Go with the flow

by Dr. Jonathan Wright

Q: I’ve been having trouble urinating. My urologist says it’s most likely caused by prostate enlargement, but since I don’t have any other symptoms yet, he prescribed a drug just to help me with urination. I’d prefer a natural approach, though, if there is one.


Dr. Wright: The medication your urologist likely prescribed is called isosorbide dinatrate, which is a synthetic formulation that works by improving the production of nitric oxide, a substance that relaxes vascular and other smooth muscles. But there’s no need to use a space alien molecule when there’s a natural substance that does the exact same thing. It’s an amino acid called L-arginine.


I’ve written about L-arginine many times over the past few years. Admittedly, one of its more “attention- getting” benefits is that it improves erectile dysfunction (ED). But it’s also useful for all sorts of vascular diseases since it dilates blood vessels and improves blood flow.


There are two types of L-arginine — “time release” and “regular.” Time-release is preferable for urinary problems because, although it has a lower peak, it lasts longer. For men having difficulty urinating, I generally recommend taking 3 g of L-arginine daily in addition to other nutrients and botanicals that help improve prostate health (such as zinc, essential fatty acids, and lycopene).


You can find regular L-arginine at most natural food stores. And you can get it at: emersonecologics.com



Eating late makes esophageal reflux worse

Thirty patients with gastroesophageal reflux (GERD) symptoms were randomly assigned to consume a standard meal either six hours or two hours prior to going to bed. The next night they consumed the same meal at the alternate time. The meal contained 900 kcal and consisted of a McDonald’s Big Mac, French fries, and 600 ml of a carbonated soft drink. Acid exposure was measured for 48 hours using a Bravo wireless pH system. The mean amount of supine acid reflux was significantly greater after the late evening meal than after the earlier evening meal (p = 0.002). There was no significant difference in total symptom score between the two days.


Comment by Dr. Alan Gaby: The results of this study indicate that, if you have GERD and plan to eat a large junk-food meal, you probably should eat it far away from bedtime. It is noteworthy that the researchers considered a large hamburger, fried potatoes, and a glass of sugar-water infused with carbon dioxide a “standard meal.” Maybe if patients with GERD raised their standards, they wouldn’t have GERD anymore. Nevertheless, it seems logical that reflux would be less likely to occur if dinner were given ample time to enter the small intestine prior to lying down for the night.


Piesman M, et al. Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? Am J Gastroenterol. 2007;102:2128-2134.


Cut your risk of kidney stones down to (almost) nothing—no prescription required by Dr. Jonathan Wright


I’m no longer amazed by the advice given today by “mainstream” medical doctors on preventing the most common type of kidney stones (the calcium oxalate variety)––but I am still disappointed. Some doctors say to cut back on dietary and supplemental calcium, even more counsel their patients to reduce calcium and salt and to drink lots more water. A few even give prescriptions for diuretics. None of this is necessary (or helpful for that matter). Yet the mainstream seems to be turning a blind eye to methods clearly proven to help.


In 1974, two Harvard researchers found that magnesium oxide (300 milligrams daily) and vitamin B6 (10 milligrams daily) could reduce the risk of recurrent calcium oxalate stones by 92.3 percent.1 Their research was published in the Journal of Urology.

Harvard? Journal of Urology? What more could a urologist ask for when it comes to research? I gave copies of the article to individuals I worked with to give to their urologists, but nothing changed. The recommendations for low calcium diets just kept on coming.


In 1991, the British Journal of Urology published another prevention study. During a five-year investigation, researchers determined that the use of 10 grams (less than 1 tablespoon) of rice bran twice daily after meals reduced new calcium oxalate kidney stone formation by 83.4 percent.2 To this day, not one person I’ve asked has been told by his or her urologist about this harmless treatment.


As I said earlier, this just doesn’t surprise me anymore. After all, it took the physicians at the British Admiralty over 150 years to implement one of the earliest successful scientific experiments concerning the beneficial effects of nutrition on illness—the prevention of scurvy with citrus fruit. And it took 19th century medicine more than 50 years to eliminate “childbirth fever” by simply having physicians wash their hands. Modern medicine still hasn’t learned that good nutrition can prevent nearly 100 percent of toxemia of pregnancy. I could go on, but you get the idea.


But back to kidney stones: The same amounts of magnesium and vitamin B6 found effective in preventing calcium oxalate kidney stones back in 1974 can be found in many high-quality multiple vitamin-mineral formulations today. To get enough magnesium and vitamin B6 from a “muliple,” be sure to take the four to six capsules daily that are usually called for by the labels of these products. Add 2 or 3 teaspoons of rice bran twice daily, and your chances of a calcium oxalate kidney stone recurrence are close to zero.


Orange Juice Consumption May Reduce Risk of Kidney Stone Formation


KIDNEY STONES, NEPHROLITHIASIS – Orange Juice, Lemonade, Calcium Oxalate, Uric Acid

“Comparative Value of Orange Juice versus Lemonade in Reducing Stone-Forming Risk,” Odvina CV, Clin J Am Soc of Nephrology, August 2006; [Epub ahead of print]. (Address: Charles and Jane Pak Center for Mineral Metabolism and Clinical Research and Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

E-Mail: clarita.odvina@utsouthwestern.edu


In a randomized, crossover study involving 9 healthy subjects and 4 stone formers, the author suggests that “short-term orange juice consumption could result in biochemical modification of stone risk factors.” While on a constant metabolic diet, the subjects were randomized to receive distilled water, orange juice or lemonade daily for 1 week, in a crossover design. After each intervention, urinary samples were collected for acid-base parameters and stone risk analysis. While urinary calcium levels did not significantly differ between interventions, urinary oxalate was higher, and uric acid was lower during the orange juice intervention, compared to the lemonade and distilled water interventions. Additionally, calculated supersaturation of calcium oxalate was lower in the orange juice phase, compared to the distilled water phase. Despite the fact that lemonade and orange juice had comparable citrate content, orange juice demonstrated greater alkalinizing and citraturic effects than lemonade. Thus, this study suggests that the consumption of orange juice may exert a protective effect against kidney stone formation. These results warrant further studies.

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