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Stem Cell Therapy in Orthopedics by Dr. Michael Cohn, MD

6/26/2016

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Stem cell therapy is a blazing hot topic in orthopedic medicine. Stem cells offer the potential to improve joint pain in many disease states by helping the repair process. Stem cell therapy used to be cost-prohibitive for most people aside from athletes and celebrities. Now with improved and more affordable harvesting and processing systems, stem cell therapy is now within reach for millions of individuals.

The potential benefits are endless and patients across the country (and in my office) are seeing and feeling it for themselves. Stem cell therapy can be a way to avoid the pain, costs (insurance deductibles and co-pays, time away from work), and recovery time often associated with surgery. In other cases, stem cell therapy can be a useful adjunct to surgery to supercharge the tissue repair process at the time of procedures such as arthroscopic rotator cuff repair, ligament and nerve repair surgery just to name a few examples.
 
Stem cell therapy is often utilized as a simple in-office procedure. The stem cells are directly injected into the injured tissue site under ultrasound guidance. Patients walk out of the office with a band-aid and begin the recovery process right away. Return to light activities is immediate and return to exercise and sports such as golf and tennis can begin within a few days, as opposed to the weeks or months of downtime after surgery.

While there is no treatment with a 100% success rate, stem cell therapy offers patients the potential to avoid surgery, with a high rate of patient satisfaction and diminished joint pain. Stem cell therapy does not preclude the option to have definitive surgery at any time in the future if one's disease state and associated pain progress over time.
 
Stem cells can be ethically and safely obtained in several ways now. A patient's own stem cells can be harvested and concentrated from a needle blood draw from the hip's bone marrow or extracted from fat tissue, both in the office setting under local anesthesia to numb the area. Alternatively, stem cells can be harvested and processed from human placental tissue obtained at the time of scheduled cesarean sections with the full consent of the donor. In addition to stem cells, abundant growth factors are contained in these products to help attract your body's own reparative cells to the injured tissue site where the stem cell therapy is delivered.
 
There have been several promising studies demonstrating the potential benefits of stem cell therapy for many orthopedic conditions. This is an area of abundant ongoing research as it holds great promise for contributing to our progress in the area of joint restoration.



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​For more information on shoulder arthritis, stem cell injections and shoulder surgery head over to Dr. Michael Cohn's Blog and Website.  
 


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Dr. Michael Cohn, MD Palm Beach Shoulder, Elbow, Wrist and Hand Surgeon.
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Part III   Reversing Prediabetes

5/30/2016

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Photo Credit: BonnieHenderson from Morguefile.com
A major health concern worldwide is the continued increase of people with prediabetes and diabetes. There are estimates of more than 470 million people developing prediabetes by the year 2030, and each year 5-10 percent of people with prediabetes will progress to diabetes mellitus.  With proper detection and treatment of prediabetes the onset of diabetes can be delayed and even prevented.  ​

Prediabetes can be reversed with the proper nutrition, weight loss, exercise and healthy lifestyle as we have discussed in previous posts.  Additional factors in reversing prediabetes are prescription medications, supplements and meditation.  

Metformin
Metformin is the primary prescription medication recommended for treatment of prediabetes.  Metformin was recommended by the American Diabetes Association Standards of Medical Care in 2013 and is still recommended in the latest 2016 edition.  Check out the ADA 2016 recommendations and more information on preventing diabetes: 2016 ADA Recommendations.  
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The ADA suggests metformin therapy for prevention of type 2 diabetes should be considered in those with prediabetes, especially in those with BMI (Body Mass Index) >35, those aged <60 years, and women with prior gestational diabetes mellitus.  Additionally, metformin has been shown to be safe long-term as well as have secondary health benefits such as reductions in body mass index (BMI) and light density lipoprotein cholesterol (LDL) or bad cholesterol.   

Vitamin D
Some studies have suggested that vitamin D helps prevent the progression of prediabetes to diabetes, however, a recent study showed that vitamin D 20,000 IU per week for five years, did not prevent progression from prediabets to diabetes. This study came from the journal of clinical endocrinology.

The reasoning behind the importance of vitamin D supplementation originally came from studies such as those published by the Journal of Endocrinology from 1988.  These studies suggested that vitamin D deficiency in experimental animals leads to reduced insulin secretion which may be restored with vitamin D supplementation.  

