"Do not be desirous of having things done quickly. Do not look at small advantages. Desire to have things done quickly prevents their being done thoroughly." Confucius.

In college in the early 1970s I became interested in yoga, natural foods and meditation. Later when I lived in Japan for one and one-half years, I studied acupuncture and shiatsu massage at the Atami School of Acupuncture. I also studied yoga and nutritional therapies under the guidance of Sensei Masahiro more

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Integrative Medicine


Low Dose Naltrexone

I have been in medicine for over 30 years and have seen a few medical miracles…people who recover from “incurable” diseases or come back from the brink of death to live active, full lives. However, at heart I am a medical skeptic. I recoil when pharmaceutical and supplement companies reveal their latest miracle hair loss formula, weight reducing compound or other improbable cure for difficult or distressing diseases. Yet, once in a great while, a truly exceptional innovative medicine emerges.

When I first heard of low dose naltrexone (LDN), I was moderately interested. Now I believe it to be a true miracle drug for a wide variety of autoimmune diseases in the same way that the discovery of antibiotics in the 1940’s was for a wide variety of bacterial illnesses.

LDN is a very reduced dose (usually 4 ½ mg) of naltrexone which is used in a 50 mg formulation to help heroin and narcotic addicts stay off of their addicting harmful substances by blocking the body’s opiod receptors. A New York City doctor, Bernard Bihari, MD discovered that naltrexone at low doses can balance the immune system making it an effective treatment for immune deficiencies, autoimmune diseases and possibly cancers.

My own clinical experience with LDN is presently limited to its use in autoimmune diseases which include multiple sclerosis, psoriasis (including psoriatic arthritis), Sjogren’s syndrome, rheumatoid arthritis, lupus, and inflammatory bowel diseases (ulcerative colitis, Crohn’s disease). There are many, many other autoimmune diseases.

Here are a few examples from my own practice:

Behcet’s Syndrome is an incurable autoimmune disease characterized by painful ulcerations and sores in the skin, vagina, mouth and other areas. My patient, a women in her late 50’s, had lifelong full blown Behcet’s including severe chronic pain, burning eyes, and recurrent very painful and distressing skin sores and ulcerations in her mouth, digestive tract, and vagina. She had tried all known potential treatments and failed to improve. The only treatment that did help temporarily was high dose steroids (prednisone) when she was doing very badly. After only a few weeks on LDN all her ulcers healed and all her pain resolved.

Sjogren’s Syndrome is characterized by dry eyes and dry mouth but also involves many other organ systems. My patient, a women in her early 60’s, had severe arthritic pain associated with her Sjogren’s. She had failed to improve on all the usual treatments and was scheduled to start a powerful immune suppressant medication which would so strongly reduce her immune response that she would be susceptible to infections and at high risk for cancers. After one week of LDN her pain completely resolved and she did not need to start the immunosuppressant medication.

Psoriatic arthritis is a painful autoimmune arthritis which occurs in patients with psoriasis. My patient, a middle aged woman, had a complete resolution of her chronic joint pain within weeks of starting LDN. Her skin psoriasis also resolved. This patient had also started a gluten free diet and had taken some supplements that also had helped prior to starting LDN, but it was the LDN that dramatically improved her condition.

There are many other examples of dramatic improvements in autoimmune problems with LDN. It is now my first line treatment for most autoimmune diseases. For more information see:


Adrenal Exhaustion Syndrome

The adrenal glands are 2 small (kidney bean size) glands that are located immediately adjacent to the kidneys and in the embryo derive from the same tissue as the kidney. They secrete many hormones including the “fight or flight” hormone adrenalin (epinephrine), the blood pressure regulating hormone aldosterone and the stress modulating hormone cortisol.

Cortisol, the body’s main defense against stress, is produced day and night to deal with all the everyday stresses. It is produced in larger amounts when there is more stress of any kind…emotional or physical. Therefore cortisol production is increased when there is financial stress, relationship stress, physical illness, chronic pain, over work, lack of adequate rest or sleep, excessive worry, poor nutrition, toxic exposure including excessive alcohol and recreational drugs, etc.

