in the prevalence of mental disorders.

For example, in Catalonia, Spain around 90,000 persons older than 70 receive continued treatment with APs (seven monthly supplies per year). Of those, around 22,000 live in nursing homes. Taking the lowest estimate of relative risk of 1.7, if the annual incidence of pneumonia among the non-exposed is 10% in a nursing home, the incidence among those exposed to APs would be 17%, and 70 additional cases of pneumonia attributable to APs would be expected for every 1,000 treated persons (from 100 to 170). For 20,000 exposed persons living in nursing homes, the annual number of additional cases would be 70 x 20 = 1,400.

It is important also to remember that metoclopramide, prochlorperazine and a number of other drugs given for nausea or other gut disturbances are essentially the same drugs as the APs, and can cause tardive and respiratory dyskinesias as well as the other problems linked to these medicines.

Anticholinergic drugs

The consumption of anticholinergic drugs increases the risk of pneumonia by 1.6 to 2.5-fold.[19],[20],[21]

Various drugs of different therapeutic groups exhibit anticholinergic effects:

Anticholinergic drugs are commonly prescribed to the elderly. Published estimates of prevalence of use range between 4.3% to more than 20%.[22],[23],[24],[25] The pattern varies from country to country, with codeine plus paracetamol, antidepressants (amitriptyline, dosulepin, paroxetine) and urologicals (predominantly oxibutinin and tolterodine) generally being those with higher prevalence of use.

Many of these medicines have other mechanisms that can increase sedation and increase the risk of pneumonia in this way. Their anticholinergic effects can add to confusion in someone who may have respiratory compromise and contribute to aspiration in this way. The anticholinergic effect can also contribute to atelectasias in the context of a viral respiratory infection.

Opioid analgesics

Opioid analgesics cause respiratory depression with the resulting pulmonary hypoventilation; some of them (codeine, morphine, fentanyl and methadone) have also immunosuppressive effects. They increase the risk of pneumonia and respiratory mortality by 40% to 75%.[26],[27],[28]

In 2018, around 50 million persons in the U.S. (15% of adults, 25% of those older than 65), filled an average of 3.4 prescriptions for an opioid analgesic, and 10 million persons reported misuse of prescription pain relievers.[29] In Europe in recent years the consumption of mild and strong opioid analgesics has increased, particularly among the elderly.[30],[31] Fentanyl and morphine are the most commonly used strong opioids, and more recently oxycodone. Tramadol, which is also a serotonin reuptake inhibitor, is the most commonly used mild opioid. In two recently published observational studies, consumption of tramadol, compared with NSAIDs, was associated with a 1.6 to 2.6-fold increase in mortality,[32],[33] particularly in patients with infection, and in patients with respiratory disease.

Hypnotics and Sedatives

Several studies have shown an increase of 20%[34] to 54%[35] in the risk of pneumonia in people consuming hypnotics and sedatives, in particular when they are taken concomitantly with other central nervous system (CNS) depressants (e.g., opioids, gabapentinoids).

In the OECD European countries, the national consumption of hypnotics and sedatives shows wide international variability, from 5 defined daily doses (DDD) per 1,000 inhabitants per day in Austria, to 68 in Portugal,[36] and it concentrates in the elderly. In Catalonia, 38% of those older than 70 years consume at least one of these drugs.[37]

Antidepressants

In a cohort study of more than 130,000 patients, a 15% increase in the risk of respiratory-related morbidity and a 26% increase in mortality was seen among older adults with chronic obstructive pulmonary disease (COPD) exposed to SSRI antidepressants.[38] In other studies, an increase in the risk has been seen in patients exposed to antidepressants concomitantly with other central nervous system depressants.

In the OECD countries, the consumption of antidepressants varies from 11 DDD per 1,000 per day in Latvia, to 98 in Iceland.36 In the UK, the number of National Health Service prescriptions for antidepressants doubled between 2008 and 2018.[39]

Painkillers – Gabapentin and Pregabalin

In December 2019, the U.S. FDA warned about an increased risk of pneumonia and severe respiratory insufficiency and death associated with painkillers such as gabapentinoids, particularly when they are consumed alongside opioid analgesics, hypnotics and sedatives, antidepressants and antihistamines.[40] In 2017 the EMA amended the summary of product characteristics (SPC) for gabapentin to include warnings for severe respiratory depression, which may affect up to 1 in 1,000 patients.[41],[42]

The summary of product characteristics (SPC) of gabapentin states that the incidence of viral infections in randomized controlled drug trials was “very common” (more than 1 out of 10 treated persons), and that the incidence of pneumonia and of respiratory infection was “common” (between one in 10 and 1 in 100). The SPC of pregabalin warns that in treated patients the incidence of nasopharyngitis is “common” (between 1 in 10 and 1 in 100).[43]

Gabapentin and pregabalin have limited efficacy in the treatment of neuropathic pain, and they are ineffective for their main (off-label) uses in practice, i.e. low back pain with possible radiculopathy.[44],[45],[46]In spite of this, since 2002 their consumption has more than tripled in the U.S.,[47],[48]in the UK[49] and in other European countries,[50],[51] often in combination with opioid analgesics and hypnotics.[52]

Proton Pump Inhibitors (PPIs, omeprazol and analogues)

The reduction of gastric acidity and the increase in gastric and gut bacterial colonization induced by these drugs can also increase the risk of pneumonia. Two meta-analyses of observational studies have shown increases of 34%[53] to 50%.[54] More recent studies have confirmed this magnitude of risk.[55],[56],[57]

A number of studies have shown a skyrocketing increase in the use of PPIs in the last years. Thirty percent of the population in France,[58] 15% in the UK,[59] 19% in Catalonia,[60] 7% in Denmark,[61] 15% in Iceland,[62] receive PPIs without any apparent justification in one third of cases. It is thus essential to identify patients who do not need these drugs, but there is also a need to be aware of a rebound of gastric and anxiety symptoms that can occur on withdrawal.

Cancer Chemotherapeutic and Immunosuppressive agents

Patients on these drugs are more susceptible to viral and non-viral infections, and they should generally not abandon the treatment. However, between 20% and 50% of patients with incurable cancer receive chemotherapy within 30 days before death. In terminally ill cancer patients, the use of palliative chemotherapy a few months before death leads to increased risk of undergoing mechanical ventilation and cardiopulmonary resuscitation and dying in an intensive care unit.[63] In the midst of a COVID-19 pandemia, patients, caregivers and oncologists should have a heightened awareness about the potential risks to them and to others of planning and continuing palliative chemotherapy.

Many patients also receive immunosuppressive agents for inflammatory chronic conditions such as psoriasis, inflammatory bowel disease, or rheumatic arthritis of mild and moderate severity, even though these drugs are only indicated for patients with severe disease not responding to first line treatments. Many of these patients may benefit from stepping down or pausing their treatments for a while and monitoring their clinical state.

Corticosteroids – whether systemic, inhaled, or occasionally topical or given by eye-drops – have immunosuppressive effects and increase the risk of pneumonia in patients with asthma and in patients with COPD.[64],[65] Patients with severe asthma should not abandon corticosteroids, but many patients receive inhaled corticosteroids (ICs) for upper respiratory infections. For example, in Catalonia every year 35,000 children under 15 years old are prescribed an inhaled corticosteroid (IC) for occasional (apparently unjustified) use[66] (except for laryngitis with stridor). Similarly, a proportion of COPD patients do not obtain any benefit from inhaled corticosteroids and they can avoid them. In one study, withdrawal of ICs was followed by a 37% decrease in the incidence of pneumonia.[67]

ACE inhibitors (ACEIs) and angiotensin blockers (ARB)

Apart from the debate on a possibly increased risk of complications associated to ACE inhibitors and angiotensin receptor blockers (ARBs),[68],[69] a study published in 2012, with 1,039 cases and 2,022 controls, did not find an increased risk of community acquired pneumonia associated to these drugs.[70]

In patients with heart failure, ischaemic heart disease or hypertension, keeping the number of medicines to those necessary and adjusting their treatment accordingly seems more important than withdrawing ACEIs or ARBs.

Ibuprofen or Acetaminophen for Fever or Pain?

Given the effects of non-steroidal anti-inflammatory drugs (NSAIDs), it is biologically plausible that respiratory, septic, and cardiovascular complications of pneumonia are more frequent and severe if fever or pain is treated with a NSAID. Fever should not be treated ordinarily and paracetamol is safer for pain. An increased incidence of upper and lower respiratory infections associated with NSAIDs has been recorded in randomized clinical trials and in several observational studies,[71] and the summary of product characteristics (SPC) of several NSAIDs warn about them.

Such lower respiratory infections are caused by influenza and other viruses (among them common-cold coronaviruses[72]), and NSAIDs may have contributed to many deaths every year worldwide. A strong case has been put forward that an indiscriminate use of high dose aspirin contributed to the mortality of the 1918 influenza pandemic.[73] While doses like this are not used now, this stands as a cautionary tale.

