Dr. Richard Firshein helps patients find alternative treatments for food allergies, migraines, heart conditions and arthritis.
By Richard Firshein published November 1, 1997 - last reviewed on June 9, 2016
General Tso's Palpitations
Whenever I eat Chinese food with MSG (monosodium glutamate) I feel dizzy, get headaches, or even have heart palpitations. Now I always tell the restaurant not to put in MSG, but sometimes I still get these symptoms anyway. How can I be sure they are not using MSG in the food?
They may be adding something else that's similar. Instead of MSG, manufacturers often substitute hydrolyzed vegetable protein. Like MSG, hydrolyzed vegetable protein is a flavor enhancer that can help low-fat foods taste better, which is why it's so popular. You can find it in everything from baby food to canned tuna, and even potato chips: the unspecified "natural flavoring" listed as an ingredient is usually hydrolyzed plant protein or MSG itself. These additives can cause headaches because they contain glutamate, which actually excites neurons in your brain and may overstimulate some sensitive individuals.
Hydrolyzed plant proteins are often made from soy. I myself have a soy allergy and used to be bewildered by the headaches I'd get from eating "pure" tuna. Check your food labels carefully. My MSG-sensitive patients take supplements of branched-chain amino acids, which block glutamate absorption in the brain.
Does Cholesterol Count?
I'm a 44-year-old man, and there's a history of heart disease in my family. My mother, father, and uncle all had heart attacks, and last month my brother, who is 49, had one. I'm next in line and I'm getting nervous. I eat a healthful, low-fat diet and try to exercise regularly, and the weird thing is that despite my family history my cholesterol levels are actually normal. Is there anything else I can do to lower my risk?
As far I'm concerned, the cholesterol theory of cardiovascular disease is dead—or if not dead, severely wounded. Several years ago we began to realize that most people who had heart attacks had "normal" levels of cholesterol. Why, then, have we gone cholesterol-mad? It all began with a famous study in the 1970s that suggested that the higher your total cholesterol level, the greater your risk of a heart attack. In truth, the study showed that extremely high cholesterol is a risk factor. But it's far from the only factor. Cholesterol levels have become something of an obsession in our country, and they have distracted us from other important risk factors for heart disease. Drugs have been created to combat cholesterol, fat free foods have become ubiquitous, and yet heart attacks continue to be the number one cause of death. In all fairness, there has been a reduction in the number of heart attacks over the last decade, but the improvement has been minimal. We need to pay more attention to other risk factors.
One fascinating theory that has gotten a lot of attention lately is that high levels of homocysteine—a breakdown product of an amino acid called methionine—increase risk of heart disease. Homocysteine promotes free radical damage to the blood vessels. Kilmer McCully, M.D., a former Harvard Medical School researcher, first noticed this link, but was allegedly booted out of Harvard for failing to prove his ideas. Yet his theory has since been supported by scientific studies around the world, and it's now believed that as many as 25 percent of patients with documented heart disease have a genetic defect affecting both homocysteine and cholesterol metabolism. Fortunately, homocysteine levels can easily be checked by a blood test, and then corrected by supplementing the diet with vitamin B[sub 12] and folic acid, along with foods high in these nutrients, such as whole grains and vegetables. Several other proposed risk factors intrigue me. For instance, viruses and bacteria have been found at high levels in the arteries of patients who've had recurrences of blocked arteries after surgery. Heart attack survivors with elevated levels of antibodies to a common bacterium, chlamydia, are four times more likely to have continued cardiovascular problems. Antibiotic treatment for just three days greatly reduces their risk. If infection exacerbates heart disease, we may need to treat heart patients with antibiotics and immune-boosting herbs and nutrients.
An Herbal Treatment for Migraines
I suffer from terrible migraines every month. When a headache hits, I can't move or walk and the pain is so bad that I feel like vomiting. My doctor prescribes a drug called Fiorinal, which makes me drowsy and woozy. Can you recommend any safe alternatives? Strangely enough. I often feel better after I eat.
You're not alone: 23 million Americans suffer from migraines. Women are more vulnerable than men, probably because of hormonal triggers. One study found that 41 percent of women undergoing hysterectomies had a history of migraines.
Several supplements have been shown to help migraines, and their side effects are nonexistent or mild. The most potent is the herb feverfew. A 1988 study in The Lancet took the medical community by surprise: researchers found that feverfew reduced migraine occurrences by 25 percent. I tell migraine sufferers to take 1,000 milligrams of the herb daily, standardized to 0.2 percent pathenolide, feverfew's active ingredient.
Magnesium may also help; it dilates blood vessels that can become painfully constricted during migraines. One study showed that a magnesium injection stops migraines within 20 minutes. There are virtually no side effects. In severe cases I give a magnesium injection and then recommend daily oral supplements of 500 milligrams to prevent further attacks.
A Complex Kleenex Rx
For the past 20 years I've suffered from chronic sinus congestion. Eight years of allergy shots did almost nothing for me, so I take a decongestant every day. If I skip even a day, though, I feel awful. It worries me that I'm so dependent on medicine, but I work full time and have two teenaged children, so I don't have time to feel ill. Can you help me?
Chronic sinusitis, or sinus inflammation, is very common, and it's important to determine whether it is due to allergies, infection, or both. Infection often reveals itself through a mildly elevated white blood cell count and tenderness in the sinus. An X-ray will confirm that the sinusitis is due to an infection; if that's the problem, a month or more of antibiotic treatment may be required for a long-standing case.
If your congestion is due to allergies, shots won't help unless you reduce exposure to the triggering allergen. For instance, if you are allergic to molds and are exposed to them daily, the allergy shot will only compound your problem. This is true of pollens, dust mites, and foods as well. It would be a good idea to get tested for allergies to all of these triggers, and then to eliminate them from your daily life as much as possible.
Molds can be a powerful trigger of chronic sinus problems, so I recommend that you test your home for them. One patient of mine, a 42-year-old writer, had a house in upstate New York surrounded by woods. As soon as he moved in, his sinus congestion worsened, and he became dependent on medicine, just like you. The house was damp and turned out to have a leaky, moldy roof. His condition improved once he fixed the roof and bought a dehumidifier.
Vitamin C and the herb stinging nettle may also improve your condition. Both are natural antihistamines that help prevent allergic reactions. Vitamin C is a powerful immune booster as well, which is a benefit if your congestion stems from an infection.
Easing Arthritis Naturally
I'm 38 years old and experiencing joint pain in my hands and thumbs, which is especially worrisome because I work as a massage therapist. My doctor says I have the early signs of arthritis and he recommends physical therapy and Mortin. Are there any natural approaches I should consider?
Natural remedies can be very effective against joint pain. First of all, there is a documented connection between rheumatoid arthritis—an autoimmune disease in which the body attacks its own joints—and low levels of vitamin E and beta carotene. These nutrients, moreover, are crucial in the fight against free radical damage, which is also implicated in arthritis. You can have your vitamin levels checked to see if they are low.
Another exciting supplement, glucosamine sulfate, seems to be very effective against arthritis—particularly osteoarthritis, a wearing down of the cartilage that can occur with age. This supplement is a cartilage extract that seems to reverse inflammation and to stimulate and rebuild damaged cartilage in the joints. Generally I prescribe three doses daily of 500 milligrams each. I have seen it work in nearly two thirds of my arthritic patients.