If the higher stress load continues for extended periods, the adrenal glands eventually are unable to continue to produce cortisol at adequate levels to respond to stresses. This is called adrenal exhaustion (or adrenal fatigue or adrenal insufficiency).

The symptoms are constant fatigue, low blood pressure, hypoglycemia (low blood sugar reactions), low mood (depression), craving for sugar and irritability.

The good news is that adrenal exhaustion is almost always curable with a combination of proper diet, adequate rest and sleep, and supportive supplements.

The treatment is to rest and support the adrenal glands. Here are my basic recommendations:

Rest: adequate rest and deep sleep are essential

 Diet: emphasize a variety of vegetables, fruits, whole grains, nuts, and wild cold water fish

 Moderate daily exercise (never to the point of exhaustion):

 Yoga: 30 - 60 minutes most days

 Meditation/deep breathing: daily


            Asian Ginseng 250-500 mg per day (5 -7% ginsenosides standardized extract)

            Rhodiola 500 mg per day

            Eleuthero 500 mg per day

            High potency multivitamin

            CoQ10 100-200 mg daily

            Licorice root in select cases

            Adrenal extract in select cases

            DHEA in select cases

 Medication for severe cases: Hydrocortisone (Cortef) 5 - 10 mg 2-4 times per day



Lyme Disease prevention and how to remove an embedded tick

The early spring has brought an early return of Lyme ticks. Below is some basic preventive information including how to remove the ticks.

Preventing tick transmitted infections including Lyme disease is best done by preventing tick bites. Ticks are found in all grassy areas and can happen anytime of the year that there is not a snow cover. Wearing long pants and tucking the pant legs into the socks is a good preventive measure when walking in grassy areas. Spraying DEET on your pant legs will further discourage ticks.

 Always check for ticks after walking, sitting or lying in the grass. Deer ticks vary in size, as small as a poppy seed or as a large as a sesame seed, and are easy to miss.

 If you find a tick embedded in your skin, remove it as quickly as possible. The longer a tick is embedded, the higher the likelihood of infection.

How to remove a tick

1. Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.

2. Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.

3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

If you have removed the tick, it can be tested in a lab to see if it carries the Lyme spirochete.

If a deer tick has been embedded for more than 12-24 hours, you may require treatment. If the tick is embedded for 24 hours or longer and you live in Lyme prevalent area, it is best to receive antibiotic prophylactic treatment.


The Magic Pill

Exercise is the closest thing there is to a “magic pill” to improve health. Too bad exercising is not as easy as taking a pill everyday! On the other hand, exercise is free and has no side effects. By making the effort and finding the time to exercise, you can reap all the benefits listed below:

Benefits of Aerobic Exercise:

  1. Improves mood
  2. Increases the “good” cholesterol
  3. Decreases the “bad” cholesterol
  4. regulates and improves blood sugar
  5. Strengthens bones
  6. Improves sleep
  7. Improves sexual function
  8. Decreases blood pressure and improves heart function
  9. Improves circulation to muscles and joints
  10. Improves lung function and capacity
  11. Improves usage of oxygen in the body
  12. Boosts immunity
  13. Increases muscular endurance
  14. Gives you energy
  15. Improves appearance (lean and fit)
  16. Increases metabolism which helps burn body fat and aids in weight loss

Benefits of Anaerobic Exercise (Strength Training):

  1. Makes muscles, tendons, ligaments, and bones stronger
  2. Increases lean body mass
  3. Reduces body fat
  4. Improves body’s usage of glucose and insulin
  5. Improves your appearance (sculpted and toned)
  6. Increases your metabolism

 Note: Parts of this blog is reprinted from and from the article Physical Activity, The Majic Pill by Jane Wargo and Russell Pate



Of all the determinants of health (diet, exercise, etc.), the most powerful is the working of the unconscious mind. 

Of course, the conscious mind also has a strong influence on health by choosing whether to eat a good diet, to exercise, to get enough sleep, to refrain from smoking or consumption of excessive alcohol, etc. There are also many health benefits that can be achieved by working with the conscious mind to change bad habits to good ones, by learning to relax, by learning new ways of viewing and responding to situations (cognitive behavioral therapy and biofeedback).

However, it is the unconscious mind that not only drives health related choices even more powerfully but has a more direct link to the body. At any time, whatever is manifesting itself on the unconscious mind is also manifesting itself on the body.

The idea that the unconscious mind effects the body is ancient, first proclaimed by the Buddha over two thousand years ago. In the west, over a hundred years ago, Sigmund Freud recognized that repressed emotions lurking in the unconscious can manifest as physical ailments.

More recently, John Sarno, MD has theorized the mechanisms by which repressed anger, fear and grief cause chronic pain syndromes, fibromyalgia syndrome, chronic fatigue syndrome, treatment resistant GERD (acid reflux) and other ailments. In the case of physical problems, Dr. Sarno believes the mind influences the body to protect the sufferer from feeling intense painful emotions. It does this by restricting blood flow. For example, if someone is repressing anger, the unconscious mind may restrict the flow of blood to the low back (or another site) resulting in chronic pain. The cause of the chronic pain is the repressed emotion so no amount of exercise, body work, medication can give lasting relief.

According to Dr. Sarno, the cure is to deal with the repressed emotion though acknowledging that it is the source of the physical problem and either observing or emoting that emotion.

I could site many "miraculous" cures of chronic pain in my patients who followed Dr. Sarno's method. Many more examples can be found on-line or in Dr. Sarno's books.

Here is my own story. About 6 years ago I developed fairly severe right sided low back pain. I thought it was a mere strain from over exercising but it would not go away. The intensity of the pain would mysteriously wax and wane but never resolve. Several attempts at treatment including herbs, ibuprofen, physical therapy, etc. would seem to help temporarily but inevitably the pain would return. If you have ever suffered from chronic pain you know how disruptive it is to everyday living, how draining it is both physically and emotionally, and how every movement can be torture.

One night I remembered the work of Sarno but felt I was not a good candidate for his methods because I was too self aware to be repressing any emotions. Then I thought that if I was repressing something it would probably be anger because I see myself as a calm and even person. I do not like to express my anger or be seen as angry. I decided to try emoting my anger by purposely remembering events that had made me angry in the past. I got myself pretty worked up cursing anyone I could remember who had wronged me in the past. When my back pain improved dramatically I assumed it was just the temporary rush of adrenalin and would not last. However when the pain never returned, I knew that repressed anger had been my problem the entire time!

Emoting the repressed anger was a complete long lasting cure for my back pain. However, there is another less violent alternative which is self observation. For Dr. Sarno, the observation is to notice carefully whenever one is repressing an emotion and to not let that process continue by recognizing what is happening and dealing directly with the emotion. This is an effective and practical technique. Sarno says that there is no way to see the workings of the unconscious mind directly, but that it is still possible to work with the unconscious by acknowledging its action and dealing with emotional repression at the level of the conscious mind.

However, there are  meditation techniques that give direct access to the unconscious mind. The Buddha taught a type of meditation called Vipassana which means insight. He said that every thought produces a sensation on the body and that by observing those sensations one can indirectly observe the workings of the unconscious mind. Drs. Freud and Sarno have given us understanding of how repressed thoughts or emotions can cause physical ailments. Buddha has shown in much greater depth how the unconscious mind manifests itself on the body every moment of everyday.

For more information regarding Dr. Sarno and the role of repressed emotions as causes of chronic pain and other chronic medical conditions I suggest his books:Healing Back PainThe Mindbody Prescription, and The Divided Mind.

For more information regarding Vipassana meditation and the workings of the unconscious mind I suggest the book, The Art of Living: Vipassana Meditation by William Hart.

If you really want to fully understand the unconscious mind at the experiential level then learning Vipassana meditation by doing a residential 10 day course is the only way. Go to: