Posts by: "Mitch Prywes, MD"

A recent study at the NIH NCCIH demonstrated the cost effectiveness of treating lower back pain with mindfulness based stress reduction. This is yet another reminder that there are more therapeutic approaches than pharmaceuticals to dealing with lower back pain.

Cannabis use is medically approved in 29 states and the District of Columbia for many clinical conditions. Most individuals seek out its use for reducing pain and helping with sleep. However, studies illustrate that cannabis also has anti-inflammatory and immune enhancing properties, which can benefit chronic autoimmune conditions like psoriatic arthritis.

A CBS Sunday AM segment that aired today illustrates to me just how “touch-starved’ and alienated we’ve become as an American society. The segment shows how “across the country professional cuddlers are tackling the demand for non-sexual touch,” charging clients $120 for a 90 minute session of “holding people for an extended period of time.”

It’s very true that the biochemical and therapeutic benefits of touch cannot be underestimated. The skin, after all, is the largest organ in the body, and it is rich with nerve receptors, neurochemicals, and immune modulators. Child psychologists have long recognized that loving physical contact between mothers and babies is essential for normal growth and development and for maintaining good health. Studies on the benefits of massage have also demonstrated signifiant reductions in cortisol, our body’s stress hormone.

So, this Valentine’s Day (and every day), put aside all the texting, to reach out and touch someone, and get your “free hugs” before they become commoditized by a complete stranger…


My 5 minutes of fame onstage at the Ridgefield Playhouse last November performing stand-up comedy translated into an article released online today in the Danbury NewsTimes:

You can watch my entire routine on YouTube:

It’s amazing to me, after practicing Medicine for 25 years, how one performance in front of an audience┬ácan alter the perception of how you are viewed, as well as how you might view yourself. Somehow this simple experimentation in daring to do something creatively different, allows for a kind of personal transformation and self re-invention. If only we could learn to get out of our comfort zone, sooner than later, perhaps we’d be able to explore more of what might bring joy into our life.

It seems that a recent Harvard study ( demonstrated that heavy coffee drinkers (6 or more cups/day) had a 20% decline in the incidence of prostate cancer with a dose-dependent decline in aggressive forms of the disease (up to 60% in the heaviest drinkers). Apparently, this association even holds in decaffeinated coffee drinkers!

The World Cancer Research Fund & The American Institute for Cancer Research (WCRF/AICR) Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective as well as the companion report, Policy and Action for Cancer Prevention are great online resources:

Consumption of well-done meats and, thus, exposures to heterocyclic amines (or other compounds) formed during high-temperature cooking may play an important role in the risk of breast cancer.

Food and nutrient interventions have been shown to treat the underlying pathophysiology of Parkinson’s Disease. Optimizing antioxidant function is essential and includes the folllowing:

-Coenzyme Q10: 200mg per day
-Vitamin C: 1000 mg per day
-Vitamin E: 400 IU per day
-Alpha lipoic acid: 200 mg per day
-N-acetyl cysteine: 800 mg per day
-Acetyl-L-carnitine: 800 mg per day
-Vitamin D3: 4000 IU per day
-Beta carotene: 25,000 IU per day

Other factors to consider are:

Reducing inflammation with DHA: 1200 mg per day as a supplement
Attention to lifestyle issues including exercise and weight management

Migraine is a condition that has connections to food and drink.
In one large-scale double blind trial of an elimination diet involving 88 pediatric migraine sufferers, 93% with severe frequent migraine responded and were headache-free (Egger, et al, Lancet, Oct. 1983).

An elimination diet is the gold-standard approach to elucidating which foods, if any, impact one’s health. The most common food allergens are: dairy, egg, wheat, soy, corn, citrus, peanuts, tree nuts, and shellfish.

David E. Kelley, well-known for such legal dramas as “Boston Legal,” “Ally McBeal,” and “The Practice,” has hit a home run with a courtroom scene from his latest series “Harry’s Law,” featuring an arrogant attorney (superbly played by Christopher McDonald) who takes on the Fast Food Industry on behalf of his morbidly obese client. It appears that Mr. Kelley has done his homework, using current research, trends, and health statistics to fuel the drama and highlight the fast food industry’s contribution to the obesity epidemic, mortality, and chronic disease.

