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Clinical Pearl  

There are many probiotics onthe market. In fact, many

probiotics contain a certain

bacteria called Streptococcus

thermophilus (St). (St) is

considered to be a beneficial

bacteria thought to help with

the digestion of lactose, and is

commonly used in the dairy

industry in the production of

yogurt. Even thoughresearchers have sequenced

the genomes of two common

Streptococcus thermophilus

strains, and found them to not

be dangerous (1), I personally

have observed in some children

with confirmed PANDAS

(Pediatric Autoimmune

Neuropsychiatric Disorders

associated with StreptococcalInfections) or suspected

PANDAS that they react

negatively to this probiotic

bacteria. I have had numerous

reports over the years from

parents stating that their

Rheumatoid Arthritis – Help From Integrative MedicineIncluding The Use of Low Dose Naltrexone & Minocycline

Kurt N. Woeller, D.O.

Rheumatoid Arthritis (RA) is a devastating disease leading to severe pain,joint inflammation, and often crippling disability for millions ofindividuals. Current statistics estimate that upwards of 1% of the U.S.population is suffering from Rheumatoid Arthritis. In addition, there areapproximately 300,000 U.S. children with a similar disorder of JuvenileRheumatoid Arthritis. RA rates are approximately 3:1 in favor of femalesto males acquiring the disease.

The causes are multifactorial with thefollowing being attributed to the onset of RAfor many individuals:

Stress–chemical reactions to stressful eventssuch as physical or emotional trauma.

Acute and chronic infections – viruses andbacteria may be triggers for the immunesystem to attack joint structures.

Intestinal imbalances–often from chronicbacterial infections, i.e. clostridia bacteria.

Food reactions–this is evidenced by improvements in RA with eliminationdiets, i.e. gluten (wheat protein) avoidance.

Intestinal imbalances–often from chronic bacterial infections, i.e.clostridia bacteria.

Integrative medicine has much to offer for patients suffering from RA.Much of this help comes in the form of the ability to recognize the role ofdigestive infections and adverse food reactivity that triggersinflammatory reactions which ultimately affect the joints.

In fact, independent research has shown that for many with RA, theelimination of gluten proteins helps to improve their signs and symptoms

 Dr. Kurt Woeller’s

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BIOMEDICINE UNIVERSITY

Clinical Pearl

(continued) children have vocal tics or

motor tics when they consume

a probiotic with (St) in it, and

the problem resolves when it is

discontinued. Therefore, in my

practice I will avoid giving a

probiotic that contains this

bacteria strain to anyone with a

known or suspected case of

PANDAS.

(1) “Streptococcus Thermophilus: A

Bacterium Which Is Harmless to Health."

International Research Associates. 14

Nov. 2006. 

Visit any of Dr. Woeller's

websites for more information

on his specialities & services.

www.AutismActionPlan.com 

www.AutismRecoveryBook.com 

www.AutismRecoveryTreatment.com

www.MethylB12forAutism.com 

www.RheumatoidArthritisRecovery.com

www.DrWoeller.com 

www.MySunriseCenter.com 

www.AutismSupplementsCenter.com

www.AutismSeminarsOnDemand.com

www.BiomedicineUniversity.com 

www.LabTestsPlus.com 

significantly. As reported in the journal Rheumatology (1) the authorsconcluded “the data provides evidence that dietary modification maybe of clinical benefit for certain RA patients, and that this benefit maybe related to a reduction in immunoreactivity to food antigenseliminated by the change in diet.” Therefore, one useful test toperform on ALL patients with RA is blood antibodies for Gliadin IgA, IgG,Antitransglutaminase IgA, and Total IgA.

