* In a recent study, one third of 773 individuals involved in a road accident as a driver, bicycle rider or pedestrian experienced some level of anxiety, depression, fear of travel or post traumatic stress disorder (PTSD) 3 to 12 months later and, in most cases, persisted. After one year, about half the group had phobic travel anxiety, nearly 60 per cent had general anxiety, and half were diagnosed with PTSD (Am J Psychiatry, 2001; 158: 1231-8).

* New research in nearly 1300 men suggests that, during a severe asthma attack, men are less likely than women to notice the symptoms of the attack. The reason for this is unclear, but it may be that men perceive less discomfort because of greater lung size and muscle strength, or because they generally develop asthma at an earlier age than women. Men also tend to only seek medical attention when symptoms are too severe to ignore, the researchers noted (Ann Emerg Med, 2001; 38: 123-8).

* What’s lurking in that paddling pool? Physicians in Canada have found the first outbreak of a new type of Pseudomonas infection called ‘hot foot syndrome’. This discovery was made when 40 children, aged 2 to 15, developed intense pain in the soles of their feet within 40 hours of using the same wading pool. A hot, red swelling began after a few hours, along with pain so severe that the children were unable to stand up. Three children were given oral cephalexin (an antibiotic) while the others were treated with cold compresses, analgesics and foot elevation. In all cases, the condition resolved within 14 days, although it recurred in three children after they revisited the same pool (N Engl J Med, 2001; 345: 335-8).

1. Backache. Research demonstrates that for most cases of lower back pain, chiropractic or osteopathy works far better than anything medicine has to offer (WDDTY vol 4 no 8).

2. Ear ache. In most cases, time, mullein oil, a woolly hat or a hot water bottle works far better than antibiotics in curing ear ache, according to numerous studies (Alternatives,WDDTY vol 5 no 12).

3. Fever. Fever is your body’s extremely clever method of killing foreign bugs of all varieties and shouldn’t be suppressed. Rather than worrying about the exact degrees, its more important to determine whether the problem is serious say, meningitis. Fevers for ordinary viral and bacterial infections won’t exceed 105 degrees, which isn’t dangerous.

4. Infection. For common or garden infections, first try working with a herbalist, who will prescribe echinacea or berberis, rather than antibiotics.

5. Just in case checkups, particularly if you are over 50. If you have nothing blatantly wrong with you, going to a doctor won’t necessarily protect you but is likely to unleash the entire arsenal of his testing apparatus.

6. Menopause. Unless you are among the very small percentage of women who don’t respond to other measures, holistic measures (diet, homeopathy, herbs) will help you through the change in a safer way than any doctor.

7. Chronic but not life threatening diseases. Eczema, psoriasis, non life threatening asthma all respond better to alternative measures than drugs, which only suppress symptoms (The Guide to Asthma and Eczema; PROOF! vol 1 no 3).

8. Slimming. All a doctor usually has to offer is drugs, and numerous slimming drugs have been found to be life threatening. Allergies are one of the major causes of overweight, as are calorie poor slimming diets (WDDTY vol 6 no 5 and Allergy Handbook).

9. Colds and flu. Unless you are elderly and your immune system is compromised in some way, there is nothing your doctor can give you or your child that will improve a cold or flu. Bed rest, plenty of fluids, lemon and honey drinks and homoeopathy help; antibiotics cannot.

10. Acne. Again, all your doctor has is drugs with horrendous side effects to offer you. Try diet and allergy treatment first (The Allergy Handbook).

Many patients with stubborn acne get subjected to long term treatment with broad spectrum antibiotics, which often keeps the condition at bay by killing off the bacteria involved. However, the antibiotics often provoke a chronic intestinal yeast overgrowth which will actually make the acne worse. Consequently the first line of acne treatment is Candida albicans overgrowth. Proper care also requires the removal from the bowels of toxic bacteria preferably by the use of herbal remedies Hydrastis canadensis or Berberis vulgaris.

Some studies have shown that chocolate, cow’s milk and refined carbohydrates, for example, will aggravate acne. Yet others have proved that these foods had no effect whatever. The results of various studies involving zinc supplementation have been equally inconsistent (M Murray & J Pizzorno, Encyclopaedia of Natural Medicine, Rocklin CA: Prima Publishing, 1990).

