Random clinical pearls from the 2008 Naturopathic Medicine convention in Phoenix, AZ
(Aug 13-17, 2008) on DIABETES management, the question of SOY, Vitamin D, kidney stone prevention…

Diabetes management.
Untreated, this disease will likely cause you to die sooner, and miserably.  Untreated diabetes causes blindness, deafness, cardiovascular failure and is the leading cause of lower limb amputations.  Luckily, it can be effectively managed quite well, with dedication to lifestyle changes.

Key concepts:

Eat regular, smallish meals, 3 or 4 times daily.  Keep a steady schedule for feeding to help stabilize blood sugar levels.  Each meal should have more or less equal calories from fat, complex carbohydrates and protein.  Strictly avoid refined carbohydrates.  Eat less fat if weight is an issue.  However, diabetics NEED “good” fats, from vegetables and organically raised animals.  Avoid non-organic animal products because of the toxins in their fat.  Consider the following advice, which is especially true for diabetics and those with other, nutritionally-based chronic diseases: eat like your great-grandparents did.

Beans for breakfast (lentils, black, adzuke, etc) is an excellent choice.

Diabetics need minerals (take a multi-mineral) especially magnesium, potassium and, most importantly, chromium.  Chromium (ideally picolinate) is no longer in our soil in significant quantities, nor in processed grains.  Take up to 2000 mcg daily.  5000 mcg daily has been shown to cause reversible kidney damage, so use less.  The therapeutic dose is up to 10 times higher than the commonly prescribed 200 mcg daily.

Diabetics need B vitamins — take a B multi in the 50 mg dose range (with 1000-2000 mcg for B 12)

Good snacks:
apple slices coated with cinnamon
dried cherries (another low glycemic food) with almonds
dahl

help for peripheral neuropathy:
this is a CIRCULATORY, not nerve, problem.  600 mg ALA (alpha lipoic acid) daily may help.

Brilliantly effective is a several week course of nearly nightly (5 out of 7 nights per week) of wet sock therapy.  You need a bowl of ice water, thin cotton socks and thick wool socks.  At bedtime, soak the thin socks in ice water then wring out thoroughly.  Slip onto feet while still very cold.  Cover immediately with thick socks and go to bed.  In the morning the socks will be completely dry and the feet warm.  Repeat faithfully until full sensation in the toes is restored.

help for sugar cravings:
eat protein at every meal
again, regular meals at regular times
a little bit of dark chocolate (low sugar, often made with good fats, full of antioxidants, and, most of all, really yummy)

help for diabetic ulcers:
over-the-counter Dessitin (zinc oxide paste), or
cholorophyll poultice — apply 1 tsp chlorophyll in a clean cloth or cotton wad to ulcer twice daily until healed.

You need daily exercise.  Think of it as moving, for fun!  Why is this so important?  Will it help regulate/lower blood sugar levels? Yes!  Will it improve your physical appearance?  Yes!  Will it promote strength and longevity?  Yes!  But the main reason I advocate 20 minutes of fairly vigorous daily exercise is because it has the capacity to create ecstasy — your own personal Nirvana farm!  Endorphins promote a state of bliss!

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Preventing Kidney Stones:

the main therapy is hydration — do NOT let yourself get dehydrated.  Be pro-active.

also, staying on B6 (250 mg in the morning) and Magnesium (500 mg at bedtime) is almost foolproof for prevention.

plus, avoid intensive eating of high oxalate foods such as spinach and rhubarb.
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the SOY question.  Good, or bad?
Well, according to Russell Marz (owner, Onmi Nutrition, and author of superlative nutrition textbook “Medical Nutrition from Marz”), it depends…

In general, soy does not (despite claims from Joseph Mercola, DC — who often gives excellent advice — and the Price-Pottenger Foundation) cause brain shrinkage, testicular atrophy or cancer.  Soy rarely causes thyroid problems.  Soy does have a high phytate content, which can bind minerals.  These effects, which lessen over time (with ongoing soy food consumption) are largely offset by the following: soy is HIGH in non-animal protein, fiber, isoflavones, magnesium, potassium, Vitamin K (which feed good gut flora, ameliorating digestion of soy, and all other foods) and also contains some Omega 3 (“good”) oils.  Soy beans have exceptional nutritional value with relatively low calories.

When consumed with high iodine foods (sea vegetables, fish) soy does not contribute to goiters (growths on the thyroid gland generally associated with decreased thyroid functioning).  Fermented soy is the best form of soy (natto, miso) but other commercially available soy foods (soy milk, tofutti, soy pups) can not only provide good nutrition but also medicinal components to reduce cancer risk (especially breast, prostate and colon).

Asians typically eat 15-30 grams of soy product daily.  This would be 1/2 block of tofu, or 2 glasses of soy milk, or 3 servings of miso soup, or a handfull of soy nuts.  They have relatively low rates of hormonally-induced cancers and thyroid problems.

Caution:  about 1/2 to 1 % of the US population is allergic to soy.

Also, one kind of soy to completely avoid (and this can be tricky) is GMO soy.  Much of the soybean crop grown in the US today (the world’s major soybean producer) is GMO, and grown with Roundup Ready seed.

While direct evidence of GMO plants harming humans is not available, the harm is clear to both the environment and economic interests of farmers.  GMO crops create dependence on a few multinational food corporations for staple foods, as well as causing extinction of wild plants.  GMO foods are speculated to potentially harm humans by virtue of genetically modified material being taken up by our gut flora, permanently altering the DNA of the friendly bacteria that reside within our intestines.
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Vitamin D dosing
a recently published study (Gordon, CM, et al., “Treatment of Hypovitaminosis D in infants and Toddlers” J Clin Endocrin Metab. April 15, 2008: 10.1210/jc.2007-2790) summarized that giving three different therapeutic doses of Vitamin D resulted in equivalent improvements in serum Vit D (OH-25 cholecalciferol) levels.  These 3 treatment regimens were:

1) daily dose of 2,000 IU oral ergocalciferol (Vit D2, which needs to be converted to D3)
2) daily dose of 2,000 IU oral cholecalciferol (Vit D3, the “active” form)
3) weekly dose of 50,000 of oral ergocalciferol (the expensive drug, Calcitriol)

In my experience, it is best to give D3 because some folks don’t convert D2 to D3 efficiently.  Further, D3 is less expensive.  However, the 2,000 IU daily of D3 may not be enough to get serum levels up to above 50 ng/dL.  If your levels are below 32 ng/dL you may need to supplement more aggressively (10,000 IUs daily for at least a month).

Further, some clinicans and researchers are noticing that longer term (beyound 6 weeks) of high dose weekly D2 (the drug) therapy will start to reverse beneficial trends and create not only high calcium levels in the blood but ultimately a reversal in raising Vit D levels.

Another consideration for vegans maybe that D3 tends to come from fish oil whereas the D2 drug is synthetic, and not animal based.