Another area of integrative medicine investigation is digestive function,particularly certain bacterial infections of clostridia. We know thatClostridia difficle is a trigger for inflammatory bowel in the form ofpseudomembranous colitis (PC).However, itturns out thatthere are other

forms ofclostridiabacteria thatcan contributeto a toxicburden on thebody. Inaddition to PC,Clostridiadifficle hasbeen reportedto initiateinflammatory reactive arthritis in some individuals (2). One test I

recommend is the Organic Acid Test (OAT) from Great Plains Laboratory –www.greatplainslaboratory.com . It is a first morning urine test thangives detailed information about various metabolic activities in the bodythat are important for anyone with a serious illness–including RA. Inaddition, it evaluates for toxins to candida and clostridia identifying twobio-toxins–HPHPA and 4-cresol.

Both HPHPA and 4-cresol are specific for clostridia bacteria. Clostridiabacteria are anaerobic (oxygen avoiding) bacteria that are known totrigger a wide variety of health problems (i.e. inflammatory boweldisease). Clostridia bacteria have also been known to trigger aninflammatory joint condition called Reactive Arthritis which has

similarities to RA. If HPHPA and/or 4-Cresol are elevated, it indicatesthere is a clostridia bacteria present that should be treated. Twoantibiotics–Metronidazole (Flagyl) and Vancomycin (Vancocin)-are botheffective in treating clostridia bacteria.

A treatment option for clostridia bacteria is to use either one of theseantibiotics at a 40 mg/kg split dose three times daily for 10 days, theninitiating a treatment day every 3rd day for 3 weeks. This significantlyhelps to eradicate the colonies of clostridia bacteria in my experience. 

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Low Dose NaltrexoneLow dose naltrexone has been a helpful therapy formany with autoimmune diseases, particularlyRheumatoid Arthritis. The basic function of LDN isthe ability to regulate aspects of the immunesystem that are locked in a pathway ofautoimmunity. Much of the original research forLDN’s influence on autoimmune disorders washighlighted by the late Dr. Bernard Bihari (a boardcertified Psychiatrist and Neurologist) from NewYork State (curriculum vitae - http://

lowdosenaltrexone.org/bbihari_cv.htm). What Dr. Bihariand others found was many individuals with disorderssuch as Multiple Sclerosis, Ankylosing Spondylitis, Lupus,Rheumatoid Arthritis, and a host of other diseasesincluding cancer benefitted greatly by LDN. You canresearch more about LDN at www.lowdosenaltrexone.org.I too have seen RA patients respond quite favorably toLDN taken once in the evening at a low dose of 4.5 mg in

a non-sustained releasecapsule.

The standard dose foran adult is 4.5 mg.

However, this dosagecan be modified bygiving less tobegin if needed forsensitive patients (i.e.1 mg to 1.5 mg) andthen working up slowlyevery few days to a 4.5

mg dose. Someindividuals with autoimmune disorders need to startslower with LDN dosing (because of an initialexacerbation of their symptoms, such as fatigue orweakness as the immune system alters its function), butI’ve not seen this to be necessary for patients with RA. Aneasy way to start at a lower dose is to have your chosencompounding pharmacy prepare 1.5 mg capsules of non-sustained released LDN. This way, if necessary, you canstart your patient with 1.5 mg in the evening and thenadd a second and third capsule of 1.5 mg LDN every 5 to7 days until a 4.5 mg dose is achieved. I’ve had somepatients who benefitted so greatly from LDN at 3.0 mg,that they didn’t need to go to a 4.5 mg dose

Minocycline

Thomas McPherson Brown, M.D. was apioneering Rheumatologist who treatedthousands of patients with a variety ofautoimmune disorders of mixed connectivorigin, including RA, with the antibioticTetracycline. It was Dr. Brown’s theory thathe vast majority of autoimmune diseasessuch as RA, Lupus, Scleroderma, etc. whecaused by a chronic infection (bacteria).Through the use of Tetracycline, he

achieved miraculous results with a multitude of patient

I’ve seen great success in using antibiotic therapy for Rnamely using Minocycline. The idea behind Minocycline(and Tetracycline) use is to implement it in a cyclicaldosing pattern that helps maintain bacterial suppressioand allow for the immune system to regulate itself. Indoing so, many individuals gain significant improvemenin joint mobility, reduced inflammation and pain, andsometimes complete remission of their disease. Acommon dosing schedule that I’ve found successful is asfollows:

Minocycline (aka. Minocin) – 100 mg twice daily for 10days, then

Minocycline (aka. Minocin) – 100 mg twice daily – everyMonday, Wednesday, Friday

This treatment course may take a few months to seeoptimal results. In some people, the treatment regimenmay need to be maintained for years to keep the diseasin remission.

For more information on these protocols, as well asadditional information for RA patients (as well as yourintegrative medicine practice), including testingrecommendations, have a book titled “5 Things You

 MUST Do Right Now To Treat Your Rheumatoid Arthritis” – This ebook is available for immediatedownload at www.rheumatoidarthritisrecovery.com.

(1) Rheumatology (Oxford). 2001 Oct;40(10):1175-9. A vegan diet free of

gluten improves the signs and symptoms of rheumatoid arthritis: the

effects on arthritis correlate with a reduction in antibodies to food

antigen

(2) Semin Arthritis Rheum. 1993 Jun;22(6):420-6. Reactive arthritis

associated with Clostridium difficile pseudomembranous colitis.

Two Additional Therapies That Absolutely Should Considered For Patients WithRheumatoid Arthritis – Low Dose Naltrexone and Minocycline

BIOMEDICINE UNIVERSITY

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In a study of nearly 1,000 mother-child

pairs, researchers found that prenatal

exposure to selective serotonin reuptakeinhibitors (SSRIs) was associated with

autism-spectrum disorder and

developmental delays – particularly in boys

(1). This data comes from the University of

California at Davis’ MIND Institute based on

966 mother-child pairs from the Childhood

Autism Risks from Genetics and the

Environment (CHARGE) Study.

The data was broken into three groups -

those diagnosed with autism spectrumdisorder (ASD), those with developmental

delays (DD) and those with typical

development (TD). The children ranged in

ages two to five with the majority of the

children being boys: 82.5% in the ASD group

were boys, 65.6% in the DD group were

boys, and 85.6% in the TD were boys. The

study did include girls, but there was

substantially stronger affects in boys which

suggests possible gender difference in the

effect of prenatal SSRI exposure.

(1) R. A. Harrington, L.-C. Lee, R. M. Crum, A. W.

Zimmerman, I. Hertz-Picciotto. Prenatal SSRI Use

and Offspring With Autism Spectrum Disorder or

Developmental Delay. Pediatrics, 2014

One of the best ways to promoteyour practice is through shortinformation videos about varioushealth testing and therapies youprovide. These videos should be nomore than 2 to 3 minutes inlength. Videos have a better

chance of being highly ranked bysearch engines like Google thanwritten material (which is stillimportant to do as well). You cansimply use a small camera torecord videos and then uploadthem to a designated You Tube orVimeo Channel linked to youroffice website. If you want someideas and examples on how to do

short videos go to You Tube andsearch my name “Dr. Kurt Woeller,Autism” or “Dr. Woeller, B12.”

P r a c t i c e

M a r k e t i n g T i p

I

N

TH

E

NEWS

To be competitive, you have to market yourself.

Patients are smart, self-educated information starved

consumers, and you are SELLING a service. The Yellow

Pages are a thing of the past. Consumers are taking

their health care into their own hands and choosing their

doctor by speciality. Think outside the box--if you

specialize in a certain type of treatment that isn't

readily available in other areas of the city, country or

even the world, you can do consults with clients via the

phone or Skype. Don't leave your future, and your

practice, in anyone else's hands. Think about how you

can extend your marketshare through the internet.

TIP:  Work with a company that understands Search

Engine Optimization (SEO) and will set your website up

so that the search engines, like Google and Yahoo, will

index it. This isn't a "build it and they will come"

proposition. Your internet presence is an ongoing

commitment that requires your attention (or an

employee's attention) everyday. Don't forget about the

importance of  social media as well.

BIOMEDICINE UNIVERSITY

 A PERSONALIZED WEBSITE IS THE SINGLE MOST IMPORTANT ELEMENT OF YOUR SUCCESS!

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