​More recently, studies with vitamin D supplementation for improving glucose tolerance or prevention of Type II Diabetes, have not shown very positive results (Journal of Clinical Endocrinology Metabolism 2014).   One reason may be that the effect of vitamin D on glucose metabolism is small, and that the duration of the published studies where short term.

Because type II diabetes develops gradually over many years through a prediabetic stage, it is possible that an effect of vitamin D supplementation on prevention of type II diabetes may take years to become evident.  In short, if you do have a vitamin D deficiency it is important to discuss the best way to increase your level with your primary physician.  Vitamin D deficiency is detected in the blood and your physician can recommend the correct supplemental dosage based on your lab results.  

Vitamin K1

​Those with pre diabetes have blood sugar levels that are higher than normal but not yet high enough to be considered full onset diabetes.  Vitamin K1, also known as phylloquinone, has been shown to provide beneficial effects on blood sugar and insulin health in prediabetics.  

A 4 week study showed that those who took 1000mcg of vitamin K1 significantly increased insulin sensitivity and improved blood sugar control compared to the placebo group. Blood samples were studied to measure osteocalcin, a hormone that is thought to affect blood sugar health.  Osteocalcin is a protein hormone found in bone that depends on vitamin K1 for production.  Basically, by getting enough vitamin K1 in your diet, more osteocalcin can be produced in the body helping to release insulin from the pancreas and prevent diabetes.  Additionally, osteocalcin administration in mice has been shown to decrease fat pad mass and serum triglyceride levels.  

Foods that contain vitamin K1 include kale, spinach, mustard greens, collard greens, swiss chard, broccoli, brussel sprouts and asparagus just to name a few.  There are vitamin K supplements that are available as well.  Many of these include vitamin K1 and K2.  Vitamin K also helps support healthy bones and arteries.  

Meditation

The final section in this three part series on reversing prediabetes is about the benefits of meditation.  I recommend beginning with an easy 10 minutes per day.  There are easy to use meditation apps like Headspace and Stop, Breathe & Think that will help teach and guide you through the basics.  

Meditation will help you to relax and deal with stress in a new way.  At times, life stresses us all out! However, for those with prediabetes or diabetes, stress presents additional problems.  Stress can directly effect blood glucose levels.  Also, we are more likely to participate in behaviors that are unhealthy when we are stressed. We may tend to eat more high-carbohydrate foods like chips and cookies, or sit on the couch and watch TV instead of exercising. 
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Research studies suggest that regularly practicing meditation helps people reduce their response to stress by slowing heart rate, lowering blood pressure, reducing oxygen intake, and changing the brain waves to a more relaxed state. Controlling your response to stress is also likely to lower blood glucose levels. Regular meditation will help you think clearly before acting. You will be able to handle stress more easily and make better decisions.  

There are so many ways to get started meditating.  As I mentioned above, meditation apps are an easy and inexpensive way.  Also, youtube has several guided meditation videos.  Take a look at these youtube channels; The Honest Guys and Jason Stephenson.  Take an extra 10 minutes or so out of your day to focus on yourself, it is well worth it!

Cheers to your health!






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5 Things You Didn't Know About Acupuncture                             by Mila Mintsis

4/24/2016

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Photo via morguefile.com
PictureAuthor Mila Mintsis, L.Ac. From Dynamic Sports Physical Therapy in New York, NY
In this day and age everyone has heard of acupuncture. Because of celebrities like Kim Kardashian posting pictures with needles in her face during her facial rejuvenation sessions, and athlete Kobe Bryant using it for ankle injury, acupuncture has made its way from the dark dungeons of Chinatown into the most prominent offices of Manhattan. Pain is the most common condition treated by acupuncture. However, many people do not know that this medicine has healing abilities that stretch far beyond just pain management.  Mila Mintsis, L.Ac. is a leading certified acupuncturist in New York City. She practices at Dynamic Sports Physical Therapy in Manhattan. She discusses here 5 things that you may not know acupuncture does.  

1.      Acupuncture decreases anxiety. 
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In our fast paced society, with increasing demands of work and family life and the challenges of finding balance between them, it is no wonder that such a high number of people suffer from anxiety. The statistics show an increase in usage of anxiety medications and in my practice, close to 90% of clients report feeling anxious on a near-daily basis. The bad news is that acupuncture will not solve your work or family problems. But the good news is that it will make you more equipped to deal with life’s challenges. Studies show that acupuncture increases production of endorphins, reduces prefrontal cortex activity and blocks production of stress hormones, which results in a relaxation response. Patients report feeling euphoric and experience a deep state of relaxation following treatments. Want to try acupuncture for anxiety but anxious about needles? Don’t be. People are often surprised by how gentle and comfortable of a procedure it is and many fall asleep during treatments.
 
2.      Clears up allergies. 

Allergies are an ever-present epidemic. You, as well as people you know, may be suffering from allergies. There are many theories as to why generations before us did not suffer from allergies as much as we do, but there are few solutions being offered. Recent studies have warned that allergy medications can impair brain function and increase the risk of dementia. Luckily, acupuncture can provide a relief from allergy symptoms without any side effects. There are two main mechanisms behind this effect: First, it modulates cytokines, which are secreted by the cells of the immune system and help to reduce inflammation.  Secondly, it reduces IgE levels, which are the immunoglobulins that react to allergens and produce the “allergic response”.  After treatments, people report reduction in nasal congestion, sneezing and itching and say they can breathe again. For best results, treatments must be done a few weeks before the allergy season begins. In addition, dietary modifications such as elimination of diary and sugar are recommended for longer lasting relief.
 
3.     Acupuncture can get you pregnant. 

Yup, you heard me right. After pain management, fertility is probably the most sought after treatment by acupuncture. Often performed in conjunction with Western medicine treatments, acupuncture has shown to increase the success of pregnancy rates. Acupuncture increases blood flow to the uterus; decreases anxiety and stress (which often come as a result of being unable to conceive), and regulates hormone levels.  Some studies show that receiving acupuncture before and after the embryo transfer in assisted reproduction therapies, greatly increases the odds of implantation, leading to live births. There are occasions where the man’s health impedes a successful pregnancy. Acupuncture has been found to improve sperm quality in cases of male infertility. In any case, it seems that both parties can benefit from treatments, to increase their odds of conception.
 
4.    Acupuncture helps digestion. 

Digestive complaints are another issue that has been plaguing our society. Often, when I ask my patients about their digestion, they will say that it is “good” or “normal”. Unfortunately, frequent bloating and infrequent bowel movements is the new definition of normal. Many are unaware that for good health, bowel movements have to occur daily, and frequent bloating is a sign that your body is not properly digesting the food and assimilating nutrients. Proper digestion starts with proper nutrition and Chinese medicine offers specific dietary plans according to your individual digestive issues. In addition to dietary changes, acupuncture can improve digestion by promoting the parasympathetic state, which is also known as “rest and digest”.  Most of us are constantly on the go and chronically stressed, which results in sympathetic dominance or “fight-or-flight mode”. It is our body’s way of responding to and dealing with stressful situations. This sympathetic dominance physically impedes proper digestion. Creating a favorable parasympathetic state, as acupuncture does, helps to heal digestive complaints.
 
5.     Acupuncture can get rid of your headaches.

Whether you suffer from tension headaches or migraines, acupuncture can help. A study conducted at Duke University, showed that acupuncture was better at treating headaches than aspirin. Other studies have proven acupuncture to be a valuable tool as well. Tension headaches differ from migraines and other headaches in their etiology and therefore acupuncture approaches each with a different strategy.  One of the reasons we get headaches is due to constriction of blood vessels, which reduces circulation, and can induce headache pain. Needle stimulation at specific areas on the body increases circulation and induces blood vessel dilation, which can alleviate pain. Tension or spasming in the upper back and neck muscles due to emotional stress or excessive computer use, can produce a referred pain into the head, causing tension headaches. Placing needles into involved muscle groups induces relaxation in the muscle tissue and eliminates headaches. During treatments, patients often describe a pleasant warming sensation in the back, and they feel immediately better. And most importantly, acupuncture is safe and has no side-effects, unlike some medications.
 
I hope this information was helpful and insightful. And remember life can be painful but suffering is always optional. Give acupuncture a try if you have any conditions discussed above.



 
 
References:
Duke Medicine. “Duke Study: Acupuncture Offers Better Headache Relief over Medication.” MyNC.com. Dec. 1, 2008.
 
Fang J, Wang D, Zhao Q, Hong Y, Jin Y, Liu Z, Zhou K, Jing X, Yu X, Pan R, Chang A, Liu H, Zhu B. “Brain-Gut Axis Modulation of Acupuncture in Functional Dyspepsia: A Preliminary Resting-State fcMRI Study.” Evid Based Complement Alternat Med. 2015;2015:860463. doi: 10.1155/2015/860463. Epub 2015 Nov 8.
 
