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Practitioner Question of the Month – July 2018

Dr. Michael Ruscio’s Monthly – Future of Functional Medicine Review Clinical Newsletter

Practical Solutions for Practitioners

In Today’s Issue

Practitioner Question of the Month

Practice Tip

Practitioner Question of the Month - July 2018 - help circle

Practitioner Question of the Month

Joe asks:

Do you plan to release further commentary on heavy metals and morbidity/mortality?

After your interview with Dr. Walsh I found this retrospective cohort review of 20,000 New Zealanders followed for 20 years showing no consistent link between mercury amalgams and disease, with the exception of Multiple Sclerosis which had an HR of 1.24.

I suspect that there is a small subset of patients vulnerable to heavy metals who would benefit from detox, those with advancing neurologic diseases or autoimmunity unresponsive to other treatments.

Have you found any reliable clinical signs or conditions in which you WOULD refer a patient for heavy metal detox?

This is an important question, as treatment here can be expensive.  In short, you are dead on Joe. When looking at both sides of the data on this issue it appears clear that typical environmental exposure to mercury does not pose a health risk.  Typical exposure would be through air, water, food and mercury fillings. Detriment has been documented for those with occupationally high and hazardous levels of exposure. Detriment has also been shown for a small subset of the population when exposed to normal environmental exposure.  Some data suggests these people may be allergic to mercury.

I do plan to release my research and thoughts on this, not sure exactly when, perhaps early 2019.

How do we reconcile this against patient or practitioner claims of success with metal/mercury detox?  A few thoughts

  1. The patient or practitioner may be influenced by a placebo effect.  This has been documented in a detox versus sham trial
  2. The person being treated might be part of the smaller subset of responders
  3. Other healthy changes might be occurring at the same time such as exercise, diet, sauna, etc…

It’s important not to blindly follow a clinicians ‘I have seen it clinically’.  We should be open and listen to clinicians’ testimony, however, remember that clinicians are susceptible to placebo and bias just like patients are.

Practitioner Question of the Month - July 2018 - practice tip

Practice Tip

Spend time on the floor

This isn’t a practice tip per se, but it can improve your health and mobility, which can help you feel better and hopefully practice better.  I have been performing my emailing, which I do from home, on the floor. I sit on the floor with my laptop for 1-2 hours and email. I sit in different positions, many of which are stretches, and this has improved my hip mobility in only a few days.  There is a lot you can do here, especially if you get creative. Here are couple examples.

Hip flexor – I put my lower leg against the couch to make this passive.

Practitioner Question of the Month - July 2018 - AdobeStock162499285WEB

And one for groin and glutes

Practitioner Question of the Month - July 2018 - Tip 01

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