#4: Dr. Steven Newman - Integrating Nutrition into Your Practice

[AdminWolf]

ODwire.org Radio

Episode 4: Dr. Steven Newman - Integrating Nutrition into Your Practice

In this episode, Paul and Adam have a chat with Dr. Steve Newman.

Dr. Newman is an OD who is also a Certified Nutrition Specialist.
Learn how you can integrate nutrition advice to both build your practice and improve your patient's health.

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[AdminWolf]

my apologies in advance for the discussion of paul's bowel habits. you have no idea what I have to deal with here....

 

[Steven Nelson]

my apologies in advance for the discussion of paul's bowel habits. you have no idea what I have to deal with here....

Dear God ::facepalm::

 

[Paul Farkas]

In all fairness...

my apologies in advance for the discussion of paul's bowel habits. you have no idea what I have to deal with here....

I brought up the issue to highlight that nutritional supplements can have some surprising side effects.

I told of my experience with nighttime leg cramps. Possibly a side effect of Lipitor.

I took advantage of Adam's MD training and asked him what to do. His advice was to take magnesium to alleviate the problem.

He neglected to tell me that magnesium is a laxative!

For the full story don't miss this episode.

 

[Steven Nelson]

One area where I do see a problem is that he started talking about counseling people about cholesterol and adding supplements etc to affect their overall health. I know the Texas Board would come down on you like thunder as would the Texas Medical Board for that kind of thing because it's practicing something other than optometry. You'd have an exceedingly difficult time defending that as being within the scope of optometric care because those patients would becoming in for ocular evaluations. You could say that you were acting in your role as a board certified nutrition counselor (interesting that they can be BC, but apparently ODs shouldn't), but since they came in seeking eye care, I think that license would take precedence. I'm as medical as anyone, but I bet you'd get your backside handed to you for that.

I don't know how it works at all, but I can see where the board could have an issue with it.

 

[Edward Fries]

One area where I do see a problem is that he started talking about counseling people about cholesterol and adding supplements etc to affect their overall health. I know the Texas Board would come down on you like thunder as would the Texas Medical Board for that kind of thing because it's practicing something other than optometry. You'd have an exceedingly difficult time defending that as being within the scope of optometric care because those patients would becoming in for ocular evaluations. You could say that you were acting in your role as a board certified nutrition counselor (interesting that they can be BC, but apparently ODs shouldn't), but since they came in seeking eye care, I think that license would take precedence. I'm as medical as anyone, but I bet you'd get your backside handed to you for that.

I don't know how it works at all, but I can see where the board could have an issue with it.

Asking any patient to come off of a prescribed medication could result in legal action for practicing outside our scope of practice. I would say something like "if you want to come off your cholesterol medication, I could help you nutritionally, but you will have to talk to your primary care doctor and work them him/her in regards to slowly coming off the medication." If a cardiologist is involved I wouldn't touch that patient with a 50 foot pole on nutrition. Just a word of advice from experience since cardiologists are highly trained specialist that seem to know nothing about nutrition but believe they do so trying to help one of their patients nutritionally could be your worst nightmare. Most of my patients that are on statins, I just recommend them to take CoQ10 (been doing that for the past 5-6 years) to reduce the side effects I tell them and to help their hearts. I also recommend sub-lingual B12 to all my metformin using diabetics as well.

I offer nutritional consultations to all patients in my practice and I also offer nutritional functional testing so see were their bodies need the most nutritional support. I do all this in the interest of reducing eye disease because we know diabetic retinopathy is from poor choices in diet for most patients, but now it seems macular degeneration and possibly glaucoma are from prolonged nutritional deficiencies as well.

Paul I would say if your leg cramps aren't from a CoQ10 deficiency then they maybe from magnesium and or calcium but before you go overboard taking supplements (too late huh) I would really stress that you make sure your digestion is working correctly since you need lots of stomach acid to digest and absorb minerals (also need a good form of magnesium like magnesium lactate). If you are taking any antacids, H2 blockers, or proton pump inhibitors, then you probably don't have enough stomach acid to digest your minerals and absorb them which maybe why a lot of magnesium went to your colon instead of being absorbed in your small intestine if your stomach acid is low for any reason. Also hydration could be an issue causing leg cramps. I would have to do a three day food journal and send you a nutritional assessment questionnaire by email to give you anymore information.

Edward H. Fries MS, OD, NTP

Editor's note: Thanks for the great advice. The leg cramps seemed to have vanished. Tomorrow is a tour through the Green market with samples of forbidden foods to savor. Maybe on Monday I'll think healthy dieting once more. But it's the weekend coming up...

 

[steven newman]

I personally never recommend my patients go off their Rx medications. I only delve into their lifestyle habits and arm them with information so that they may have a more intelligent conversation with their doctor that decided their medications.

We know that living a sedentary lifestyle increases you risk of developing AMD. If my patient is on a medication for their cholesterol, which is not a disease, that gives them leg cramps and decreases their energy level thereby increasing the sedentary portion of their lifestyle, hence increasing their risk of developing AMD, I am only doing my job as their eye doctor to inform them that there are treatment options and these options are best discussed between an informed doctor and an informed patient.

Most internists have a huge workload and already delegate to nurses, PA's, nurse assistants, patient coordinators, etc...

We, as optometrists, are in a unique position that we can have a conversation with a patient without them being in a gown or worrying about the blood about to be drawn from their arm. I often arm my patient with copies of studies to read and show to their MD.

Without an educated patient, I believe we will never get out of this healthcare crisis.

 

[Jeff Guthrie]

Is there any new information regarding the studies in the last two years that purported to show an increased risk of MI and CVA when diabetics supplemented with B vitamins?

 

[steven newman]

I've read through some of the preliminary studies on this and find it interesting that the authors decided to use a "high dose" B complex to lower homo cysteine rates rather than the more commonly proven form of Niacin.
Vitamins and supplements can do harm if taken in "high dosages" but pale in comparison to "high dose" Rx medications which can kill you.
This issue would fall into the category of "mis-information" and has achieved it's goal of confusing the public and promoting the "vitamins are bunk" mentality that bug Pharma needs Americans to believe in.

 

[Edward Fries]

I believe you are right about high dose vitamins causing nutrient imbalances with the laws of mass action in the body, but I also believe some of the bad or poor effects of vitamins seen in some research are from the various isomer forms arising in manufactured vitamins. In other words, I fully believe vitamins made from whole food sources are better than synthetic vitamins. I also feel we may be missing the boat on what we have determined as the actual form of some vitamins (like vitamin C) in regards to what co-factors or such truly make up the vitamin in whole foods so I'm not sure if a B complex will have any better or worse effect than straight Niacin.

I've also heard that most of the synthetic vitamins being made are by companies owned by big Pharma.