Feng, Shaoyan, Miaomiao Han, Yunping Fan, Guangwei Yang, Zhenpeng Liao, Wei Liao, and Huabin Li. "Acupuncture for the treatment of allergic rhinitis: A systematic review and meta-analysis." American Journal of Rhinology & Allergy 29, no. 1 (2015): 57-62.
 
Fox, Maggie. “Acupuncture beats aspirin for chronic headache. “ Reuters. Mon Dec 1, 2008
 
He Y, Chen CT, Qian LH, Xia CL, Li J, Li SQ, Liu BP. [Acupuncture treatment of male infertility: a systematic review]. Zhonghua Nan Ke Xue. 2015 Jul;21(7):637-45.
 
Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. “Acupuncture for tension-type headache.” Cochrane Database Syst Rev. 2009 Jan 21;(1):CD007587. doi: 10.1002/14651858.CD007587.
 
Melchart D, Weidenhammer W, Streng A, Hoppe A, Pfaffenrath V, Linde K. “Acupuncture for chronic headaches--an epidemiological study.” Headache. 2006 Apr;46(4):632-41.

N.P. "Common allergy medications could damage brain, increase dementia risk study finds." Cox Media Group National Conent Desk.  Updated: April 19, 2016-7:01AM
 
Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. “Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.” Fertil Steril. 2002 Apr;77(4):721-4.
 
Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J. “Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial.” Fertil Steril. 2006 May;85(5):1341-6. Epub 2006 Apr 5.
 
Xie Y, Wan W, Zhao Y, Ye Z, Chen H, Hong X, Wu L, Wang R, Yang J. “Impacts on the life quality of the patients with allergic rhinitis treated with warming acupuncture in winter and summer.” Zhongguo Zhen Jiu. 2015 Dec;35(12):1215-20.
 
 


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Part I              Prediabetes-A Reversible Disease

3/26/2016

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Photo Credit: Unsplash.com Christopher Campbell
Those with prediabetes have blood glucose (blood sugar) levels that are higher than normal but not yet high enough to be diagnosed as diabetes.  Doctors will sometimes refer to prediabetes as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on what test was used when detected.  Many americans that have prediabetes will convert to diabetes within 10 years.  There are an estimated 37,000,000 Americans that have prediabetes of which the majority have no idea that they do.  

Prediabetes is often without clear symptoms.  Some people who have pre-diabetes may experience some of the symptoms of diabetes.  These include frequent urination, fatigue, increased thirst and blurred vision.  People who are overweight (BMI of 25 or above) or have a family history of diabetes are definitely in a higher risk category as well as those of African American and Native American descent.  People with these risk factors or symptoms should definitely ask their doctor to have a blood test called hemoglobin A1c (HbA1C),glycosylated hemoglobin or glycated hemoglobin test.

The HbA1C test shows how well your diabetes is being controlled.  It provides an average of your blood sugar control over a 2-3 month period.  The HbA1C test measures what percentage of your hemoglobin or protein in red blood cells that carries oxygen, is coated with sugar (glycated).  The higher your A1C level, the more uncontrolled your blood sugar is and the higher your risk of diabetes and complications from diabetes.   If your HbA1c is between 5.7%-6.4% you are pre diabetic.  If it is 6.5% or above you are considered diabetic.  Ideally you want yours to be below 5.4%.  Also, you should take into account fasting blood glucose which should be less than 100mg/dl.  Those with pre-diabetes are 100mg/dl-125mg/dl and diabetes 126mg/dl or higher on two separate tests.  

So, you were diagnosed as pre diabetic, now what?  Well, there are several ways in which you can reverse this condition before it progresses.  But, before making any health or lifestyle changes definitely check with your physician first.  A good idea would be to see a doctor that practices functional or integrative medicine.  These physicians can be found all throughout the country.  Integrative or functional medicine is a healing-oriented medicine that takes into account the whole person including all aspects of lifestyle i.e. diet, exercise, family history, stress levels and environment.  It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and complementary.  
You can find local integrative doctors near you here: ACAM.org.  

