Robert Filice, M.D. - Dr. Bob's Newsletter

When Is Heartburn a Cause for Alarm?
Heartburn (or dyspepsia in medical jargon) is an extremely common symptom. More than half of patients consulting a general practitioner will have this complaint if asked. The usual habit of most physicians is to start such patients on acid suppressive drug therapy. Nearly 5% of the general population is on this type of drug. What are the chances that this type of empiric drug therapy may mask a more serious underlying condition? Well, according to an endoscopic study of 1852 patients, it depends on certain patient characteristics. This is when a patient and his physician should be concerned, and may want to avoid empiric drug therapy in favor of quick endoscopic examination of the upper GI tract:

age over 55
weight loss
difficulty swallowing

When these three factors are present, the patient is more likely to have an underlying cancer. The absence of these signs suggests that a trial of medication without endoscopy is safe and reasonable. I would also add that not all physicians are yet testing for the bacterium H. Pylori which can cause heartburn and which can be eradicated with natural and antibiotic treatment protocols. Also, be aware that low stomach acid, other digestive inefficiencies, and gall bladder problems can also cause heartburn, and that in these patients the use of acid suppression drugs will be counterproductive. Sometimes repeated courses of oral antibiotics can trigger gastrointestinal distress and yeast overgrowths. See a natural medicine physician to get closer to the root cause of your problem, rather than just covering it up with a drug.

I have recently received several parent requests to consider Lupron therapy for their autistic kids. This is a drug which turns off the production of testosterone and estrogen by inhibiting the pituitary gland, and is most commonly used to induce a false state of menopause in women with endometriosis. I got a chance to view the researchers recommending this therapy, the Geier brothers, one an MD the other a PhD, on an internet video today. Essentially they said that the autism epidemic is on its way out now that vaccines have had the mercury containing preservative thimerisol removed. They are treating current cases with DMSA and lupron. They find that these kids are mostly male, and almost all have some evidence of precocious puberty (like body hair, early masturbation, etc). This is due to high testosterone levels, despite already low pituitary hormones like FSH and LH, and no evidence of androgen secreting tumors. They postulate a different mechanism leading to the high testosterone…inability to clear it, and increased production from DHEA. The testosterone isn’t cleared in autistic kids (5 to 1 more frequent in males) because mercury will bind testosterone molecules together in sheets. This keeps the testosterone effect high while rendering the Hg unavailable to the chelating drugs. The other risk factor is inadequate glutathione pathways that excrete mercury and make the conversion of DHEA into DHEA-s possible. Unless glutathione is around in adequate amounts, DHEA will go to testosterone rather than toward estrogen. Estrogen is protective while testosterone multiplies the neuron killing effect of thimerisol by a factor of many times more.

Bottom line is that I have never treated a case of precocious puberty or autism with Lupron, and am not comfortable doing so. The researchers did not share their clinical experience with side effects. However, we should be aware in all our patients when signs of masculinization are present in association with neurodegenerative problems and heavy metal toxicity. This same mechanism may apply in MS, Lymes, and Alzheimer’s etc. We need to ask about this precocious hormonal development specifically in the autistic kids because the parents often don’t see it or comment on it. These are tough cases, but they are very interesting. The lab tests to be done would be heavy metals, testosterone free and total, and DHEA-s which will test low. At this time, I am not prescribing Lupron, but I will be watching as this theory gets tested in real life. The researchers provocatively believe that all of the previously successful therapies for autistic children derive their effectiveness by virtue of the fact that they reduce testosterone by different mechanisms, but that none of them are as specific and effective for this purpose as Lupron. 

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