April 2024 edition
Circulating Tumor Cell Testing:
A new era has dawned. And this is no April's Fools joke, either. Gone are the days when we had to solely depend on PET scans to know whether there was growing cancer activity in our bodies. Scientific developments and innovations in biotechnology has brought us to the point where today we are able to do three things with a peripheral blood draw:
1) Screen for up to 50 of the most common cancer types through the test called Galleri, offered by the US company GRAIL.
2) Test for one's specific known cancer to see if it is showing a microscopic presence in the body or multiplying over time, even when no imaging study is able to pick masses up yet (this is done through an analysis of the Pathology report submitted to the company or the actual diagnostic biopsy tissue itself). The company is called Natera and the test is called Signatera.
3) Test through a European company called RGCC, which is able to combine screening as well as testing for various genetic expressions on circulating tumor cells. This can help us identify where the originating cells come from, and this lab is even able to test these cells against dozens of natural extracts and dozens of chemotherapeutic agents. It can also let you know if your cancer is heat sensitive. *Being a European company, there's no possibility for insurance reimbursement for this test, unfortunately.
Would it sound too good to be true if I told you that all of these tests are offered as routine peripheral blood draws at the convenient location of the Mandarin Wellness Center, and that the results are back within 2 weeks for review? What about the fact that for the second example above, despite being the most expensive of the options, a claim is filed with your insurance and whatever is not paid, the rest is written off by the company, so that our patients' balances have been consistently "zero"?
Now, why would anyone, knowing all of this choose not to engage in the above tests? Well, the answer will depend on the person. Some may say that they don't want to find out certain things not to get anxious. We understand that and deal with some who have struggled with that, however we prefer to see the world as one where "information/knowledge is power", because it affords us the ability to position ourselves for action of some kind. This leads me to the second most common argument against doing such tests, which is the thought that there would be nothing we could do about it, if we find out that there are microscopic circulating tumor cells multiplying in our bodies. And that's the crux of the matter here! There are many things indeed that can be done, especially from a functional and integrative perspective. Above all, our protocols center on strengthening the body's immune system and optimizing one's nutritional status to weather various kinds of storms including cancer. We work with one's stress management, lifestyle, and offer various other therapies that can help the body in its own healing efforts. Last month's episode detailing Dr. Hartman's own cancer journey when up against Pancreatic CA is a huge case in point. So, if you have any questions about these tests for you or for a loved one or friend, please contact the office and we would be more than happy to let you know what options you have and what might be the best one for you.
Pharmaceutical Highlight: Methylene Blue
If you have been around the Mandarin Wellness Center for a while, or have been reading materials from the integrative world, you may have already come into contact with this medicine or may be on it yourself! Interestingly enough, however, I still meet people on a weekly basis who don't know about this, so I thought I would bring it to the newsletter to hone in on it and give it the attention it deserves.
Methylene Blue was developed as one of the first medicines to treat Malaria in the 1890's. It is currently used in the Emergency Rooms across the nation to treat a condition called Methemoglobinemia, a rare but serious blood disorder. Studies in animal models abound demonstrating that its ability to participate in what's called redox reactions within the Mitochondria, which are the powerhouse organelles within each cell of our body, allow it to function better providing a more stable energy supply in the currency form of ATP, and that it serves as a potent antioxidant as well. As such, it appears to have a neuroprotective function in the brain, has shown to ameliorate learning in animal models of Alzheimer's, and because of its impressive performance in areas such as post-stroke recovery, traumatic brain injury, and other neurodegenerative conditions, it is being touted as an anti-aging tool in a broad arsenal of integrative options. Furthermore, we routinely deal with it due to its in-vitro evidence of being able to kill various tick-born illness-causing bacteria and parasites. Finally, there's emerging evidence pointing to benefits for cancer patients as well. Oh, and did I mention that this is an over-the-counter medicine that's readily available? One has to take some caution if they're on a Serotonin-based medicine, but it is usually extremely well tolerated. There is a small percentage of patients who will complain of bladder irritation, but once the medicine's stopped, it goes away. Of course, it will stain the tongue for a while unless you dilute it in water and drink it through a straw, but once one gets to a certain dose, we can also send it to a compounding pharmacy via a prescription to make it more practical. A few drops with each water you drink throughout the day would be a reasonable dose as most patients will be on a dose up to 15-25 drops 2x/d. If you're going to check this out for yourself, make sure to get USP grade, which is made for human consumption. We have bottles that we've prepared at the center also if you don't trust online stores.
The MWC way:
Finally, as I continue to reflect on what sets the model of Mandarin Wellness Center apart from the regular "managed care" model that became popular in the US as of the past few decades and that has shown a record level of chronic disease in its managed populations, I was struck a few days ago by an interview that was shared with me by a friend who's attending Medical School. The interviewee is a physician and surgeon who details some of the ways that her mother was cared for at one of the nation's top hospital systems (Stanford) and how that same level of urgency and collaboration is not seen whenever the subject matter is primary prevention of disease as it's not as lucrative a thing as treating cancer in modern America (with the modern western tools of surgery, chemo, and standard radiation-- and at times, immunotherapy). So, I thought what better way to start this month's newsletter but to share this interview with you. I hope you take away some things from it as I did. Realize that this is about us, but also about the care that our parents and loved ones will tend to get. I believe that at the Mandarin Wellness Center, as well as other like-minded centers around the country and the world are offering some solutions to many of the issues raised in this interview. If you agree and you know someone who might benefit from having this information, please consider sharing this with them as well, perhaps as a way to open up a conversation about what a more ideal care model would look like. Just click on the button below to access the Podcast episode.
Sincerely,
Dr. B
March 2024
The content of this month's newsletter is exclusive to subscribers of our email listserv.
Please fill out the form below to sign up for all our content!