 Losing about 7% of your body weight or 15 pounds if you weigh 200 pounds, is an easy place to start for those overweight.  However, things are not always so easy.  A recent study from Korea concluded that visceral fat mass, or fat around the organs, acquired using dual-energy X-ray absorptiometry (DXA), has stronger associations with diabetes and pre-diabetes than other measurements.  Therefore, fat around the organs or visceral fat, is a better predictor of pre diabetes than adipose fat or fat under the skin which is the fat we can see when looking at a person (or ourselves in the mirror).  

 Visceral fat is basically excess intra-abdominal tissue accumulation.  It is fat that is actually covering the organs including the liver, pancreas and kidneys.  A sign of excess visceral fat storage is if you have a belly that sicks out and a large waist.  This is most noticeable in overweight and obese people but anyone can have visceral fat and not know it.  Visceral fat cells do more than just make your pants tight, they also cause changes in the way your body functions by producing hormones and inflammatory factors leading to heart disease, inflammation, cancer, dementia, strokes, depression and diabetes.  
Carrying a high amount of visceral fat is known to be associated with insulin resistance, which can lead to glucose intolerance and type 2 diabetes. Researchers have found that visceral secretes a protein called retinol-binding protein 4 (RBP4) which has been shown to increase resistance to insulin.  Storing excess fat around the organs increases production of pro-inflammatory chemicals called cytokines, which leads to inflammation.  It also interferes with hormones that help regulate appetite, weight, mood and brain function.

A relatively good indicator of visceral fat is to take a measurement of your waist. Harvard University notes around 10% of our total fat is likely to be stored as visceral fat, therefore if you are carrying higher amounts of body fat than is recommended, it is therefore more likely that you are also storing more visceral fat than is healthy.  The most certain way to tell if you are carrying excess visceral fat is with an MRI.  MRI's are expensive and do not tell you if you have diabetes so this should be discussed with your physician.  

In order to reverse pre diabetes, you must focus on decreasing body fat and improving your insulin sensitivity.  In part II, I will discuss ways to do this using four categories for lifestyle change;  diet, exercise, vitamins and supplements and stress reduction.  Keep an eye out for this life changing blog post coming soon!  






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How to Prevent 'Morning Breath' and Finally Cure Noticeably Bad Breath ---Interview with Dr. Justin Rashbaum, D.M.D

3/7/2015

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PictureDr. Justin Rashbaum Website: http://www.drrashbaum.com/
Dr. Justin Rashbaum is a cosmetic dentist in NYC and a spokesperson on QVC for Supersmile Whitening System.   His breath is also in good standing!

















Since publishing Dr. Suz Heals Blog less than four months ago, I have had several followers contact me in regards to oral health and hygiene.  It has always been my belief and opinion that oral health is the window to your overall health.  One topic that seems to come up frequently is how to overcome bad breath.  Many people are embarrassed to discuss this with their family or friends.  Dr. Justin Rashbaum is  an expert in cosmetic and general dentistry in New York City.  He has provided Dr. Suz Heals and our readers with expert advice on the causes of bad breath and tips on how to treat and cure it. 

Dr. Suz Heals:  What are the most common causes of bad breath?

Dr. Justin Rashbaum:  The most common cause of bad breath is bacteria.  When bacterial flora in the mouth favors the predominance of bad bacteria over good bacteria, those bacteria give off toxins that result in bad breath, also known as halitosis.  



Dr. Suz Heals:  What are some great preventive measures to combat this unsavory bacteria?

Dr. Justin Rashbaum:  The oral cavity is equipped with a vast array of proteins to target this bacteria. How does it do that? Saliva!  Saliva is not just a lubricant to help in eating but also protects the oral cavity from harmful bacteria in the form of combative proteins. Ever wonder why we have the term "morning breath"? Your saliva flow is markedly lower at night while you sleep, which allows bacteria to grow.  
However, saliva also acts as a pellicle to coat the teeth, for which other materials and organisms can adhere.  If you ever wonder why the elderly have "old people breath", a part of it is that as we age, salivary flow diminishes (xerostomia).  Those bad bacteria proliferate over the good bacteria.  Common ways to combat these are salivary activating products like Biotene rinses and chewing gums.  More apparent forms of bad breath such as tooth decay and tartar (bridged bacteria that adheres to the teeth, also known as calculus) can be treated by visiting the dentist routinely.  


Dr. Suz Heals: Besides the elderly, who may be predisposed to having bad breath? 

Dr. Justin Rashbaum:  People that have GERD are prone to burping, whose emitted gas, is not necessarily an aphrodisiac!   Also, people on low carbohydrate diets, although great for losing weight, cause ketosis, which causes the body to burn fat deposits and can produce bad breath.  Also, people with highly exaggerated tonsillar formation can have folds that harbor bacterial deposits.

Obviously, certain foods such as garlic and onions, and certain medications, can cause unsavory breath but follow your oral hygiene regimen and this will be of limited concern.  

Dr. Suz Heals:  What is the most common place for tartar to form?

Dr. Justin Rashbaum:  The most common place for tartar to form is in the backs of the lower front teeth due to a salivary duct that opens up in that area.  Anywhere a salivary duct opens up is most prone to calcifying and the ability for bacteria to bridge together.  If you see tartar forming there, it is time to go to the dentist, as a toothbrush alone will not remove bridged tartar.  



Dr. Suz Heals:  In your opinion, what is the BEST way to prevent bad breath?

Dr. Justin Rashbaum:  The best way to prevent bad breath is to see the dentist regularly.  And I don’t mean every six months.  It kills me that people have come to assume you should see the dentist every six months.  You know why people have grown accustomed to believing that? Because that's the frequency insurance companies will pay for.  For people in stable periodontal condition, I believe visiting the dentist three times a year is sufficient.  However, for patients who have gingival recession, deeper gum pockets, a significant number of dental restorations, a history of poor plaque and tartar control, gingival bleeding and other dental issues, that frequency might need to be increased to four or five times a year.  This is until the patient is in a more stable situation where three times a year may suffice.



Dr. Suz Heals:  When is it time for someone to seek care for their noticeable bad breath?

Dr. Justin Rashbaum: Unfortunately, it is difficult  to know when to seek care for chronic and noticeable bad breath.   Most people will refrain from telling you for fear of your feelings being hurt.  The best way to solve this problem is to visit the dentist routinely with no lapses in care. Period.  The professional staff has nothing to lose by telling you the truth. You should know they are only there for your benefit.  Hygienists, I can tell you, have a strong sense of pride when they see one of their patients improve their oral appearance from a hygienic standpoint.  

Dr. Suz Heals:  Can you please give our audience some healthy and inexpensive at home tips to keep help cure their bad breath?

Dr. Justin Rashbaum:  I recommend chewing oral probiotics daily, such as EvoraPlus to favor the positive oral bacterial flora over the noxious kinds.  I recommend using alcohol free mouth rinses because the presence of alcohol in rinses can actually contribute to an increase in harmful bacteria. Such is the case for Listerine which is now coming out with its alcohol free Listerine Zero!  Even moderating your consumption of alcohol is a good start!  B
ad breath can be a combination of many factors and it takes a comprehensive approach to treat bad breath accordingly.



The Super Smile System is a highly proven whitening toothpaste system developed by the Father of Aesthetic Dentistry, Dr. Irwin Smigel.  This uses a proprietary ingredient called Calprox to non abrasively remove stains from teeth and prosthetic surfaces. 



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    Dr. Suzanne Fuchs has a passion for nutrition, health and fitness.  She aims to connect the dots between our overall health and the substances that go into our bodies on a daily basis by using only evidence based medicine, science and expert advice.    
    Dr. Suzanne Fuchs currently practices concierge foot and ankle medicine and surgery in Palm Beach and Palm Beach Gardens, Florida at LuxePodiatry™ 
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    If you have health concerns you should contact your physician for professional advice.

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    Dr. Suz Heals.com  is intended to be used for educational and information purposes only. Dr. Suz Heals.com and its Editors do not advocate nutritional supplementation over proper medical advice or treatment and this sentiment will never be expressed through pages hosted under Dr. Suz Heals .com.  If using any pharmaceuticals or drugs given to you by a doctor or received with a prescription, you must consult with the doctor in question or an equally qualified Health Care Professional prior to using any nutritional supplementation. If undergoing medical therapies, then consult with your respective Therapist or Health Care Professional about possible interactions between your Treatment, any Pharmaceuticals or Drugs being given, and possible nutritional supplements or practices hosted on Dr. Suz Heals.com.  Dr. Suz Heals.com does not assume liability for any actions undertaken after visiting these pages, and does not assume liability if one misuses supplements. Dr. Suz Heals.com  and its Editors do not ensure that unforeseen side effects will not occur even at the proper dosages, and thereby does not assume liability for any side effects from supplements or practices hosted under the domain of Dr. Suz Heals.com.



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