In the absence of specific data regarding COVID-19, paracetamol seems less likely to cause complications.

Concomitant use of Various Drugs

In modern health care settings, concomitant consumption of several of the drugs mentioned in this report is prevalent, increasing the risk of pneumonia.[74] The concomitant use of multiple drugs, particularly in older populations, has also more generally been linked to increased rates of hospitalisation and an earlier death.[75],[76]

In particular, the concomitant consumption of a PPI with one or more psychotropic drugs seems to be highly prevalent in nursing homes,[77] where the risk of contagion and of pneumonia is higher.

Opioids, all antipsychotics, and antidepressants have effects on the heart, as evidenced in lengthening Q-T intervals.[78] Azithromycin and hydroxychloroquine also prolong Q-T intervals and the addition of these drugs to prior treatment may accordingly cause problems.

Conclusions

Several widely used medicines, such as antipsychotics and antidepressants, opioid analgesics, anticholinergic drugs, gabapentinoids, proton pump inhibitors, and inhaled corticosteroids can increase the risk of pneumonia by 1.2 to 2.7 times.

Elderly patients are particularly likely to receive one or more of these drugs. These treatments are often ineffective, and given for unnecessarily long periods, at wrong doses, or for non-approved indications.

Although there is wide international variability in the use of these drugs, their prevalence of use in the elderly population is often higher than 10 percent, and sometimes it reaches 40-50 percent. With such a high consumption and a high baseline incidence of viral infection and pneumonia, these drugs can have a significant negative public health impact, and the number of victims can be of the order of hundreds per million inhabitants.

In the present situation of pandemia, unnecessary and harmful treatments should be reviewed and eventually stopped.

[Editor's note: This article is not meant to replace the advice of your doctor. Please consult with your personal physician before making any adjustments to your health care routine.]

This article was co-written by Dr. David Healy, MD, the CEO and principal founder of Data Based Medicine Americas Ltd.. He is an internationally respected psychiatrist, psychopharmacologist, scientist, and author. A professor of Psychiatry at Cardiff University in Wales, David is a former Secretary of the British Association for Psychopharmacology, and has authored more than 200 peer-reviewed articles, 200 other pieces, and 20 books.

David has been involved as an expert witness in homicide and suicide trials involving psychotropic drugs, and in bringing problems with these drugs to the attention of American and British regulators, as well raising awareness of how pharmaceutical companies sell drugs by marketing diseases and co-opting academic opinion-leaders, ghost-writing their articles. His latest book, Pharmageddon, documents the riveting and terrifying story of how pharmaceutical companies have hijacked healthcare in America and the life-threatening results. He also publishes through his blog DavidHealy.org and on Twitter @DrDavidHealy.

References

[1]    Butlletí Groc,  2016. Antipsicóticos: mala ciencia, pseudoinnovación, prescripción desbordada y yatrogenia. https://www.icf.uab.cat/assets/pdf/productes/bg/es/bg293-4.16e.pdf

[2]    Trifiró G, Sultana J, Spina E. Are the safety profiles of antipsychotic drugs used in dementia the same? An updated review of observational studies. Drug Safety 2014;37:501-20.  doi:https://doi.org/10.1007/s40264-014-0170-y

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After about 20 years of my own inner healing work, and listening to many clients tell me their life stories, I’ve arrived at the perspective that the number one need of any person is to feel and know unconditional love - by being seen and heard. When we’re not acknowledged for who we truly are, as a human being and as a beautiful Soul-Spirit, it awakens painful wounding with many tentacles. It’s been that way for eons, ever since the human race was subjugated into the cycle of self-enslavement because the harmony of our Divine Inner Feminine and Divine Inner Masculine was seen as a threat to the dark, anti-life forces. It's worth reflecting then, that if we've learned for so long not to been seen and heard in our wholeness, how can we see ourselves and hear ourselves in our Divinity now?

The Experience of Not Being Seen and Heard

To first get a sense of what this topic might mean to you now, I've listed here some of the ways that you may not have been heard or seen as a child in the past. Each is followed by how that may continue to manifest in your current life experience.

If you haven’t yet identified how you were not seen or heard, please take a moment now to ask yourself about that. Let it be made conscious, as otherwise it will continue to be a source of unhappiness and inner conflict. Every one of us came into this incarnation as a wonder of creation – an innocent child full of promise. And we relied on someone to warm us, feed us, and keep us safe.

Your Inner Child's Pain

No less vital to our physical nourishment was our need to be acknowledged for our uniqueness. To feel cherished and valued we wanted our Mom and Dad, or our caregivers, to listen when we spoke, to see what we could do, and to respect our preferences. And when we felt insecure, we wanted them to notice that we felt scared. In fact, we needed them to acknowledge all of our emotions because these were the most fundamental and earliest means of expressing who we were!!

Since people come to me to help them heal their pain, my work may skew my perception, but I can probably count on one hand the number of times I’ve heard somebody say that they felt unconditionally accepted. Even when they tell me that they knew they were loved, they realize that they didn't feel really acknowledged. Unhealed hurt creates feelings of aloneness, being misunderstood, rejected or abandoned.

This is such a prevalent issue that it’s not attached to birth order or family dynamic in any particular way. For example, an only child may feel she was never heard because she served as mom's confidante and her own needs were not heard. The second born may have always been compared to his sibling so he was never accepted for his own talents or difficulties. The middle child may feel he was never recognized because he was neither seen as the most reliable nor the one with the greatest needs - he got lost. The youngest child may feel she was not seen because everyone else had already "been there done that' and she was dismissed. An abused child certainly wouldn’t have been cherished for his/her presence, and the gifted child may have only been acknowledged for her/his intellect.

In all cases, Mom and Dad did the best they could for us, in alignment with their consciousness at the time. For some of us, sadly, this did not just mean that childhood was less than ideal, it meant being treated as invisible. The experience of not being seen and heard varies widely, but no matter how seemingly inconsequential or dire a child's circumstances, it's the child's perception of those experiences that creates their trauma. If it was perceived as shaming, it was shaming, no matter how minor or innocent an incident was to Mom or Dad. If a child feels dismissed for what they feel, say or do, a child feels devalued. If this message of unworthiness or conditional acceptance is repeated often enough, a child learns to think that this is who they are. Self-hatred, self-abandonment and self-rejection is given centre stage in his/her self-perception.

How This Wound is Perpetuated

Not being seen or heard is a tremendous set-up for continuing to seek external approval and validation, perfectionism, pleasing others, trying to belong, sexual manipulation and superficial relationships, substance abuse/addiction, tyrannical behaviour, rebellion of authority, and all sorts of wounded ego coping strategies and sub-personalities.

It's also easy to see why effective communication can pose to be such a challenge in relationships.  If we’re still carrying this wound, a simple misunderstanding can quickly lead to hurt, defensiveness, and unravel any harmony into conflict. Emotional vulnerability and intimacy is frightening if we cannot trust that we will be heard and seen when we share our emotions, needs and desires. Of course, we would want to protect our most precious heart.

The Core Split Between Masculine and Feminine

A child learns who they are through the wounds of Mom and Dad, passed subconsciously from one generation to another. But this is not just childhood pain. It’s a planetary wound rooted in the split between the masculine and feminine energies that has pervaded the collective consciousness. Distorted masculine energies have dominated the feminine through patriarchal controls completely imbalancing this Divine relationship. It's known as gender splitting and it touches every aspect of our living on Earth and our experiences. It’s at the core of all deception strategies throughout our galactic history, and it leads to soul disconnection and fragmentation.

This planetary wound has impacted every individual’s inner, sacred balance. When the masculine body is not connected, balanced and integrated with the feminine body one is not being acknowledged by the other. The inner wisdom that we receive by our inner Divine feminine is not carried through in compassionate action by our inner, Divine masculine. This is why we have individuals mired in the distraction of doing, and denying the heart, or being too passive, instead of openly flowing with love, and acting upon their inspired, intuitive wisdom.

If we do not heal, and see and hear our Divinity within, we remain split. It begins in childhood.

If a child is not seen, his/her feminine principle learns to disappear.

If a child is not heard, his/her feminine principle learns inner confusion.

If a child is not seen, his/her masculine principle learns to dominate.

If a child is not heard, his/her masculine principle learns to avoid.

The Suppression of the Collective Consciousness

The weight of this gender split influence is in our DNA and Light-body and keeps us thwarted. It’s been carried through many timelines in humanity’s history. In our many other incarnations, many of us were not accepted for being healing expressions of love, expressing intuitive gifts, or leading our lives through Divine intelligence. In fact, we were persecuted, and our cellular memories carry the painful sense that we were abandoned by God. This illusory separation from God creates many spiritual fears: humiliation, self-doubt, losing identity, knowing too much, being locked up, being trapped, losing our soul, etc. These then can manifest as a feeling that it's not safe to be seen and heard in this world, and that it's best to stay in the background or stay small.

The hierarchical patterns that have prevailed on this planet are intended to ensure that we stay in our place and do not "rock the boat". We receive the message that we’re not allowed to be authentically ourselves and be powerfully visible. In fact, we can have inorganic etheric implants that hold fear thought-forms of being found or seen, which distort our conscious desires to be seen and heard. Implants of patriarchal domination that instill a hive mentality can include submitting to external power, carrying out orders, unworthiness, fear of punishment, not questioning authority, and being seen but not heard. Finding our voice to express our truth can seem very frightening, as would accepting our genuine nature.

The Truth

It would seem that we cannot step into our fullest expression and be seen and heard when these influences run so deep. We can feel frustrated to release the subconscious limitations we continue to place upon ourselves, especially if we inherently know that we’re here with purpose. But our power is greater than our fears. Each person has chosen to be on Earth, and chosen to be here in a way that contributes to humanity, even if we sometimes feel ‘small’, powerless, or lost at times.

If we understand this larger context of our reality, we can acknowledge that not being seen and heard has been enforced on many levels. Instead of living with this wound, we can accept the truth of the way that things are playing out on Earth, and focus on reclaiming our sovereignty with healing.

In every person there is a spark of God's Light, even if it seems as though that spark is almost indistinguishable. This Light is the foundation of our Light-bodies and this can never been broken, extinguished or suppressed in its entirety. We do, however, have to intend and choose to reclaim and expand it. It takes diligence to work through the layers of resistance and density that we inherit through our ancestry when we come into this incarnation. Some people are here to purposefully clear that ancestral energy for the collective so it can seem especially difficult. Yet, if we choose to be free, healing is possible for everyone.

Seeing and Hearing our Own Divinity

What matters right now, as we make daily choices, is that each of us sees our own Light. It's up to each of us to see and hear who we truly are as infinite consciousness. This begins with self-honesty: being willing to take a good look at the misperceptions we have of ourselves and listen to our truth. Instead of being afraid of the pain that we may find, we lean into it and confront it, and ask, "Is this the person that I want to be and who I present to the world on a daily basis?" If the answer is 'no', then there is work to be done, and we can seek healing support. But this is not about having to push through the obstacles, and nor is it about falling into despair. It’s that each of us can access that part of us that holds the seed of truth instead of the seed of fear.

To see who we are as a vast consciousness being may require imagination and vision. We may not yet feel aligned with our infinite and authentic Spirit, and so when we’re doing our inner work and clearing the pain from our past it can feel heavy. We may wonder at times what we’re moving toward and need encouragement. The tree reminds us of our organic life force. When we plant a seedling we trust in its full nature, its whole potential that’s in its morphogenetic field. Our whole potential is in our field as well. Every part of a tree has value - the branches, the leaves, the blossoms, the roots, its colour, its fragrance, texture shape and its healing properties - and yes, any part can be compromised.

In the same way, every part of us matters – those aspects that have been informed by experiences, internalized messages, and fears as well as joys. Yet, attentive, loving care can heal the painful, wounded parts and open our Divine heart. If we feel that we’re like a weak seedling that will not offer much, then that's what we will become. But if we can see ourselves in our fullest capacity, then we will see what beautiful fruit and blossoms we have potential to bear, and this is our en-courage-ment. We can inquire within: "What do I still need to see and hear in myself to know my wholeness?" and "What do I still need to see and hear in myself to accept myself fully?" Then imagine giving this to yourself - FEEL it and expand it!

Our planet has evolved from a third-dimensional reality mired in ego to a higher consciousness of the soul. There is no question that we’re ascending. While we collectively and personally continue to evolve there is still much healing to be done. Our vision for ourselves and for humanity is paramount because it can help all of us through our personal and collective transitions with less upheaval and more grace.

When we reclaim and respect our Divine inner feminine and Divine inner masculine we create balanced, inner, sacred marriage. We can then know ourselves as Christ-Sophia, the Divine child that is sacred light, sacred sound, and an expression of infinite love. There is no need to fight to be seen and heard. We can let go. All we need to see and hear is from within. Our God-Self within is our witness.

Let's practice forgiveness toward those we feel did not see or hear us. Let's forgive ourselves for not hearing and seeing who we truly are. And let's remember that sometimes the most gentle, healing words that we can say are simply, 'I see you, I hear you." May we direct this love to our inner child first.