Integrative Medicine

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Integrative Medicine

• REYNALD ALTEMA, MD
• 37th AMHE ANNUAL CONGRESS
• MONTEBELLO, QUEBEC

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Integrative Medicine

• "Mind/body medicine is of course nothing
  new--What is new is the legitimization of
  research in this field to the point of government
  funding and the incorporation of mind/body
  programs into the offerings of major medical
  institutions, many of which are noted for their
  conservatism and scientific bent." William
  Collinge, MPH, PhD, Researcher.
• massgeneral.org/bhi
• BENSON-HENRI INSTITUTE AT HARVARD.

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DISCIPLINES

• Homeopathy
• Naturopathy
• Ayurveda
• Traditional Chinese Medicine
• Massage Therapy
• Herbal Medicine
• Chiropractic
• Acupuncture
• rosenthal.hs.columbia.edu

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Participating Institutions

• Mass Gen. massgeneral.org/bhi.
• University of Arizona
• www.integrativemedicine.arizona.edu
• University of Calgary
• Canadian Institute of Natural Integrative
  Medicine
• www.ucalgary.ca
• University of California, Los Angeles
• Collaborative Centers for Integrative Medicine
• www.uclamindbody.org
• University of California, San Francisco
• Osher Center for Integrative Medicine
• www.ucsf.edu/ocim
• Columbia University
• Richard and Hinda Rosenthal Center for
  Complementary Alternative Medicine
• www.rosenthal.hs.columbia.edu

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Glucose Toxicity

• When there is too much glucose, 4 different
  pathways to circumvent glycolysis
• 1-Hexosamine
• 2-Advanced glycation end products (AGE)
• 3-Diacylglycerol (DAG)-protein kinase C
• Polyol
• Thiamine activates the Pentose pathway via
  Transketolase, removing Glyceraldehyde-3
  phosphate and Fructose -6 phosphate. It prevents
  steps 1-3.

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Advanced Glycation End Products (AGE)

• Formation of AGEs yields to free radicals such as
  Reactive Oxygen Species (ROS).
• Takes place via Receptor for AGEs(RAGE).
• AGES affect endothelial cells and monocytes.
• AGES cause irreversibe crosslinks with collagen,
  proteins and lipids.
• Presence of AGEs accelerates aging and causes
  cellular dysfunction..
• Presence of AGEs increases microvascular as well
  as microvascular complications in Diabetes such
  as Retinopathy, Nephropathy...
• 1-Tan et al.
• 2-Balakumar et al. The multifaceted therapeutic
  potential of benfotiamine. Pharmacological
  Research. June 2010.

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Benfotiamine

• Thiamine analogue
• Better absorbed than Thiamine.
• Gets converted to Thiamine
• Improves diabetic neuropathy
• Was developed in japan for treatment of alcoholic
  neuropathy.
• Ref 1-Stracke H,. A benfotiamine-vitamin B
  combination in treatment of diabetic
  polyneuropathy. Exp Clin Endocrinol Diabetes
  1996 104(4) 311-6.
• 2-Tan et al, AGE, RAGE and ROS in Diabetic
  Nephropathy. Seminars in Nephrology. March 2007.
• .

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OMEGA-3 FATTY ACIDS

• EPA-Eicosapentaeinoic acid
• DHA-Docosahexaeinoic acid
• Dose
• for cardiovascular protection 1.5 gm/day.
• for antiinflammatory action 4-6 gms/day.
• Concentrated preparations
• Krill oil-not to be used in case of shellfish
  allergy.
• Vectomega-very concentrated.

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Omega-3 Fatty Acids

• 1-HTN GRADE A
• 2-HYPERTRIGLYCERIDEMIA GRADE A
• 3-SECONDARY PREVENTION OF CAD GRADE A
• 4-PRIMARY CAD PREVENTION GRADE B
• 5-RHEUMATOID ARTHRITIS GRADE B
• 6-ANGINA PECTORIS GRADE C
• A-nlm.nih.gov/medlineplus/druginfo/natural/patient
  
• B-Lee et al Mayo Clin Proc. March 2008
  83(3)324-332

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BROMELAIN

• Extract of pineapple.
• Proteolytic enzymes papain, chymotrypsin,
  bromelain, phosphatases, glucosidases,
  etc.
• Properties antiinflammatory, digestive enzymes,
  antiedematous.
• Uses alongside antibiotic, other
  antiinflammatory meds.
• H. R. Maurer. Bromelain biochemistry,
  pharmacology and medical use. Cell. Mol. Life
  Sci. 58 (2001) 12341245.

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CoQ10 Cholesterol Synthesis
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Oxydative Phosphorylation
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Uses of Ubiquinone

• 1-Patients on statins.
• 2-Patients who have cardiovascular
• Comorbidities. It improves cellular function.
• 3-As antioxidant.