View the video on Facebook:

Many of my patients who are taking nutritional supplements often do not understand why they take them, or whether there is a true health benefit to their use. In the case of diabetes mellitus, there are several nutritional supplements which may benefit the diabetic patient. Below are some of the nutrients that can provide support for the diabetic patient:

Alpha Lipoic Acid (ALA): a metabolic anti-oxidant that may be helpful in diabetic neuropathy (600-1200 mg daily, taken in divided doses)

Chromium picolinate: trace element required for proper maintenance of carbohydrate and lipid metabolism, it has been shown to improve the glucose/insulin system in diabetics. Doses of 600-1000mcg/d are being studied in the newer clinical trials.

Magnesium: affects many cellular functions including energy metabolism, cell proliferation, the transport of potassium and calcium ions and modulating signal transduction. Magnesium deficiency has a negative impact on glucose homeostasis and insulin sensitivity and is involved in the evolution of complications such as retinopathy, thrombosis and hypertension in type 2 diabetics (Walti 2003). As magnesium is intracellular, RBC magnesium is a more sensitive indicator of deficiency. Hypomagnesemia has been linked to poor glycemic control, coronary artery diseases, hypertension, diabetic retinopathy, nephropathy, neuropathy, and foot ulcerations (Pham 2007). A meta-analysis of 9 randomized, double blind, controlled trials concluded that oral magnesium supplementation might lower fasting plasma glucose levels in diabetics (Song, et al., 2006).Magnesium supplementation may be important when considering the vasoconstrictive effects of hypomagnesemia and the magnitude of vascular disorders seen in those with diabetes (Whang, Sims, 2000). Patients with diabetes, and those with significant risk factors for the disorder, should be encouraged to limit refined grains and acquire their energy from whole grain products rich in magnesium. Metformin can deplete magnesium levels, as well as vitamin B12 and coenzyme Q10. If supplementing, magnesium lactate, aspartate, and glycinate are all gentle on the GI tract and less likely to cause diarrhea. The dose varies but is generally 300-500 mg per day.

One note of caution, the kidney is the principle organ involved in magnesium homeostasis. Magnesium supplementation in patients with renal disease must be done with caution.

Vitamin D: Accumulating evidence suggests that low levels of vitamin D might be involved in the development of type 2 diabetes(Liu 2010, Mathieu et al., 2005, Chiu et al., 2004). Given the overall health benefits of vitamin D it just seems to make sense that 25-hydroxy vitamin D levels be checked and supplementation recommended if levels are lower than 35 ng/mL (many experts would argue a higher serum level).

Thiamine/B1: Thiamine is a water-soluble vitamin essential for normal metabolism of fat, glucose and protein as it is involved in key pathways of cellular energy synthesis. 75% of patients with diabetes were shown to have reduced levels of thiamine and increased urinary excretion of thiamine relative to controls (Thornally,et al 2007). Low thiamine levels correlated with increased levels of vascular adhesion molecules, known markers for vascular disease. It may be advisable for diabetic patients to take a multiple vitamin that provides 25 mg per day of thiamine.

A growing body of research supports the use of music therapy as an effective mind-body therapy in infants and children. Music has been shown in controlled studies to reduce pain response and anxiety in a variety of pediatric settings including neonatal intensive care units, procedure rooms, emergency department waiting rooms, and in the peri-operative setting. Music therapy can be used alone, or in conjunction with relaxation therapies such as progressive muscle relaxation or visualization.

A great resource is the American Music Therapy Association:

I think authenticity is the key to your relationships with your patients, as with others. “Keeping it real” means that whatever you share genuinely comes from the heart, which represents the deepest part of one’s soul, or spiritual self. We learn from our patients, just as they do from us, and this communication or energy exchange, when flowing purposefully, is timeless, and its therapeutic benefit beyond measure.

The Environmental Working Group (EWG) a nonprofit organization that advocates for policies that protect global and individual health, issued research about which types of produce had the highest pesticide load and for which an organic purchase makes the most sense. This was summarized well on Dr. Andrew Weil’s website:

Dirty dozen: fruits & vegetables to always buy organic:

Foods you don’t have to buy organic: