Linda came to the Goldberg Clinic in 2015 having been diagnosed with Rheumatoid Arthritis, High Blood Pressure, Depression and Irritable Bowel Syndrome. She was taking 3 prescription drugs at the time of her initial visit. At the Goldberg Clinic, a comprehensive work-up was performed and key underlying factors were identified. Based on the data collected, an individualized program was developed for the patient to follow. After 4 months of care, the patient is drug free and has reports an 85% overall improvement in her condition. As a result of getting healthy, the patient has lost 20 pounds.
Why Inflammation is Not the Enemy
Paul A. Goldberg, MPH,DC,DACBN,DCBCN
The Goldberg Clinic for Chronic Disease Reversal
Paul A. Goldberg, MPH,DC,DACBN,DCBCN
Over the four decades I’ve been in health care, one of the most challenging obstacles I’ve faced with patients has been medically prescribed corticosteroids. At times when interviewing a new patient I feel that I can simply assume they have been on steroids as the frequency of usage among patients we see is so great. Other common drugs used include extensive use of antibiotics, antacids, synthroid and anti-depressants… all making a patient’s journey back to health more difficult and complex.
The use of corticosteroids, including prednisone, are almost universally prescribed by medical physicians of every variety…general practitioners, family practitioners, internists, dermatologists, rheumatologists, gastroenterologists, urologists, etc. Corticosteroids are prescribed for numerous conditions that involve inflammation and/or allergic reactions including asthma, eczema, dermatitis, ulcerative colitis, crohns disease, sinusitis, iriditis, ear inflammation, bronchitis, nephritis, arthritis, bursitis, neuritis, carditis, thyroiditis and virtually every other medical condition including some cancers. It is the go to drug for medical physicians, along with antibiotics, as it will suppress virtually any type of symptom…but at what cost?
The body protects itself against infection, toxicity, injury and other insults through inflammation. Despite what many in standard and alternative medicine would have us believe, inflammation is neither the enemy nor the problem. Inflammation is a constructive action purposely created by the body. It serves as a marshaling of the body’s resources and a key component in allowing us to recover from a wide variety of injuries and insults. To believe otherwise is to imagine that one of the most basic defense mechanisms of the body is a “mistake”… that the body is hapless in its actions and that we somehow know better. Such belief has allowed for the massive employment of not only steroids but also a plethora of other anti-inflammatory drugs obtained both over the counter and via prescription on a daily basis.
Inflammation is a manifestation of the body attempting to normalize function, to repel invading organisms, to eliminate toxicity and to gather the body’s reparative forces to the site of injury. It is the result of adverse circumstances, not the cause of them. Whatever might be causing inflammation needs to be addressed and eliminated. When this is successfully accomplished the inflammation will go away as its services will no longer be needed. Put simply…address and remove the causes of the inflammation and the body no longer has the need to produce it.
Our patients know that we are interested in renewing their health and vitality…not the mere suppression of symptoms that leads to further disease complications. The risks and complications of employing steroids are numerous and serious in nature and have adverse effects that can lead to a downward spiral in a person’s health and seriously lessen their opportunity for recovery. We continue to see numerous patients who have gotten on the corticosteroid train, often taking multiple steroid drugs from different physicians. A dependency on them is created that makes health restoration challenging.
Steroid usage makes it difficult to determine what is occurring with a patient physiologically as steroids deviously mask underlying conditions. They make it more difficult to make an accurate determination of the causes of a patient’s problems both in terms of performing an accurate physical examination and in conducting laboratory testing. Steroids mask underlying causes while undermining a person’s normal physiological state.
Common Side Effects of Prednisone and Other Steroids
- Hormonal- By increasing the production of glucose from amino-acid breakdown and opposing the action of insulin, corticosteroids can cause hyperglycemia, insulin resistance and diabetes mellitus. We have seen patients who have developed diabetes in as little as a few weeks due to a course of prednisone administration.
- Gastro-intestinal: The use of prednisone and other corticosteroids has led to the formation of gastric ulcers. When there are infections present in the GI tract steroids will exacerbate them. Steroids also lead to thinning of the gut lining which ironically can make the individual more susceptible to the very allergic reactions that they were given steroids for.
- Metabolic: Corticosteroids cause a loss of muscle tissue and increase body fat in the face, resulting in "moon face," where the face becomes enlarged often making the patient resemble a chipmunk. Steroids also may lead to the development of tissue on the back referred to as a "buffalo hump". The body loses muscle tissue due to the diversion of amino acids to glucose. Steroids are catabolic in nature.
- Lowered Resistance to Infection: The use of steroids leads to lowered body resistance to infections of all kinds including bacterial, fungal and yeast infections.
