Integrative Medicine
REYNALD ALTEMA, MD
37th AMHE ANNUAL CONGRESS
MONTEBELLO, QUEBEC
Integrative Medicine

"Mind/body medicine is of course nothing new--What
is new is the legitimization of research in this field to
the point of government funding and the incorporation
of mind/body programs into the offerings of major
medical institutions, many of which are noted for their
conservatism and scientific bent." William Collinge,
MPH, PhD, Researcher.
massgeneral.org/bhi
BENSON-HENRI INSTITUTE AT HARVARD.
DISCIPLINES

Homeopathy

Naturopathy

Ayurveda

Traditional Chinese Medicine

Massage Therapy

Herbal Medicine

Chiropractic

Acupuncture
rosenthal.hs.columbia.edu
Participating Institutions

Mass Gen. massgeneral.org/bhi.

University of Arizona

www.integrativemedicine.arizona.edu

University of Calgary

Canadian Institute of Natural & Integrative Medicine

www.ucalgary.ca

University of California, Los Angeles

Collaborative Centers for Integrative Medicine

www.uclamindbody.org

University of California, San Francisco

Osher Center for Integrative Medicine

www.ucsf.edu/ocim

Columbia University

Richard and Hinda Rosenthal Center for Complementary & Alternative Medicine

www.rosenthal.hs.columbia.edu
Glucose Toxicity


When there is too much glucose, 4 different pathways to
circumvent glycolysis:

1-Hexosamine

2-Advanced glycation end products (AGE)

3-Diacylglycerol (DAG)-protein kinase C

Polyol
Thiamine activates the Pentose pathway via
Transketolase, removing Glyceraldehyde-3 phosphate
and Fructose -6 phosphate. It prevents steps 1-3.
Advanced Glycation End
Products (AGE)
Formation of AGEs yields to free radicals such as Reactive Oxygen
Species (ROS).
Takes place via Receptor for AGEs(RAGE).
AGES affect endothelial cells and monocytes.
AGES cause irreversibe crosslinks with collagen, proteins and lipids.
Presence of AGEs accelerates aging and causes cellular dysfunction..
Presence of AGEs increases microvascular as well as microvascular
complications in Diabetes such as Retinopathy, Nephropathy...
1-Tan et al.
2-Balakumar et al. The multifaceted therapeutic potential of benfotiamine. Pharmacological Research. June 2010.
Benfotiamine

Thiamine analogue

Better absorbed than Thiamine.

Gets converted to Thiamine

Improves diabetic neuropathy

Was developed in japan for treatment of
alcoholic neuropathy.
Ref: 1-Stracke H,. A benfotiamine-vitamin B combination in treatment of diabetic
polyneuropathy. Exp Clin Endocrinol Diabetes 1996; 104(4): 311-6.
2-Tan et al, AGE, RAGE and ROS in Diabetic Nephropathy. Seminars in Nephrology.
March 2007.

.
OMEGA-3 FATTY ACIDS
EPA-Eicosapentaeinoic acid
DHA-Docosahexaeinoic acid
Dose
for cardiovascular protection: 1.5 gm/day.
for antiinflammatory action: 4-6 gms/day.
Concentrated preparations:
Krill oil-not to be used in case of shellfish allergy.
Vectomega-very concentrated.
Omega-3 Fatty Acids
1-HTN
GRADE A
2-HYPERTRIGLYCERIDEMIA
GRADE A
3-SECONDARY PREVENTION OF CAD
GRADE A
4-PRIMARY CAD PREVENTION
GRADE B
5-RHEUMATOID ARTHRITIS
GRADE B
6-ANGINA PECTORIS
GRADE C
A-nlm.nih.gov/medlineplus/druginfo/natural/patient
B-Lee et al Mayo Clin Proc. March 2008 83(3):324-332
BROMELAIN
Extract of pineapple.
Proteolytic enzymes: papain, chymotrypsin, bromelain,
phosphatases, glucosidases,
etc.
Properties: antiinflammatory, digestive enzymes,
antiedematous.
Uses: alongside antibiotic, other antiinflammatory meds.
H. R. Maurer. Bromelain: biochemistry, pharmacology and medical use. Cell. Mol. Life Sci. 58 (2001) 1234–1245.
CoQ10 & Cholesterol Synthesis
Oxydative Phosphorylation
Uses of Ubiquinone
1-Patients on statins.
2-Patients who have cardiovascular
Comorbidities. It improves cellular function.
3-As antioxidant.