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Expert offers natural ways to treat respiratory diseases.

SAN DIEGO--Taking an integrative holistic medical approach to treating respiratory disease requires addressing the patient's environment, immune system balance, and emotional health.

At a meeting sponsored by the Scripps Center for Integrative Medicine and the American Board of Integrative Holistic Medicine, Dr. Robert S. Ivker described four steps to achieve this goal:

* Heal the mucous membrane by reducing and/or eliminating inflammation. Striving for optimal air quality is key, said Dr. Ivker, cofounder and past president of the American Board of Holistic Medicine. He defined this as air that is free from pollutants and has a humidity level between 35% and 55%, a temperature between 65[degrees] and 85[degrees] F, 100% oxygen saturation, and a negative ion content between 3,000 and 6,000 0.001-mcm ions/[cm.sup.3].

Home-based methods for achieving optimal air quality include using a negative-ion generator that does not emit ozone, an electrostatic or pleated furnace filter, and keeping the furnace, air ducts, and carpets clean, without the use of harsh chemical-based cleaning agents.

Dr. Ivker recommends the use of a warm-mist room humidifier in bedrooms and offices, especially during the winter months. Certain plants can also assist in cleaning the air, including those that remove formaldehyde (Boston fern, chrysanthemums, striped Dracaena, and the dwarf date palm) and carbon monoxide (spider plant).

Other strategies for healing mucous membranes include getting proper hydration with good-quality water (0.5 ounces per pound of body weight per day), using a saline nasal spray with aloe vera or other anti-inflammatory herbs every 2-3 hours, using a steam inhaler for 15-20 minutes 2-3 times per day, inhaling medicinal eucalyptus oil frequently, and swabbing peppermint oil outside of both nostrils following use of saline nose spray

Nasal irrigation has also been found to alleviate sinonasal symptoms (Otolaryngol. Head Neck Surg. 2001;125:44-8). Options include the Sinu-Pulse, a pulsatile irrigation device that removes biofilm covering the mucous membrane. This is "the most effective and most expensive option at around $100," Dr. Ivker said. Other methods include using a neti pot or SinuCleanse, or squeeze bottle sinus rinses such as that available from NeilMed Pharmaceuticals.

* Strengthen and/or restore balance to the immune system. Inflammation increases free radicals, so emphasize organic fruits and vegetables, whole grains, fiber, and protein, said Dr. Ivker, of the department of otolaryngology at the University of Colorado, Denver.

Exercise helps. He recommends 20-30 minutes of aerobic exercise at least three times a week, plus stretching and strengthening exercises. If patients have no exercise regimen, "start very gradually," he said. "Patients with chronic and fungal sinusitis have a weakened immune function, so you don't want to recommend strenuous exercise right off the bat."

Dr. Ivker also recommends "emotional exercises," including "safe" anger-release techniques such as pounding one's fists on a pillow or punching bag, screaming, laughing, crying, and writing in a journal. In a randomized study of asthma patients, writing about stressful experiences had a favorable effect on symptoms (JAMA 1999;281:1304-9).

The growth of laughter yoga ("www. laughteryoga.org) shows that the idea of not taking life too seriously is catching on. "There are laughter yoga clubs starting up all over the country," he said. "It's a great immune strengthener, a blood pressure, blood sugar, and Cortisol reducer."

He emphasized that getting at least 7 hours of sleep per night "is possibly the most overlooked key to overall well-being and a strong immune system. A lack of sleep is one of the most common causes of colds and sinus infections."

* Mitigate fungus/Candida, if applicable. Patients with suspected fungal sinusitis or Candida/yeast overgrowth--typically the most severe cases of chronic sinusitis--often have food allergies and sensitivities and should avoid sugar, milk and other dairy products, fruits, vinegar, mushrooms, alcohol, and bread and other foods that contain yeast or wheat. After 3 weeks, "you can start to introduce nongluten grains such as brown rice, quinoa, millet, and so on," he said.

In a study, Dr. Ivker and his colleagues showed the effectiveness of a holistic combination of fluconazole and a restrictive diet for chronic fungal sinusitis (Altern. Ther. Health Med. 2009;15:36-43).

"We still don't have a consistently reliable diagnostic test for fungal sinusitis. Genova [Diagnostics'] Comprehensive Digestive Stool Analysis is currently the best test we have, but it's not consistent. There are still too many false negatives. I use the patient's history, clinical picture, and Dr. William Crook's Candida Questionnaire and Score Sheet," he said.

One antifungal supplement he routinely recommends is 100% pure allicin as found in the products Allimax and Al-limed from AlliMax International Ltd. He begins with 720-900 mg t.i.d. and gradually decreases the dose to 180-450 mg every day over the course of 3-4 months.

Dr. Ivker had no conflicts of interest to disclose.
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Title Annotation:PULMONARY MEDICINE
Author:Brunk, Doug
Publication:Internal Medicine News
Article Type:Report
Geographic Code:1USA
Date:Mar 1, 2009
Words:797
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