February 2024
The year of validation?
Pharmaceutical Highlight: Tylenol
Acetaminophen is one of the most prescribed medicines in the US. It is found in most homes around the country. It also is among the top causes of acute liver failure in the United States. One of the reasons why is that it depletes Glutathione production by the liver-- the very molecule that the liver uses to do the heavy-lifting of its detoxification. How ironic that a medicine that we consider so safe and give to babies due to even low fevers (which are the body's own healing system getting activated to fight invaders) could deplete one of our biggest allies against disease! I admit that I used to rely a lot on Tylenol with my Geriatric population of patients for its analgesic effects because we were trying to avoid the side effects of NSAIDs (gastritis, hypertension, cardiovascular and kidney risk), however, this was before I understood the power of natural compounds such as Curcumin-95,Arnica, Ginger, Peppermint, etc. So, while we may still rarely use it, now my thinking about it has changed significantly. Another interesting fact about it is that to this day, despite all these years and billions of doses being taken around the world over the past few decades of this drug, we do not know exactly what its mechanism of action is. Isn't that curious? So, next time you mindlessly reach out for the drug cabinet and take out the Tylenol at the first sign of discomfort, please think three times before doing so, and consider what other possible alternatives might be less toxic and yet, provide relief.
Welcome to another monthly edition of our Mandarin Wellness Center newsletter! We're bringing you quite a bit of valuable information on this edition and I believe some of this will be very welcomed by our community. Some of it may be deeply upsetting to read, but it may be necessary to see how in a way, there is a long overdue reckoning that revolves around the issue of medical gaslighting (defined by me as the medical system, primarily through doctors, shutting down or making patients feel guilty for expressing their symptoms, when they don't fit the box that those doctors were trained in or have expertise in). I know many of our readers have experienced this relentlessly in the past, some of you continue to experience it today, unfortunately. The best antidote to this phenomenon, however, is to empower ourselves with the knowledge and to embrace a like-minded community of people who can encourage and pick us up when we're feeling beat down by the system. Well, check out this recently published article:
https://www.mdpi.com/2227-9032/12/1/78
Sincerely,
Dr. B
Referral Spotlight
I have been meaning to publish something about my experience with this group that's doing amazing work here in town for awhile and now, the time has finally come. They're called Coastal Health Institute and they're located near the Town Center area on Gate Pkwy. The center was started by Edsel Bittencourt, who is a holistic Physical Therapist, who has had an extensive career in the field and was the designer of the Mayo rehab suite decades ago. He has a team of other like-minded holistic professionals, including some physicians who do different forms of dry needling, acupuncture, homeopathic injections, etc. The reason I want to bring light to this clinic is that I have never had a professional relationship with a center that has a 100% rate of helpfulness to my patients. Having studied in Chicago, trained in North Carolina, between Duke and UNC-Chapel Hill, and having lived close to a decade in Jacksonville now, I have never had a colleague with a perfect track-record of helping every single patient that I have referred there in the past. It started out with a patient with classic Lyme arthritis in the knee (swollen, painful, warm to the touch, causing a limp, stiff) which had been there for many months, and she'd gone to several places for different procedures, and nothing had helped. Until she recalled Edsel (had known him for many years already) and decided to give them a try. On the first visit, she noticed the swelling come down a fair amount; she kept returning and every time, there was further improvement. I was so impressed because I had already seen this knee several times without any amelioration that I said, "I have to go check this place out" and so I did and was impressed with their warmth and compassionate presence as well. Needless to say, the next patient with similar symptomatology improved, and from then on, it has been a delight to direct patients there who really need help from physical ailments that are getting in the way of their quality of life. One of the reasons that I wanted to release this information about them now is that their success rate is being noticed by the community and they're becoming quite busy, so if you or your loved ones need some major therapeutic interventions, I wouldn't delay in making my way over there. Probably the best endorsement, however, that I could give is the answer to the question of "Would you take your mother there to be treated?" can be answered with an emphatic "yes" and this is not hypothetical, as they also helped her immediately improve her frozen shoulder around the Thanksgiving holiday. Check them out at: https://coastalhealthjax.com/
In the News: IV Hydration and Vitamin Infusion
Prompted by a tragic, premature death in south Florida in 2021 due to selenium toxicity in an IV bag, Florida Senate Bill 672 is in works to be passed into legislature in July 2024. While we grieve and lament the thought of this happening, this bill could very easily prevent patients from receiving IV therapy care.
If passed and enacted, the Stephanie Balais Act (“SB672”)would create additional rules surrounding IV therapy. The bill would requirehealthcare providers to obtain a complete self-screening assessmentquestionnaire from a patient before administering IV hydration. Healthcareproviders would not be permitted to administer IV hydration to patients forwhom it would be unsafe based on the results of the questionnaire or otherwise.Additionally, healthcare providers administering IV hydration would be requiredto provide patients with information regarding potential side effects and risksof IV hydration, instructions on when to seek medical attention, and a visitsummary. It also would obligate healthcare providers to notify a patient’sdesignated physician if IV hydration was administered.
These requirements can create access barriers and place anundue bureaucratic burden on patients and clinics, as well as a likely increasein cost for this therapy. We encourage you to read the bill here: https://www.flsenate.gov/Session/Bill/2024/672/BillText/Filed/HTML and makeyour own decision. If you’d like to write to your local senator, use thereference list below:
· Baker & Clay Counties: http://www.flsenate.gov/senators/s6
· Duval County: http://www.flsenate.gov/senators/s5
· Flagler, Putnam, & St. Johns Counties: http://www.flsenate.gov/senators/s7
· Nassau & Duval Counties: http://www.flsenate.gov/senators/s4
January 2024
Happy New Year!
By the time this is published, we'll already be in the New Year, so first of all, I wish you all a blessed New Year and hope you have had a wonderful holiday season with family and friends. I also have another word of gratitude at this time for every single one of you who is committing to our wellness center by signing up for the concierge program. I know it's not for everyone, but for everyone who has already signed up or is signing up right now, please know that this program truly allows us to start the year on a strong note. Our center is staffed to take care of myriad requests that come in on a daily basis from our patients, we have to purchase a lot of material to keep the IV suite running strong without delays of service, and as a relatively low-volume practice where we give maximal time at each encounter without any institutional backing, pharmaceutical kick-backs, or insurance reimbursement programs, our obligations each month at times have exceed our income-- So, thank you again for making it possible for us to serve our community, region, and beyond by your trust in what this center represents and is doing. May all of us enjoy better health and wellness, body, mind, and spirit in this new year!
Dr. B
New Year's Resolutions:
How many of us have set out to accomplish some record-breaking goals for a new year only to fail miserably before January's done before? I certainly have, embarrassingly more than once! So, does that mean that we should give up on the whole thing and pretend like we don't have a new year to make plans? Far be it from us! I think that each new day is a new chance for reviewing our lifestyle and see where we might need to refine or improve how we're living and hopefully make better choices or set ourselves up for success. The background to this, of course, comes from the fact that more than 90% of our modern-day western world are directly correlated with lifestyle choices, not genetics (even though as Chris Kresser says: Our genes load the gun, but lifestyle pulls the trigger!) And of course, when we think of lifestyle choices, two categories primarily come to mind: "Diet and Exercise". And rightly so, despite the cliche that this phrase has become even in mainstream/conventional offices where this is part of the templated notes and often isn't much further elaborated than that, or when it is, it's followed by outdated catch phrases such as "low fat, low cholesterol, low sodium diet".
And while we will not be able to exhaust our thoughts on this subject, I'll share a few thoughts that hopefully will be helpful and provide some balanced, if not timely, encouragement. I myself, this past year have been able to incorporate a few new routines to my lifestyle: I have been walking the dog in the morning most days of the week, whereas before we had him get his steps in outside in the backyard; I have been working out before going to work (even at times causing me to arrive a bit late, as some of you know well!); and I have completed an elimination diet to figure out intolerances and after a couple of iterations since June, I have identified "corn" and "cayenne pepper" as culprits.
So, what are some of the things that you might want to incorporate into your lifestyle this year?
If there's one thing in the diet department that most of us could probably do better in is reducing the amount of ultra-processed foods. Ultra-processed foods can be recognized by being packaged in boxes or plastic wrappings and having dozens of ingredients, as opposed to low-processed foods which may have gone through some processing but very little and may have a handful of ingredients. Ultra-processed food products contain artificial (so-called "natural flavors"), flavor-enhancing molecules that often are excitatory to the brain, stabilizing chemicals that have no nutritive value at all but can only extend shelf life-- and as I read recently, "the longer the shelf life, the shorter life we can expect to live" if we continue to indulge in it. An ingredient that is often found in ultra-processed foods that I am most concerned about is highly refined seed oils. Seed oils (soybean, corn, canola, safflower, sunflower, etc.) are virtually everywhere these days, especially in packaged goods or whenever we eat out in restaurants, and these constitute primarily polyunsaturated fats that undergo a very high heat and many different manufacturing processes to come to the consumer and they are packed with omega-6 fatty acids that are highly inflammatory. Instead, let's have more real, unadulterated fats, including the natural butters (grass-fed and organic is best!), ghee, olive oil (cold-pressed and organic or at least from the Mediterranean), coconut oil, avocado oil. So, here are a couple of things that most of us could strive to reduce in the coming year. And notice, I haven't touched on sugar, gluten, etc. We'll devote more time to other such topics in the coming months.
As for exercise, I will affirm the desire to walk more steps during the day and 10,000 steps a day is a worthy goal, but it's not a magical formula by any means, because much of it has to do with the effort that one puts into their steps. Show me two people, one who walks in a stroll-like pace 10,000 steps a day and another who walks most of those steps briskly, and I will show you completely different metabolic health statuses. But in my mind, much more important than just the absolute number of steps we take each day is the strength of our muscles and our overall body composition (how much body weight is composed by fat as opposed to muscle). Especially, for those of us who have the 5th decade of life, weight or resistance training (whether with the calisthenic principle of using your own body weight and gravity, with bands, free weights, or machines) is the best way to work on improving our body composition. I am proud to say that my sister in her low 50's added more than 5 pounds of muscle weight to her body composition in 2023! Let's strive to work on this, whether with a personal trainer or by ourselves.
But above all, I think one of the most important concepts when it comes to lifestyle change is to have an accountability partner. This could be literally someone who's walking the same journey as you and has similar goals, or it could be someone who wants to support you in your personal goals and will provide encouragement, a shoulder to lean on, reminder calls, check-ins to see about your progress and hear of bumps on the road-- who, in a non-judgmental way, could help promote better health for you. This should be someone you get along with very well and whom you trust and can confide in. But hopefully, it should be someone who provides a positive, uplifting environment for you. This is a way to set yourself up for success in your journey. Here's to better health this year!
Pharmaceutical highlight-- Proton-Pump Inhibitors:
“Contraindications of Proton-Pump Inhibitors”
I continue to have conversations about this medicine with patients and so I thought it fitting to mention it here. Proton-pump inhibitors, or PPIs, include medicines commonly known as Omeprazole, Prilosec, Pantoprazole, Protonix, Lansoprazole, or Nexium (the "purple pill"). These are potent acid-reducing medicines that stop the action of this enzyme called proton pumps that pump hydrochloric acid into the lumen of the stomach (the space within the cavity that is the stomach organ). An important context for this is that in normal physiologic function, the place in our body that is supposed to be the most acidic is the stomach (it can signal for the sphincter between the esophagus and the stomach to close shut, more on this later), it can help to kill parasites that are coming through in foods, it helps to activate enzymes that are crucial for us to absorb certain micronutrients and vitamins such as the notorious B12, etc. So, whenever we take these powerful medicines, and especially become dependent on them over time, this means that we have essentially been boycotting our very digestion and absorption system. How can there be optimal health this way? That's precisely my concern. I have met innumerable patients who have been taking these types of medicines for decades, but I have made it my mission to educate them on the long-term consequences that have already been well investigated and there's an ever-increasing laundry list of complications related to these medicines (I'll share a link to an article that summarizes these findings at the end of this section). But, while it's undeniable that these medicines can provide some temporary relief (because they lower the acidity of the gastric juice that is being refluxed up into the esophagus from the stomach), one of the most ironic things is that the vast majority of patients who are suffering from reflux disorder, actually have LOW stomach acid production and so while relatively speaking, the even lower stomach acidity will improve the heartburn feeling in the chest, it's not getting at the root of the issue. Many conditions and substances will contribute to low stomach acid production including antibiotics, NSAIDs, stress/anxiety, etc. So, rather than continuing to take these medicines, if you or a loved one has been on them, of course under the supervision of their provider (because a few percentage of patients will have Barrett's esophagus, which has to be treated more carefully because it's thought to be a pre-cancerous condition of the esophagus), please consider tapering off them slowly. Further digestive support including digestive enzymes and stomach acid support may be needed. Other tips would include drinking lemon water a few minutes before meals or apple cider vinegar mixed in with water prior to meals. This can set the stomach up for good digestion. The good news is that I have been able to help many patients come off these medicines successfully and now there's even hope for the Barrett's esophagus patients with the new area of peptide therapies that can provide tissue regeneration.
Here's the article, as promised: https://www.verywellhealth.com/side-effects-of-proton-pump-inhibitors-1742874
December 2023
A Word of Thanksgiving
This has been a transformational year in my career. Meeting so many patients over the last 9 months has been rejuvenating to my mind as we have a well-informed group of engaged patients who have teach me so much about intently listening to the patient, doctoring compassionately, and I have thoroughly enjoyed going through material that many of you have brought to me to dig into, including books, research journal articles, products, organizations, etc. What a gift it has been for me! As we just went through a special family-centered Thanksgiving holiday, I could not start this newsletter any other way than to highlight the gratitude that I have to be able to come every day to work and serve each and every one of you. In the better portion of a year, along with the Functional and Integrative Medicine Course that I took, with about 200 lectures by a few dozen of the top minds of the field, YOU have trained me to become a better physician committed to searching for the root causes of dis-eases and a more natural and non-toxic approach to healing. I am humbled at how much more I have to learn and grow and yet, I am extremely grateful for the grace that you have shown to me during this transitional period in my career. I am looking forward to a long career serving my neighbors to the best of my ability. Thank you for helping make the Mandarin Wellness Center what it is and for spreading the word for its continued growth!
Dr. B
Introducing IV Ozone at MWC!
Ozone is a naturally occurring substance that is made up of 3 Oxygen molecules together (O3 instead of the more familiar formula of O2). It has been used for over a century for medicinal purposes and used to be commonplace in American hospitals in the early 20th century. Its uses include chronic infections (bacterial, viral, fungal, and even parasitic), cancer support as it both can help to activate the immune system function as well as provide a pro-oxidative pressure to the tumor microenvironment effectively killing cancer cells. Due to its hyperoxygenation effect, it can disrupt many chronic disease processes, which often depend on a low-oxygen state. Some health and wellness seekers have made sure to get a session of Ozone therapy (whether in IV form such as the one we're offering, or in another form-- rectal or vaginal insufflation or otherwise), periodically for optimization of the immune system and to prevent infections (think oil change every quarter for the engine of the car to work at optimal efficiency). The Mandarin Wellness Center has the pleasure of welcoming Tabetha Gayton, an experienced Registered Nurse (She also finished a Nurse Practitioner course, has a Master's in Business Administration and even got her PhD in her spare time) to provide this essential natural and integrative therapy and she will be offering her services on an appointment-basis every Friday afternoon. Our first patient already received the therapy the day after Thanksgiving! For more information on this exciting game-changing therapy, check out: oxygenhealingtherapies.com
COVID Shots
