- Osteoporosis
- ArthritisIn addition to the incredibly common off-label prescribing all physicians do, alternative doctors are prone to use things for off-label uses that aren't so common: Omacor (fish oil) for reducing joint pain, Clomid (clomiphene) for increasing low testosterone in men, low-dose naltrexone (LDN) as an immune stimulant in all kinds of diseases (MS, pancreatic cancer, rheumatoid arthritis...), etc. Indeed, it is the innovative use of current medications that drives progress and benefits patients without increasing costs.
- Pediatric CareI had the pleasure the other night of having dinner with Richard Linsk MD, a pediatrician who has recently opened an office here in Ann Arbor on south Main street. He's focusing on the treatment of autism and ASD, and does general pediatrics. He used to be in the University of Michigan health system, but as he started doing more treatment of autism he invoked the ire of the systems' autism "specialists" (who don't seem to do much more then sedate the kids) and has had to branch out on his own.
- Primary CareFor medical students. Sadly, the No Free Lunch doesn't turn up any drug-rep free primary care physicians in Ann Arbor (though it does find a pediatrician in Ypsilanti).
- Family PracticeThe country doctor, whom patients could once call on for any ailment, lives on in Family Medicine. What had been called the GP, or General Practitioner, has been given additional training in the specifics and generalities of medicine in the 21st century. In Family Medicine, we treat individuals in the context of their lives: their families, their jobs, their communities. We treat what we can in the office and refer what we can't. We coordinate treatment to provide efficient, effective health care.
- Emergency CareUnfortunately, they don't tie total expenditures (including hospitalizations and specialists) to a provider. So, a doctor could come in looking good by kicking people out of his office after 6 minutes and charging a level 3 visit (getting in 10 visits an hour) for each one and then they end up going to urgent care or the hospital because they don't feel any better or they get a side effect they weren't warned about. In this scenario, while delivering lousy care, the doctor would be bringing in five times what I am by seeing people for 40-60 minutes and charging for a level 5 visit. Meanwhile, I'm spending time educating patients and looking at the big picture, keeping them out of the hospitals, and they accuse me of overutilizing as if I'm where all their money is going.
- Flu ShotsCame out a couple months ago and claimed that there are 36,000 deaths annually from the flu so everyone should get flu shots. I’ve become a bit skeptical of these recommendations.
- Electrocardiogram
- Pneumonia
- ImmunizationsWhen these new mRNA vaccines were coming out, I was very hesitant. As a medical practitioner, I was eligible to get them right away, but as of today, I still have not gotten a vaccination for COVID19.
- Pregnancy
- Internal Medicine
- Autism
- Multiple SclerosisBesides estriol having a 50 year history of use and listing in the US Pharmacopeia, it was in the precursor to Premarin (that was made from pregnant women's urine- but it proved too difficult to collect), and is used by Wyeth itself in products sold overseas. Recent research has shown estriol may reduce the risk of breast cancer and be beneficial in treating multiple sclerosis.
- Diabetes Care
- Thyroid
- Thyroid CancerHistory of thyroid cancer and now completely without a thyroid: with her other problems, she may not be converting T4 (in synthroid, what is usually prescribed) to T3 (the active thyroid hormone), sometimes lab tests can help but sometimes you just have to do a trial of the different forms (Armour thyroid, cytomel, or compounded thyroid hormones) and see where the patient feels the best.
- X-Rays
- Mammography) (preferably in addition to mammography, but also for people who don't tolerate mammography or for whom mammography otherwise isn't a good idea), find the source of
- Chemotherapy), and how it uses lower doses of chemotherapy with fewer side effects than conventional chemotherapy and may even produce better outcomes (though there’s not much research on it). One of them asked why more doctors aren’t learning how to do this. To me, the reason seems straightforward in our current medical system: there’s no economic incentive to do it.
- EczemaHer mom brought her in to see what other options she had. We tried some IV vitamin C and it worked fantastically. I was a bit nervous about using it in someone so young, so I started with small doses, and she got a little better but it would come back. I progressed to larger doses and got the infections to clear up. It worked so well, in fact, that her grandmother told me that the only side effect of the IV vitamin C treatments was that her eczema would clear up.
- LesionsFor her MS: Estriol (one of the estrogens, this is the weakest estrogen and least inflammatory) ~6 mg daily (this is the estrogen that is most elevated in pregnancy which is one time women with MS have fewer symptoms, a trial of estriol showed reduced white matter lesions in women with MS on estriol) applied transmucosally (this avoids the first pass liver metabolism that gives more metabolites from taking pills); vitamin D, enough to get her blood levels up to 60 ng/ml (plenty of data showing a connection between low vitamin D and MS); low dose naltrexone 3-4.5 mg before bed (learn more about it from
- PsoriasisIt seems like it may be helpful in other autoimmune disorders as well (asthma, MS, eczema, psoriasis, food allergies). Time will tell.
- Burns
- AllergiesI've seen a lot of people make huge improvements by removing foods that bother them, and frequently suggest allergy testing or an elimination diet to root out these problems. The interesting thing on this day was the diversity of the symptoms that resolved with removing wheat from these people's diets.