Nevertheless, other nutritional supplements have offered consistently good results. Chromium has been reported to produce glucose tolerance and to bring about a rapid improvement in patients with acne (M McCarthy, Med Hypoth, 1984, 14: 307-10). Acne has also improved with selenium and vitamin E supplementation, which eliminate free radicals (G Michaelssen & L Edqvist, Acta Derm Venereol (Stockholm), 1984, 64(1): 9-14). Folic acid supplementation has also been shown to be beneficial in cases of acne (T J Callaghan, Curtis, 1967, 3: 583-88). Pyridoxine (B6) supplementation has been shown to be useful in eliminating or reducing acne, especially during premenstrual flare ups (B L Snider & D F Dietemen, Arch Dermatol, 1974, 110:130). Although vitamin A supplementation in high doses (daily doses of 100,000 IU or more) has been shown to be beneficial in acne in well controlled studies, we advise against its use because of potential toxicity. A low fat diet, along with corn oil (omega-6 fatty acid) supplementation was also shown to improve patients (W R Hubbler, Arch Derm, 1959, 79: 644).

Nutritional therapists suggest people with acne avoid the following: inorganic iron, as it inactivates vitamin E; female hormones, which is antagonistic to vitamin E (milk contains such hormones); extra iodine (as in some table salts); commercial carbonated drinks (these usually contain brominated vegetable oils); and extra vitamin B12.

In an experimental study, a combination nutritional regime of most of those nutrients was given to patients. Ninety two per cent had a good to excellent response, and 43 per cent had a 90-100 per cent clearing of their condition in two months or less (S Ayres & R Mihan, Curtis, 1981, 28: 41).

Harald Gaier is a registered Naturopath, Osteopath & Homoeopath.

At 18, I started taking the Pill along with the Minomycin. In my early 20s, my acne resurfaced and my doctor gave me Minocin, telling me it was the same as Minomycin. Instantly, I suffered side effects severe digestive upsets and weight loss.

A year later, I restarted the Pill. One day, out of the blue, I had an episode of severe dizziness, followed by a migraine of such intensity and duration that I went to see my doctor. I also wanted an answer to other perplexing ‘incidents’ lack of blood flow to my fingers and toes, strange purple spots on my jawline which bled beneath the skin, breathlessness and strange flu like episodes.

The doctor told me that on no account could the Pill cause headaches, and that I needed to see a psychiatrist. I reacted by throwing out all of my acne medication and pills. Within four weeks, I felt better.

My acne, however, worsened considerably, so I reluctantly obtained more Minocin. The new packet had a leaflet saying that Minocin is thought to increase bloodflow to the capillaries, which is believed to contribute to healing acne. Horrified, I didn’t take the medication as my previous bleeding beneath the skin was probably due to the drug.

At 28, I became pregnant, and everything was fine for the first six months. Then, I began to feel very tired, and the baby stopped growing. At 30 weeks, I gave birth to a stillborn baby. A doctor at the hospital told me he had seen such a case before in a woman with lupus and blood tests were needed. But, at the six week check up, the obstetrician told me I didn’t have lupus antibodies, but antibodies to cardiolipin. Could this have caused the stillbirth? Years passed. I was unable to become pregnant again.

Then, a magazine article on lupus described a related problem called ‘sticky blood in pregnancy’. I wrote to the lupus group cited in the article and asked them what anticardiolipin was. They sent me a photocopy of a paper stating that it was the name of the antibody they had referred to.

Eventually, I was diagnosed with an autoimmune disease like lupus. HS, Sussex……

The UK Committee on Safety of Medicines has received reports of adults and teenagers developing the paralysing syndrome after using the drug. In one case, a 31-year-old man who’d used 80 mg/day of oral isotretinoin for five weeks is unable to do much besides blink; in another instance, a 13-year-old boy given 50 mg/day, then 30 mg/day, for three months must now be kept on a ventilator.

The incidence of GB syndrome with isotretinoin is one in every 50,000 patients (BMJ, 2004; 328: 1537).

Bextra (valdecoxib), one of the new generation of COX-2 inhibitors, a supposedly safer version of the NSAIDs for arthritis sufferers, can cause life-threatening skin conditions.

The discovery was made in America, where the drug has been approved for use since November, 2001. Patients are now being warned to look out for any kind of skin rash – and if one appears, to stop taking the drug immediately.

The drug was approved for use in UK and Europe only last July, so word will not have gone out here yet.

If you are taking Bextra, watch out for any rashes; if you know someone who’s taking the drug, let them know.

The acne drug, Accutane (isotretinoin), can cause aggressive and violent behaviour, new research has discovered. People who take the drug for long periods may be particular vulnerable, and the reaction can also be magnified if the patient is also taking a corticosteroid or phenytoin.

To find out more about the dangers of drugs, read Secrets of the Drug Industry, which you can order from our website http://www.wddty.co.uk/shop/details.asp?product=341

But how much longer it enjoys this position is in question after it has been associated with causing serious adverse reactions, some life threatening.

Doctors have reported several deaths among patients taking the drug. One 39 year old woman needed a liver transplant when her liver failed after being on the drug for just four weeks.

Leading US dermatologist Dr Alice Gottlieb wants to see the drug used with greater caution after one study discovered it caused a discolouration of the bones in the mouth of 10 per cent of users. Other serious adverse reactions have included autoimmune hepatitis and lupus.

The onset of symptoms have varied. Serum sickness reactions have been reported after just 16 days on the drug, while hypersensitive reactions, such as rash, fever and liver problems, have occurred within 24 days. Several cases of drug induced lupus have been reported up to two years after being on the drug.

Minocycline, a tetracycline, is known to cause gastrointestinal problems such as nausea, anorexia, vomiting and diarrhea.

Discolouration of teeth is fairly common, although Wyeth, the manufacturer, says that this is reversible once the drug treatment has stopped. Children under the age of 12 whose teeth are still developing may not be so lucky, and they may have discoloured teeth for the rest of their lives.

People with a history of liver problems, and pregnant and breastfeeding women, should all avoid the drug.

Manufactured by Ortho, it is available either as a lotion, gel or cream; the lotion is best suited for large areas, such as the back, the gel for severe cases of acne. and the cream for dry and fair skin.

It is a very powerful treatment, although the manufacturer is not exactly sure how it works. With it come a range of side effects, although so far they have all been reversible. The most common is severe rash and peeling, an indication that the treatment should be suspended or stopped.

The treatment should not be used by eczema sufferers, or by pregnant women and those who are breastfeeding; although there has never been a study involving pregnant women, Retin-A has affected the growth of the fetus in rats. “Tretinoin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus,” says the US Physicians’ Desk Reference 1992 although, as we are talking about acne, it’s hard to imagine an instance when that would apply.

Equally worrying are the potential risks that Retin-A users can run when out in the sunlight. The manufacturer has made it very clear that people should not be out in sunlight for any length of time, or use sunlamps while using the treatment. Those with suntans should wait for normal colouring to return before using the drug.

The worry is about the possible link to skin

cancer, although no long term studies, either among

humans or animals, have ever been carried out. Small scale tests among animals have produced varying results.

Latest surveys show that after six years, 65 per cent of acne patients receiving topical and oral treatments for the condition will develop a resistance to the antibiotics. Skin swabs, taken from 3,201 acne patients attending dermatology clinics between 1991-97 by Anne Eady and colleagues of the Skin Research Centre at Leeds University, showed evidence of the antibiotic resistant bacteria Propioni bacterium acnes.

The Leeds study group found that antibiotics and resistant bacteria can be spread through touch. A 1996 report stated that a significantly higher proportion of siblings and close contacts of patients on long term antibiotic treatment carried resistant strains of staphylococci on their skins compared with the control group.

The group suggests that doctors only prescribe antibiotics when absolutely necessary and that treatment courses be kept short (Lancet, 1998; 351: 422).

By the time I went back to see him a few months later, my skin had cleared up so much that he was doubtful as to whether I should even take the heavier drug Roaccutane. He said that

I could go on taking erythromycin for years without any side effects. Is this true? Isn’t it harmful to take antibiotics over a prolonged period? J M, London……….

A:Antibiotics for acne were in the news recently when it was discovered that minocycline, used to treat acne in thousands of young people, was found to cause autoimmune and liver disease. A group of researchers from various hospitals in Harrogate, Birmingham and Leeds in Britain analyzed 16 cases of hepatitis and 11 cases of minocycine induced systemic lupus erythematosus, which had been reported to the UK’s Committee on Safety of Medicines, plus several others which occurred following use of the drug. Two patients died while taking the drug for acne; another needed a liver transplant. Drug induced hepatitis is rare, only occurring with several drugs, including methyldopa and diclofenac. Nevertheless, the damage to the liver was similar to that seen with Reye’s syndrome and with high dosages of tetracyclines, especially in pregnancy.

Although acne is sometimes associated with autoimmune disease, all patients recovered within three months of stopping the drug, and in five cases, patients reexposed to the drug had a recurrence of autoimmune disease, leading the researchers to conclude that their illness definitely stemmed from reaction to the drug. “Safer alternatives should be considered for treating acne,” the researchers wrote (BMJ, 1996; 312: 169-72).

Minocyline, an antibiotic and member of the tetracycline family, had been a drug of choice because it is well absorbed and only needs to be taken once or twice a day. It’s also the only tetracycline to which acne has so far not become resistant (Medical Monitor, February 7, 1996). In 1993 alone, 800,000 prescriptions were filled for the drug in Britain alone.

It’s also been found to cause eosingophilic pneumonitis (acute inflammation of the lung, which can be caused by chemicals). Again, the reaction resolves itself within a few weeks of stopping minocycine (BMJ, 1996; 312: 138).

Minocycline can also cause blue black discolouring of your skin, mucus membranes, nails, adult teeth and even internal organs. One study found that 4 per cent of patients suffered from skin pigmentation problems on 200 mg a day (Br J Dermatology, 1996; 134: 693-5).

Although an BMJ editorial argues that the first line treatment of acne ought to be tetracycline or oxytetracycline, there is some suspicion that tetracyline can aggravate or bring to the fore pre existing systemic lupus erythematosus.

Besides turning children’s teeth yellow, tetracyclines can cause benign intercranial hypertension and should be stopped immediately if you develop a headache or signs of any increased pressure in your head. The BMJ says that early recognition is important to avoid invasive investigations or treatments with steroids or immunosuppressant drugs like cyclosporin.

Because acne is so resistant to many antibiotics, doctors are now attempting to combine erythromycin and benzoyl peroxide in a topical preparation; one study showed it worked better than the antibiotic alone (British J Dermatology, 1996; 134: 107-11).

As for erythromycin, another antibiotic which is not indicated for acne in the US Physician’s Desk Reference, by the way there have also been reports of liver dysfunction, sometimes with jaundice and potentially life threatening pseudomembranous colitis.

It’s important to recognize that antibiotics don’t just kill the bad guy germs. Any antibacterial drug alters the normal intestinal flora (that is, the several pounds of “good” bacteria residing there), leaving you open to long term problems like “antibiotic associated” colitis caused by toxins produced by Clostridium difficile, necessitating that you take another drug to wipe out this bacteria, or by an overgrowth of yeasts like candida albicans. Since candida infections increase your susceptibility to allergies a frequent cause of acne over the long term antibiotics simply make the problem worse.

All this should convince you that there is no such thing as “perfectly” safe long term antibiotics use; in fact, there’s still a good deal we don’t know about the effects over time. Links have been made between long term use of antibiotics and learning difficulties in children and even diabetes (See WDDTY vols 6 no 11 and 5 no 6).

Other worries have surfaced about Roaccutane (isotretinoin) Accutane in the US a synthetic derivative of vitamin A, which has also been used successfully in the treatment of acne. In the Physician’s Desk Reference, Roche warns in a special box that Roaccutane use has been associated with a number of cases of benign intracranial hypertension. Early warning signs include headache, nausea, vomiting and visual disturbances. It’s also been linked with decreased night vision, inflammatory bowel disease, hyperostosis (increase in size of bone), hepatitis and elevations of liver enzymes (in approximately 15 per cent of patients). One quarter of patients on the drug experiences an elevation in blood triglyceride levels, and 7 per cent experience raised cholesterol levels. High blood triglycerides may increase the risk of a heart attack or pancreatitis.

Most worrying, Roche warns that for young women there is an extremely high risk that a taking Roaccutane during pregnancy can result in a deformed child. Hence, in America, the drug is countraindicated in all women of childbearing potential unless the patient has severe, disfiguring acne; can comply with mandatory contraceptive measures; has received warnings about the drug and the need for two contraceptive measures; has had a negative pregnancy test within a week prior to starting therapy; and begins therapy on the second or third day of a menstrual period.

The drug can also cause increased tolerance to contact lenses. Up to 80 per cent of acne patients suffer from skin problems, such as dry skin, skin fragility, itching, nosebleeds, dry nose and dry mouth. Some 90 per cent of Roaccutane patients experience inflammation and cracking of the skin of the lips a usual indication of a vitamin deficiency and 16 per cent of patients develop musculoskeletal symptoms, such as arthralgia. Nearly 1 in 10 patients experience eczema like rash and thinning of hair, and one patient in 20 experience peeling of the palms and soles of the feet, skin infections, gastrointestinal symptoms, headache, urogenital problems and tiredness.

If that list isn’t long enough, patients have also suffered seizures, emotional problems, dizziness, nervousness, drowsiness, insomnia, depression, a pins and needles sensation, hairiness, changes in skin pigment, herpes, respiratory infections, gum inflammation, arthritis and tinnitus. Plus, five patients with normal eyes prior to treatment developed corneal opacities; cataracts have also been reported. Although most side effects have resolved once the drug was discontinued, many have persisted.

In our view, all other routes should be exhausted before otherwise healthy individuals subject themselves to a number of life threatening risks with these potent and potentially dangerous drugs. And at the end of the day, antibiotics don’t “cure” the condition, which after all, stems from an excess of sebum, the fat excreted from the sebaceous glands, rather than an invasive bacteria.