- Skeletal Issues: Osteoporosis is a common side effect of long-term corticosteroid use. Use of inhaled corticosteroids among children with asthma may result in decreased height. We have seen numerous patients over the years whose long-term use of steroids has resulted in vertebral body collapse. One 55-year-old woman who came to our clinic, who had been on steroids for arthritis for over fifteen years had experienced vertebral compression fractures to five dorsal and three lumbar vertebrae leading to a height loss of six inches.
- Neuropsychiatric: A wide variety of psychological/emotional aberrations have been related to steroid usage including steroid psychosis, anxiety and depression. Conversely steroid usage may cause a feeling of artificial well being referred to as "steroid euphoria.".
- Eyes: Chronic use predisposes to cataracts and retinopathy.
- Dependency: Extended use of steroids leads to increasing dependency upon them. The longer steroids are used and the higher the amounts employed, the weaker and more atrophied the adrenal glands become due to the degenerating effects of steroid replacement. We have repeatedly seen patients with autoimmune diseases e.g. ulcerative colitis, crohn's disease, and rheumatoid disorders who’ve become dependent on steroids leading to an ongoing downward spiral in their health status.
History of Corticosteroids
In 1930 an extract of animal adrenocortical tissue was found to serve as a replacement for human adrenal glands that were failing. Steroids (Cortisone) were first clinically employed in the mid 1940’s. Their use was initially heralded as being curative for Rheumatoid Disorders and there was much optimism initially expressed in their application. Shortly after the other shoe dropped as serious side effects became visible. Patients had to take larger and larger doses to obtain the same amount of symptom suppression. Side effects (noted previously) such as cataracts, adrenal atrophy, mental disorders, osteoporosis, infections, etc., became widely evident. Nonetheless due to their dramatic initial suppression of symptoms steroids continue to be a cornerstone of medical treatment.
Challenges for Patients On Steroids
The longer a patient has been on steroids and the more they have taken, the greater the health recovery challenge is. Reversing the downward health spiral that long-term steroid usage causes is neither simple nor quick. Patients must understand that perseverance and a long-term effort will be required if the downward trend is to be reversed and health is to be regained.
If a patient is on steroids when we first see them, as is often the case, they will be advised to come off them as quickly as the prescribing medical physician deems prudent. Packages of steroids are often given in what is termed a “Medrol Pack” which starts the patient at a high dosage and then lays out a prescribed plan of reduction, built into the prescription, with the patient generally reducing their use by 5 to 10 mgs per week from the initial dosage of (typically) 40 to 60 mgs of prednisone per day.
Going cold turkey from even short-term steroid usage can be hazardous. The challenge is that as steroid usage is reduced, whatever symptoms they were prescribed for will likely return and often worse than they were previously. The steroids did not “fix” anything long term and in most cases have markedly weakened the bodies immune and endocrine systems. Skin disorders often re-erupt, joint pains often return with vigor (sometimes excruciatingly so), colitis symptoms may return with a wicked vengeance including increased cramping, bleeding and frequency of diarrhea. Whatever the steroids were prescribed for comes back even worse in a large number of cases. The phrase enjoy now and pay like hell later is appropriate in regards to the employment of medical steroids. In these scenarios the medical physician will often times simply prescribe another round of steroids. This further complicates the chances for a long-term improvement in the patient’s health. To not get off the steroids will diminish the opportunity for the person to ever live a healthy life.
The frustration and anxiety many patients experience seeing the return of symptoms is common. The discomfort involved in the withdrawal of steroids can be severe. Many feel hopeless not knowing where to turn. We tell them that the road back is going to be difficult but to continue on the corticosteroid train is a one way ticket to defeat. The longer one stays on steroids, the more times prescriptions are employed, the less the opportunity becomes to return to dependable health.
The Will to Get Well…The Right Actions to Make It Happen
The Goldberg Clinic develops protocols that we employ in helping patients get through steroid withdrawal, each of which must be tailored to the individual and are based on their own case. Physiotherapy, nutrient support, extensive rest and sleep, sunlight, and encouragement are all important. Corticosteroids are anti-nutrient in their action causing both increased needs and increased losses of numerous essential nutrients including amino acids, vitamin C, calcium and magnesium. Over time the GI tract is also damaged further, limiting the flow of nutrients needed for maintenance and repair of tissues.
We must remove the causes of why the body is engaging in inflammation and address those causes specifically. Sadly, when physicians graduate, they are ill prepared for working with patients with severe inflammatory problems, leading them to seek ways to suppress inflammation rather than uncovering and addressing the causes of it. In this regard corticosteroids are an easy road for the physician to take.
Understanding nutritional biochemistry and the causes behind inflammatory responses has long been a priority at the Goldberg Clinic. We have developed our skills through a combination of academics, personal experience with illness, internships in Natural Hygiene, practice experience, teaching clinical nutrition and by developing an understanding of clinical topics related to inflammation e.g. dynamics of the Arachadonic Fatty Acid Cycle, gut dysfunction and dysbioisis, glucose dysregulation, protein putrefaction, bowel overgrowth, carbohydrate fermentation, stress related illness, etc. All of these can contribute to poor health and inflammatory responses. Understanding these and other topics both academically and practically helps us to help patients.