My reflection and plea: Three years ago, when operation warp speed was being hailed as a modern-day miracle that would be breaking all sorts of records of bringing a novel mRNA technology to bear on billions of people around the world and unleashing a brand new vaccine in the middle of an evolving pandemic with a highly-mutating virus, previously known to belong to a class of coronaviruses which had been responsible primarily for common colds, I recall being gravely concerned. First of all, because it had been known that in order to do safety studies, it would take on average about a decade. Now, all of a sudden, we had figured out how to squeeze long-term safety studies into a couple of months? I was incredulous and again, gravely concerned. A few months later, when I finally gained access to the original Pfizer study paper and saw that there were actually more deaths in the vaccine intervention group (21) compared to the control group (17), I knew that we were going to be in big trouble with the massive rollout of these shots. A year later, it became clear to me that there was a significant coverup taking place because Pfizer and the FDA wanted to hide the complete package of original documents about their protocols for 75 years, but a judge ordered them to release it in 8 months. We have continuously learned about issues not only with these shots' safety since then, but also about their woeful lack of efficacy in preventing covid infection as well as transmission. That's why the conversation about boosters became so predominant and in fact, now we're at booster #6! One of my primary concerns was that never before in history had we come up with a shot that would essentially take over our native genetic machinery inside our cells and cause it to betray us in order to synthesize a foreign protein, namely the infamous Spike Protein or S protein, which the coronavirus uses to gain access to our cells. Prior to this, we in the medical field, would be thinking that this is akin to opening the way for Prion diseases (remember "mad cow" disease?) as diseases where free-flowing foreign proteins which are prone to being misfolded would lodge themselves in random parts of our bodies and wreak havoc. But this time around, hardly anyone thought of this ominous possibility. Soon enough, however, several voices began to rise blowing the whistle about this condition being associated after the shots including Dr. Richard M Fleming, PhD, MD, JD, The Children's Health Defense organization, Steve Kirsch, Adam Gaertner, Dr. Paul Alexander, Jessica Rose, PhD, and others. This appears now to only have been the tip of the proverbial iceberg. Since 2021, we have seen a catastrophic signal in mortality in the life insurance industry as documented by Ed Dowd, finance analyst and investor who wrote the book "Cause Unknown" on the epidemic of sudden deaths (which we continue to witness almost on a daily basis with 95% of the ones in the limelight receiving no cause of death and most of these happening since 2021 in previously healthy individuals, many athletes in top shape and it's taking place suddenly prior to them even being able to make it to the hospital--unprecedented) Unfortunately, I could go on and on (about the contaminations of DNA material in the shots, all the hearings that are taking place all over the world, the fact that the shots move everywhere and anywhere in the body and don't stay in the muscle, that there are studies now showing the more shots one gets, the more covid one tends to have, etc.), but time doesn't permit me at this time. My plea to everyone reading this is to stop getting these shots if you have gotten any until now. And if you believe you have been injured in any fashion, please reach out to our center as there are several strategies that can help with detoxification. Here are some resources for further information:
https://wethepatriotsusa.org/shot-dead-movie/ (a documentary featuring 3 families whose children lost their lives following covid shots)
https://substack.com/@stevekirsch (Silicon-Valley tech guy turned investigative reporter who has offered 10 million dollars for a debate on covid vaccine safety and wasn't taken up on it)
https://childrenshealthdefense.org/ (The not-profit organization created by Presidential candidate and nephew of late JFK, Robert F. Kennedy Jr.)
https://www.realnotrare.com/ (a grassroots website dedicated to vaccine injured people to show their stories to the world)
https://www.react19.org/ (a complete website with at least 3.500 peer-reviewed case reports of vaccine injuries of all types)
December is Chron's/Ulcerative Colitis Awareness Month!
Related to these as well as other autoimmune conditions, and other conditions for which a well-balanced immune system is paramount (e.g., chronic infections and cancer), I wanted to take the time and either introduce or re-acquaint you with Low Dose Naltrexone, also known as "LDN". Originally synthesized in the early 1960's, Naltrexone was approved in the 80's as a medicine to help with various addictions as its mechanism of action blocks the body's endorphin receptors, responsible for the runner's "high" of exercise. Another term for Endorphins is Opioids and thus, Naltrexone (as well as Naloxone) was used to save people from acute intoxication as well as chronic addictive behaviors. However, serendipitously, during the AIDS epidemic in New York City, a physician called Dr. Bihari noticed that his patients who were all on the same cocktail of drugs for HIV viral suppression had better outcomes if they also had been taking Naltrexone. He then went on to make further observations and began experimenting with lower doses until he found that a dose about 10% of the original full dose was the optimal immunomodulatory dose that found the happy medium of the least amount of side effects for the maximal benefit. From then on, much clinical experience by integrative medicine physicians as well as research has been carried out about this medicine and whether the condition of interest is a chronic stealth infection, such as Lyme disease, cancer, or autoimmune diseases (of which there are 100 recognized entities currently), this medicine has been shown to be an invaluable tool in the arsenal of healing therapies. The mechanism of action is related to the fact that our endorphins are immunoprotective and help guide our immune system to work in a more efficient manner. When this low dose blocker has its action, it causes the body to sense a relative lack of endorphins, which leads to a counteracting reaction of releasing more endorphins than had been previously manufactured by the body. This response from the body illustrates a principle called "hormesis", namely a stress that causes the body to react and by reacting in the way it does, causes us to have an advantage. Exercise is the most classic example of this: we tear muscles during strenuous activity, and we rise stronger the next morning. Finally, unlike many of its counterparts, this medicine is rather affordable, so this adds an extra layer of incentive for us to learn about it. If you would like more information about this promising medicine, or know someone who suffers from any of these types of conditions, please check out the following websites and let us know if you or your friend would like to have a consult with us to discuss whether or how this could fit into their overall regimen. Here are some resources for further information:
https://draxe.com/health/crohns-disease-diet/
November 2023
November 2023 Newsletter
The leaves are falling, our clocks are falling back an hour, and most relevant to you: even our prices at the Mandarin Wellness Center are falling as well! After much heartfelt reflection upon learning from people in our community here in Jacksonville who have been ill for years, believe in this natural and integrative approach to medicine and yet cannot afford to be seen at our practice; we have worked hard with management to restructure all that we can to make way for as many people who prioritize and value their health to have access to us. Having said that, with inflationary pressures all around us, we certainly cannot guarantee that we will be able to maintain this new fee schedule, so this is the opportune time to get your family members, neighbors, co-workers, and friends aware of all the good work that our center can do as we partner with them to aid their health and healing journey!
Sincerely,
Dr. B
Cholesterol
Just the name cholesterol causes a great swath of our American population to cringe. That’s the power of messaging (aka propaganda). There’s a long and twisted history behind how we got here to where we think that a naturally occurring biological molecule that our body produces, that gives rise to most hormones in our body, that serves as gatekeepers for our very cells, and that nourishes the synaptic neuronal connections in our brain is worthy of being demonized and opposed at every turn with lab- synthesized pharmaceuticals. You may have learned that it takes on average 17 years for scientific discoveries to make it into the regular PCP’s office. Well, the story of cholesterol in America unfortunately has been even worse. We have been learning a lot about this over the last several years starting with the documentary Sugar Coated by Robert Lustig that exposed the sugar industry and its relationship with big Pharma and Ivy League schools. We have also had wonderfully clarifying lectures from our Functional and Integrative Medicine certification course on this topic and it emphasized that cholesterol levels correlate poorly with cardiovascular death, triglyceride levels are a much better predictor of risk and yet, this is caused by overconsumption of fructose especially high-fructose corn syrup and refined sugars, that the basic cholesterol panel is woefully outdated to do us justice for risk stratification and we are missing key pieces of insight that we can get from an advanced lipid panel. For
instance: a. What is our number of Lipid particles? b. Are we ApoA or ApoB predominant? c. What’s the degree of oxidation in our LDL? d. What’s the breakdown between small density LDL versus high density ones? e. What’s our Lp (a)? And other independent risk factors for cardiovascular disease are also omitted from the basic cholesterol panel but these are extremely important, namely, Homocysteine, fasting insulin, A1C, hs-CRP, Fibrinogen/D-dimer, etc. At our clinic, we recommend an advanced lipid panel for adults 40 and older at least once as a baseline and perhaps once every 2-5 years to trend as these factors are all dynamic and responsive to lifestyle, diet, and supplementation regimens. For further information on this topic, please check out Dr. Hyman’s podcast with Dr. Krauss https://m.youtube.com/watch?v=jByFc2smOrg
...and Dr. Saladino and Dr. Malhotra https://m.youtube.com/watch?v=kFwjeKLG9KQ
Pharmaceutical Highlight
Semaglutide (aka Wegovi, Mounjaro, Ozempic, etc.) is a GLP-1 agonist, an Incretin, which signals satiety, which sounds great as something that could help so many people around the world who have food cravings and even who suffer from a food addiction. However, while it provides some opportunities for those people and we’ve heard and met a few people who have benefited from this temporarily to kickstart a process of dietary re-education, many issues are beginning to surface. Here are the most notable among them: First, contrary to how we’re supposed to lose weight in a healthy and sustainable way, namely by shedding adipose (fat) tissue, these medicines cause up to 50% of weight loss from muscles by accelerating Gluconeogenesis which facilitates rebound weight gain once the medicine is stopped (since it’s so expensive at about $12,000/year, many who start it have to give it up). But it doesn’t stop there. These medicines also have been linked to an increased risk of thyroid cancer, pancreatitis, gallbladder inflammation; it also lowers stomach acid release and slows down gastric emptying, both of which could worsen reflux. Furthermore, Europe is currently investigating it for suicidal ideations, and reports are coming out of ileus—bowel paralysis, which is a surgical emergency.
Finally, it’s contraindicated for fertile women due to pregnancy/teratogenic concerns. So, does this mean that it’s the worst medicine on the market? No, there are worse ones out there, but it just means that we need to be well informed and take every precaution to not have unrealistic expectations and potentially cause harm. But if you’re a diabetic who’s also obese and your disease is not well controlled despite lifestyle changes and other safer medicines, then this is definitely a route to consider.
November is American Diabetes Month. A valuable source for information, support, and help can be found online at https://www2.diabetes.org/, the website for the American Diabetes Association.
Did you know that Dr. Balbino has an Instagram channel dedicated to sharing tips on diet, natural health, and personal things that he values? Check him out at @balbinotito or
https://www.instagram.com/balbinotito/ and be sure to see previous posts, like and share with friends and family members. It takes a village to raise awareness of health and wellness as we’re seriously outnumbered and way out funded by big industry messaging, as we shared above in this newsletter already.
October 2023
An Update from Dr. Hartman
Greetings everyone!
June 1 was my last official day of work. I had a couple of weeks to goof off and catch up before my youngest daughter Heather informed me that she had gone into labor. I packed up and my husband Bob drove me down to Orlando to stay with her through the labor and birth of my grandson Max, 7 lb. 7 oz. Then I stayed in Eustis with Heather, my son-in-law Josh, and Max for 10 days. It did come in handy to be able to write prescriptions for problems that came up. What a privilege – not only to be alive after pancreatic cancer, but to be retired and free to help and spend time with them! After a few weeks, I went back to help with some post-partum difficulties. Again, it was such a blessing to be retired and have the freedom to be available. Best of all is that Heather and Josh are building just two lots down from us – grandma time!
Then in late July 26 – August 8 Bob and I took a vacation in New England. We toured the Mystic Seaport (replica of an authentic whaling town/ship), Mystic Aquarium, a boat tour outside the town and Bath Iron Works (which constructs Navy ships today), Maine Arboretum and Gardens, and more. I had the delightful opportunity to visit two (former?) patients that live in Maine. One of them lives on an inlet of the Bay of Fundy where the difference between low and high tide is 14'. So, we saw the inlet at high tide, and the next morning, went walking through the rocky exposed area – which on our phones showed that we stood in the Bay of Fundy. Just amazing!
We took a tour to see puffins – Atlantic Sea birds that once they fledge, live only on the water for five years until they return to the island of their birth to mate and hatch their young. They can fly up to 55 mph, and dive 200 feet underwater! The puffin colonies that originally inhabited the Maine coast had died out (hunted for their meat, feathers, and eggs, and some of their home islands were used for bombing practice by the US military). Then in the 1970's and 80's the National Audubon Society transplanted chicks (pufflings) from Newfoundland to sites off the coast of Maine and were able to produce an amazing renaissance of puffins! Sadly, I couldn't get a good view of the puffins – I couldn't keep the binoculars focused so far off in the distance with the constant bobbing of the boat. But their photographs on the net look amazing - like a cartoon! - beaks demarcated in yellow, orange, and gray and triangular black-only eyes outlined by indentations.
Once home, I had a lot of catching up to do with seeing patients, mail, and most of all my garden. A year ago, my sainted husband Bob consented to build me some raised garden beds. The advantages are multiple:
1. filling them with compost/composted cow manure, perlite, fish emulsion for fertility vastly superior to our sandy Florida soil
2. putting the plants up around waist height, rather than scrabbling on the ground (oh my aching back!)
We started with 6 raised beds, but I kept overflowing into extra greens containers lining the front walkway and pots of overflow plants that ended up covering a large tarp. Things just didn't do as well in pots as the raised beds. We were limited by areas with sufficient sun because of our heavy tree canopy. Well, recently we had to take down a large tree in our back yard (that had repeatedly rained down large branches that expensively pierced our screened enclosure). So now I finagled another 4 raised beds from my beleaguered husband. I am in hog heaven! It's so exciting to see tiny new seedlings of beets, red garnet amaranth, green callaloo spinach, Egyptian spinach, arugula, Asian greens, carrots, spinach, cucumbers, tomatoes, zucchini, peppers, broccoli, cauliflower, Romanescu broccoli, Brussel sprouts, cabbage, Bok choy, Chinese cabbage, watermelon radishes, icicle radishes, watermelon, butternut squash, gourmet lettuce, kohlrabi (weird, huh?). I've researched all kinds of plants – mostly tropical – that survive our brutal heat from May to October.
My daily routine is beginning to gel. I typically get up late – 7-8am or even 9 am if I stayed up reading fiction. I try to clear out my email, work in my garden, take care of bills and the mess on my desk, and lately, have even been able to work a bit on my book on my experiences with cancer. I wish I loved writing – I have a mere 30 pages written. I'll keep plugging away. I do take the extra time to exercise, prepare healthy meals (you should see my amazing home-grown organic salads!), and have down time for surfing the net and reading (mostly fiction).
All my circulating tumor counts reflecting pancreatic cancer have been zero for 3 years! I still maintain a stringent supplement regimen and diet – because I don't want to do the cancer gig a third time! But all looks well!
I submitted an abstract on herbal treatment of Lyme and co-infections to ILADS (International Lyme and Associated Diseases Society) that was accepted and will grant me the opportunity to speak (for an entire 30 minutes) at the upcoming seminar in October. I'm excited to be able to share a great regimen that works so well. I used to be discouraged that many of the talks had so little useful information for clinicians – and now I can present clinically useful information as I always wanted to see it!
Something you may not all be aware of is that twice a month I'm at the office for acupuncture only visits. So, if you're missing your acupuncture (or me), one treatment a month is included in your concierge contract.
Speaking of Mandarin Wellness Center, I am massively grateful for Dr. Balbino: what an absolute gem! I don't know what I would have done if I hadn't been able to pass the baton to someone who is kind and caring, a fabulous listener, and adept in traditional and alternative medicine. He seems to have absorbed a decade of experience treating Lyme disease – he really is very astute. There is no one in North Florida who is half as knowledgeable, and only a few doctors in the state that have taken the time to learn what he has. And every time I speak with him, he relates information new to me about integrative medicine (in addition to his ongoing reading, he spent a significant amount of time and money on a very valuable certification course.) If you haven't met him, be ready for a delight. And if you're meeting any health challenges, he is so much like me (only younger and I'm afraid smarter!); you are sure to feel that you are in the very best hands. And given that he works more days a week than I did, there are typically openings in hours or days, not weeks. Of course, all the previous staff – Chelsea, Cindy, Linda, Rachel, and Kayla are still there for you.
Dr. Shirley Hartman
National Prescription Take Back Day: Saturday, October 28th, 2023
Did you know that prescription drugs thrown in the trash can be retrieved to be abused or illegally sold, or that drugs flushed down toilets contaminate the water supply? The drug overdose epidemic in the United States is considered a public health, public safety, and national security threat. The Drug Enforcement Administration hosts National Prescription Take Back Day during the last Saturday of the months of April and October. DEA sponsors collection sites throughout the country where medications can be dropped off for proper disposal. It is encouraged for anyone to bring any expired, unused, or unwanted medications to designated collection sites for proper disposal. To find a drop-off location nearest to you, use this link:
https://www.dea.gov/takebackday#collection-locator.
-
Locate all medications in your household and ensure that they are securely stored (all lids are tightly on bottles, away from the reach of children and pets, etc.)
-
Inventory the medications and identify which are unwanted and/or have expired dates.
-
Label each of those identified medications with clear signage that indicates disposal and take them to a collection site between 10 a.m. and 2 p.m.
September 2023
A Hearty Welcome to our second edition of the MWC Newsletter!
Today, I wanted to let you all know that after an intentional period of slowing down the access for new patients, to concentrate on the handoff of established patients with Dr. Hartman, we are now 6 months in and have made some adjustments to the schedule to better accommodate new patients in a timely fashion—in fact, we have been able to work through a backlog of prospective patients and are ready to receive new referrals. So, if you, who know what this center has stood for, know someone who is not finding root-level causes to their chronic problems or who want to take their health to the next level and be proactive to prevent chronic disease, let them know we would love to serve them! And this brings me to the important question:
Who’s the ideal patient for the Mandarin Wellness Center? Our ideal patient is one who, while grateful for the advancements of western medicine, understands that too often, it lacks the answers to the chronic diseases with which we deal in this day and age and thus wants to integrate a diagnostic-centric and pharmaceutical-based approach with a more holistic way; the ideal patient is one who is open to learn more about how their body functions and wants to partner with a physician who will give them the time to be heard enough to get personalized insights to get well; the ideal patient is one who is willing to change their lifestyle in order to maximize their results as they receive guidance; the ideal patient is one who will challenge their physician to keep their commitment to first doing no harm and to lifelong learning; the ideal patient is one who wants a physician whose sole loyalty is to them and not to insurance companies, a medical system, or other governmental agencies. Do you happen to know any friend or family member who could be ideal patients to refer to us? If so, please have them reach out today to the office and one of our caring staff members will be happy to get them started in the process of onboarding them.
- Dr. Balbino
Chronic Pain
Chronic pain is defined as pain that continues for longer than 12 weeks, despite medication and/or treatment. Back and neck pain, Fibromyalgia, Lyme Disease, diabetes, arthritis, and IBS can be marked by chronic pain. In studies, it was found that chronic pain affects more women than men. Chronic pain can also aid in the development of loneliness, isolation, and even depression. It can impact your sleep and cause insomnia. Your doctor may recommend a pain management specialist to help you navigate your treatment of chronic pain. Diet, medications, physical therapy, and lifestyle changes all impact your pain levels.
Many times, people with chronic pain are prescribed opioid medications (also known as narcotics or controlled substances). Opioids, or narcotics, are drugs that have high dependency rates, and can be very dangerous if not taken as directed. You should always consult your doctor before starting a regimen that includes an opioid drug; your doctor can educate you on specific drugs, their side effects, and dependency or withdrawal symptoms. If you or someone you know is facing opioid dependence or withdrawal, speak with your doctor, or call the Substance Abuse and Mental Health Services Administration, or SAMHSA, 24 hours a day, 365 days a year: 1-800-662-HELP (4357). SAMHSA provides referrals to treatment facilities, support groups, and community-based organizations.
Did you know? Frequency Specific Microcurrent and acupuncture are alternative, holistic-based approaches to the treatment of chronic pain, and both services are offered at our center. You do not have to be a patient of Dr. Balbino’s to take advantage of these wonderful treatments. For more information, or to schedule an appointment, please call our office today; immediate openings are available!
Alzheimer's Disease
Alzheimer's Disease is a degenerative brain disease that is the most common form of dementia. An estimated 6.7 million Americans aged 65 and older are living with Alzheimer's in 2023. Seventy-three percent are aged 75 or older. While some medications can ease the effects of Alzheimer’s, there is currently no cure. There are different stages of Alzheimer’s Disease, and changes in the brain can begin to occur, unnoticed, years before symptoms arise. Some signs or symptoms to watch for include daily memory loss, difficulty developing or following a plan (like a recipe), having trouble with familiar places and daily tasks, confusion regarding the time and place, vision problems, trouble following conversation, misplacing items (sometimes in strange places), poor judgment with money or grooming, withdrawal, and irritability when a routine is changed. The CDC lists the top 8 risk factors for Alzheimer’s as high blood pressure, little to no exercise, obesity, diabetes, depression, smoking, hearing loss, and binge drinking. If you or someone you know may have signs or symptoms of Alzheimer’s, speak with your doctor about options for treatment and management practices.
“The End of Alzheimer’s” by Dr. Dale Bredesen is highly recommended by Dr. Balbino as it shares decades of research that is now culminating in peer-reviewed published research showing reversal of cognitive decline in adults suffering the life-altering changes of Alzheimer’s. The approach and protocol that Dr. Bredesen espouses is remarkably similar to the functional and integrative approach that we practice at the Mandarin Wellness Center.
The End of Alzheimer’s - By Dr. Dale Bredesen (apollohealthco.com)
Do you have a testimonial of your care or health regarding Mandarin Wellness Center or Dr. Balbino? We would love to hear from you! We would like to highlight our patients’ personal experiences on the Mandarin Wellness Center website and within the monthly newsletter.
If you would like to submit a short testimonial, please email us at office@mwcjax.com and use the subject “Testimonial.” Your privacy matters to us, and we will only use your name or initials with your permission. Please let us know in your email if you’d like to use your full name, initials, or remain anonymous. We look forward to continuing to serve you, and to hearing your stories! (as shown, Italic)
August 2023
Gastroparesis Awareness Month
Gastroparesis slows and stops the movement of food from your stomach to your small intestine, even without a blockage present. This means that your stomach cannot process food or empty itself normally. 1/3 of diagnosed cases are directly related to diabetes. It has also been linked to surgery, infection, and autoimmune diseases. Common symptoms include indigestion, bloating, upper abdominal pain, nausea and/or vomiting, acid reflux, blood sugar fluctuations, and constipation. For more information on gastroparesis, Dr. B recommends:
https://healinggpnaturally.wordpress.com/2013/11/25/understanding-your-digestion- dr-mercola/
Summer Sun Safety Awareness Month
Every person is at risk for sun exposure, sunburn, skin cancer, heat exhaustion, heat stroke, and dehydration during the hot summer months. Keep yourself safe by following these tips:
1. Limit your sun exposure between the hours of 10 am and 2 pm, the hottest and most intense
part of the day, when the UV index is at its highest. A safe approach is to intentionally and
gradually expose yourself for 15-20 minutes to increase melanin and activate Vitamin D, all the
while preventing actual burns.
2. Wear sun-protective clothing (long sleeves, pants), sunglasses with UV protection, wide brim
hats.
3. Use “broad spectrum” sunscreen that has an SPF of 15 or higher, following instructions for use.
4. Medications can increase your UV sensitivity; check with your doctor if you have concerns.
5. Take plenty of breaks, drink lots of water, and utilize the shade.
Did You Know? Mandarin Wellness Center offers a variety of IV treatments, including HYDRATION FLUIDS! Immediate appointments are available. For a limited time, we are offering a 10% discount for first time IV, Micro Current, and Hyperbaric Chamber visits. This includes people who aren’t patients of Dr. Balbino, so let your friends and family know!
In The News:
Jacksonville Lyme disease patients say they had to ask a dozen times for a test
Researchers at the University of North Florida say official Lyme disease statistics underestimates the number of people with Lyme Disease.