Monitoring inflammatory levels via the sedimentation rate and the HsCRP helps to keep us focused objectively towards the patient's recovery as we follow these parameters to track our progress (see below). Medical Physicians are commonly befuddled on how our patient's inflammatory markers almost invariably improve despite the fact that the patients have gotten off their steroids and other anti-inflammatory drugs. Functional tests such as fatty acid, digestive and immune system analyses are often productive in pinpointing the steps we need to take to help bring the patient to recovery but of particular value is understanding how the patient got sick in the first place and a thorough case history and hygienic review of the patient's habits reign supreme in this regard.
Most important, however, is for the patient to understand the process. To understand the need to be perseverant and not hastily jump back on steroids to ease their discomforts even when those discomforts are troubling. When patients can see that there is a light at the end of the tunnel if they work together with us in a persistent and dedicated manner…. if they decide to get off the drug train and employ the will to get well along with definitive actions…then the beacon of light leading to recovery becomes visible. Taking the right steps needed for each case, even when the journey might be arduous, we can arrive at our health destination and our own personal victory over disease.
Examples of Before/After Inflammatory marker (HsCRP: Normal < 3.0) for patients of the Goldberg Clinic previously treated with steroids:
Paul A. Goldberg
The Goldberg Clinic For Chronic Disease Reversal
Paul A. Goldberg, M.P.H., D.C., DACBN
“It takes all sorts to make a world”
Your patient feels ill and desperate. He has been diagnosed with a disease with a scary name, a chronic illness requiring a lifetime of drugs and medical supervision just to control the symptoms. A pit forms in his gut and life takes on a gloom following him day and night.
Step back for a moment and consider the patient’s situation. He is infinitely different from every other person on the planet including anyone ever given the diagnosis. Why should he be labeled in such a way and thrown into one big diagnostic soup? There is a more rational alternative, looking upon him as an individual with a unique constitution and not accepting the dismal medical outlook given to millions of chronically ill people labeled with rheumatoid arthritis, lupus, colitis, crohns disease, multiple sclerosis or a slew of other names. As a practitioner who has worked with chronically ill patients for over 35 years addressing each patient as an entity of their own I know that addressing the unique characteristics of each person is essential to the recovery of those with chronic disease problems of all kinds.
With each new patient that walks into our clinic I ask myself, “what makes this person different?” What factors led to the development of their disease? What actions need to be taken specific to their individual nature to permit recovery?” Unraveling these questions puts each patient with a chronic disease, regardless of their diagnosis, on the best path towards health renewal.Read More
The Goldberg Clinic
Paul Goldberg, MPH,DC,DACBN
It has been over forty years since President Nixon declared a “War On Cancer” and signed the National Cancer Act, which allocated $1.5 billion over three years for cancer research and control. President Richard M. Nixon set a goal that Cancer would be cured by 1976. Did not happen. Others said it would be by 2000, then by 2015 and President Obama has vowed to find ''a cure'' for cancer as part of the economic stimulus package increasing federal money for “cancer research” by a third.
Since the war on cancer began, the National Cancer Institute has spent $105 billion with other agencies, universities and drug companies spending billions more. Yet, cancer rates have barely budged. Some cancers have increased. We remain a nation in which more than one out of every three people will get cancer in their lifetime. The statistics are sometimes bent to make the problem look better or worse but we know that the problem remains and is growing. Is cancer just an impossibly hard problem?
Cancer is not a single entity in my opinion. Research lurches from fad to fad -- cancer viruses, immunology, genomics, etc., and the grim facts about cancer are often lost among the messages from the media and medical centers. Then there are the volunteer groups with their charity walks and bike rides for “the cure” and by businesses who are in the “pink”, hinting that they are pressing for the cure with your financial support…if only we walk far enough, ride our bikes far enough and you give enough of your money!
The message generally given is that cancer is preventable if you are screened regularly with things like mammograms that emit radiation that is known to cause cancer! The message continues that if your cancer is caught early your chances of being cured are high, and that if your cancer is potentially deadly new treatments may save you. As many with cancer have learned the real picture is not so glowing.
What epidemiologists have demonstrated is that the major reason cancer has become so prevalent is due to our environment…the air we breathe, the water we drink, the food we eat, the chemicals in our environment including our homes, the radiation we are exposed to, the materials we spray our foods with, what we spew into our environment from a multitude of sources all interplaying with our genetics. We cannot determine who are parents will be but we can play a role in our environmental exposures.
There is compelling evidence that avoidable environmental factors play the major role in the causation of most cases of the cancer, sometimes from one or two sources though usually from a multitude of sources. This is seen by comparing cancer incidence in different countries or sometimes simply in different communities. For a cancer that is common in one country, there is another country where the incidence is several times lower and when the people of one country go to another country they tend to develop the same incidence of the cancer in that new location. Migrant populations tend to adopt the pattern of cancer incidence typical of the host country and therefore the differences in cancer rates appear to be due to environmental, not genetic, factors.
There are also subgroups within nations whose way of life reduces the total cancer death rate. One out of three people in the US acquire cancer but the rate of cancer among strict Mormons in Utah, for example, is only about half that among Americans in general. Cancer incidence is also low in certain relatively affluent populations in Africa. All of this again points to environmental factors i.e. the air we breathe, the water we drink, the food we eat, the radiation we are exposed to and other factors pertaining to how and where we live and what we are exposed to. These factors are best demonstrated by observational studies as opposed to doing laboratory research in the artificial environments of medical laboratories using petri plate cells and hapless laboratory animals that are brutally submitted to horrendous cruelties by the millions each year all needlessly.
If indeed it is environmental factors that largely determine our risks of cancer than our emphasis should be, both in terms of prevention and the resolution of cancer, on developing the right conditions under which to encourage the growth of healthy normal cells while discouraging the conditions under which cancer cells proliferate.
The medical approach of seeking out cancer cells and destroying them, however, does the opposite. Using “therapies” that are themselves highly toxic, e.g. chemotherapy and radiation therapy, therapies well known to be capable of inducing cancer themselves is illogical and counterintuitive, yet remains the mainstay of modern cancer therapy and research and has been for many years.
We do not pretend to have all the answers to cancer. We do however, promote living in specific ways that support healthy cellular growth i.e. provide the right conditions of health. If cancer occurs we think it is logical and wise to also promote an internal and external environment that is conducive to healthy cellular growth. This does not include bombarding our tissues with toxic chemicals and radiation despite the authority and glamour of modern medical institutions and their massive buildings, high tech machines and thousands of workers in white coats representing, supposedly, the epitome of scientific wisdom.
Our patient, Mr. Vincent Guida, interviewed in the video below was medically diagnosed with Hodgkin’s lymphoma and set upon a course of conventional chemotherapy. The side effects were so horrendous that he abandoned the chemotherapy and chose to undertake steps, under our direction, that would rebuild his health and address the chemistry of his body naturally. Having taken the initial steps, he then returned to his medical physicians to be assessed to see what his status was. These results are presented below.
The Goldberg Clinic works with patients who have cancer but we do not treat Cancer. We have no panaceas to prevent cancer or to “cure” it. We do not claim to be invincible to cancer ourselves. We do believe, however, that our best chances for good health and for recovery from any disease are to implement the right conditions, tailored to the individual, that build and support health from a biological, mental and spiritual standpoint. This is our approach to patients coming to us with cancer. This is our approach to all patients.
Paul A. Goldberg
The Goldberg Clinic
Success Story: Hodgkin's Lymphoma and Diabetes
Patient presented to the Goldberg Clinic with Medical Diagnoses of Hodgkin's Lymphoma and Diabetes. The patient was undergoing Chemotherapy at the time of his initial visit. After just five treatments, he decided to discontinue Chemotherapy due to the onset of debilitating side effects including severe nausea, fatigue, weakness, and constipation. At the Goldberg Clinic, a comprehensive case history, physical examination and functional laboratory work was performed and key underlying factors were identified. Based on the data collected, recommendations were made and an individualized program was developed for the patient to follow to support his overall health and function. In just five months, the patient has shown significant improvement including increased energy and vitality, twenty pound weight loss, the normalization of his blood sugar and, most importantly, "dramatic improvement" in the appearance of cancerous lesions according to recent imaging studies (see reports below).
Imaging study: Piedmont Hospital, February 2nd 2015
Hemoglobin A1C Before/After
HEMOGLOBIN A1C (BLOOD SUGAR READING) HAS NORMALIZED IN JUST 5 MONTHS. THE PATIENT (PREVIOUSLY DIABETIC) IS NOW NO LONGER IN THE DIABETIC RANGE. THE PATIENT IS DRUG FREE.
Dear Dr. Goldberg,
I want to update you on our daughter. When she came to you in 2006-7, she was suffering from Psoriatic Arthritis. She had quit dating, thinking she would never have a life. Today, I am happy to tell you, she is wonderful. She finished her PhD program at University of Texas (pharmaco-epidemiology) and is married (see picture attached). I have wanted to write you for years. She continues to follow your advice.
You gave her back her life and I will be forever grateful.
Thank you and may God continue to use you.
PS. Her first appointment with you was on June 12, She called in early September, crying, saying, " Mom, I don't hurt! I don't hurt!" I still cry when I think about it.