Fratellone Medical Associates

Family and Primary Care Medicine

Happy & Healthy Family

Fratellone Medical Associates is a full service medical practice integrating both conventional and alternative therapies for adults and children.

Safety is a major concern in any treatment for disease. Nutritional supplements should be used with discretion and under the guidance of a health care professional. Unfortunately, patients view that if a supplement at 500mg is good, then 1000mg will be better. This is almost never the case. Some medical conditions require the use of both conventional and alternative therapies, and even some of these treatments may require intravenous supplementation as well as oral supplementation.

These are some of the diseases/ailments we provide treatment for in our medical center in New York City:

Acne Heartburn Rosacea
Back Pain Hives Sinusitis
Canker sores Impotence Stress control
Colds Indigestion Tinnitus
Conjunctivitis Insomnia Ulcers
Constipation Leg Cramps Urinary Incontinence
Contact Dermatitis Migraines Varicose
Cough/Bronchitis Periodontal Disease  
Diarrhea Poison Ivy  

Acne
Acne is a disorder of the skin that causes the pores to clog and produce pimples. They are also known as whiteheads and blackheads and are most often found on the chest. Sometimes, in extreme cases, acne can spread to the upper neck, back chest and shoulders. It is usually a problem in adolescence but can be seen in adulthood for other reasons.

Causes:

Treatment:

Back Pain

Back pain is the second most common ailment presented to a doctor’s office next to the common cold. It also accounts for the increased disability cases as well as sick days for employees. One must remember the spine is a finely tuned instrument that needs its “band pieces” to work in synchrony with the whole orchestra. The band pieces include the ligaments, muscles and bone.

The first step after the physical examination is to have the patient undergo various testing, which includes common x-rays as well as either a CT or MRI. These tests are needed to further delineate bone structure, fractures, ligament tears, herniated discs and even osteoporosis.

The treatment depends on the type of injury. We do know that bed rest is essential. Your body will be in tune when it is time to move. While lying in bed, there are three simple exercises that can be done:

  1. Bent knee sit-ups – While in bed, lie on your back with your knees bent. Extend your arms towards your knees and do a sit-up. If unable to do a full sit-up, then lift both your shoulders and head off the bed.
  2. Pelvic tilt – Lie on the bed or floor and tilt your pelvis so that the small of your back (the curvature area) is flattened to the floor. Press your back down while counting to twelve.
  3. Wall press – This requires that you get out of bed, if able. Stand about 10 -12 inches from a wall. Bending your knees and let your back rest against the wall. Press the small part of your back into the wall, feeling the stretch in both the back and in the anterior (front part) of your thighs. Hold for a count of twelve.

Treatment:

Canker sores
Canker sores, also known as common mouth ulcers, are usually viral in origin. They can be solitary or in clusters and appear as small round ulcers with raised red borders. The cause is unknown but it is thought to be a malfunction in the immune system on some level.

Causes:

Treatment:

Common Cold

A cold is caused by a virus, usually the rhino or adeno virus. Some of the symptoms of the common cold include stuffy nose, sneezing, dry sore throat, fatigue and even some temperature.

Causes:

Treatment:

Conjunctivitis
Conjunctivitis is also known as “pink eye". The signs and symptoms include the eye becoming pink, feeling itchy and gritty and the crusting of eyelids caused by discharge. The true definition is the inflammation of the conjunctiva of the eye. If this occurs routinely, then this is allergic conjunctivitis.

Treatment:

Heartburn
Countless people suffer from digestive disorders, which can result in nausea, bloating, diarrhea, heartburn, constipation, coated tongue, belching, foul breath, a bad taste in the mouth, palpitations and shortness of breath.

Heartburn is a burning in the chest. This can either come from cardiac systems or gastrointestinal. It is vital to call 911 and go to your nearest emergency room. Heartburn can be the first sign or symptom of impending heart problems.

If you know that you are experiencing heartburn, then you might have had it after a heavy meal. Perhaps there is too much hydrochloric acid in your stomach or even not enough digestive enzymes in your system. This type of heartburn can be caused by heavy meals, coffee, medications, spicy foods and even alcohol.

Heartburn can lead to esophagitis (inflammation of the esophagus), gastric ulcers and even infections like Helicobacter pylori.

Treatment:

Impotence
Over the years, men in the practice have identified three basic problems–prostate disease, lack of sexual desire and impotence. As men get older, there is little or less interest in sex with their partners. This lack of desire may be linked to stress, medications and depression. There are even psychological problems that can trigger impotence, where counseling and reassurance can often help. The definition of impotence is simply a permanent or temporary inability to have or maintain a sufficiently rigid erection to achieve intercourse.

Causes:

Treatment:

Migraines
If you are an individual that suffers from migraines, then you know how debilitating this type of headache can be. A migraine must be differentiated from cluster or tension headaches. There are many neurologists who exclusively treat migraines. However, once the migraine starts, you often have to rely on a conventional drug medication.

If you experience any of the following, then you are more likely to have a migraine rather than a cluster or tension headache:

Causes:

Treatment:

A Discussion About Vitamins

It is important to understand the types of vitamins. There are soluble and non soluble vitamins. Unlike fat soluble vitamins (Vitamin D, E, A and K), water soluble vitamins are not stored in the body and must be replenished on a daily basis.

B1
Thiamine is a cofactor vitamin and a deficiency of thiamine (often seen in very strict vegetarians) results in a disease called beriberi. The symptoms of beriberi include muscular wasting, swelling of tissues, mental confusion and ultimately death. Studies with cyclists and athletes have claimed that mega doses of Vitamin B1 did not improve their performance as was previously thought.

Riboflavin
It is important because it is an essential component of a larger coenzyme (FAD). FAD is used is many reactions of the body and in the mitochondria (the power-house of every cell which produces energy or ATP). If you do not have enough riboflavin, then you will experience burning and itching, especially of the eyes and mouth. Unfortunately, the dietary sources of riboflavin are meat and dairy. Thiamine works with riboflavin, which works with niacin.

Niacin/Nicotinic Acid
It is converted to nicotinamide, which becomes a vital coenzyme for the mitochondria to make NAD. Until 1918, symptoms such as muscle weakness, diarrhea and tremors baffled scientists. The disease entity for these symptoms is called Pellagra. You cannot randomly take niacin because it can be toxic in high doses. A low protein diet must have some supplementation with niacin. Niacin deficiency has been linked to heart disease and cancer. Niacin is a type of B vitamin that is water-soluble. Leftover amounts of the vitamin leave the body through the urine. Niacin can be formed in the body from tryptophan, which is an essential amino acid found in meat, poultry, fish and eggs. Therefore, if your diet contains these foods, then your need for niacin from other sources will be reduced. I would recommend more fish (providing these fish are low in mercury) rather than meats. For those fish lovers, avoid tuna, swordfish, catfish, bottom dwelling fish and all crustaceans.

B6
Vitamin B6 is a water-soluble vitamin and is part of the vitamin B complex group. Pyridoxal phosphate (PLP) is the active form and is a cofactor in many reactions of amino acid metabolism. In 1934, a Hungarian physician, Paul Gyorgy discovered a substance that was able to cure a skin disease in rats (dermititis acrodynia) and this substance he named vitamin B6. In 1938, Lepkovsky isolated vitamin B6 from rice bran. In 1939, Harris and Folkers determined the structure of pyridoxine and, in 1945, Snell was able to show that there are two forms of vitamin B6 (pyridoxal and pyridoxamine). Vitamin B6 was named pyridoxine to indicate its structural homology to pyridine. All three forms of vitamin B6 are precursors of an activated compound known as pyridoxal 5′-phosphate (PLP), which plays a vital role as the cofactor of a large number of essential enzymes in the human body. The dosage of B6 must be regulated as an overdose of this vitamin can lead to peripheral neuropathy (damage of the nerves). At least one preliminary study has found that this vitamin may increase dream vividness or the ability to recall dreams. It is thought that this effect may be due to the role this vitamin plays in the conversion of tryptophan to serotonin.

The intake of this vitamin, from either diet or supplements, could cut the risk of Parkinson’s disease by half according to a prospective study from the Netherlands. Pyridoxine has a role in preventing heart disease. Without enough pyridoxine, homocysteine builds up in the body, which can damage blood vessel linings and set the stage for plaque buildup when the body tries to heal the damage. Vitamin B6 prevents this buildup, thereby reducing the risk of heart attack. Pyridoxine also lowers blood pressure and blood cholesterol levels and keeps blood platelets from sticking together. All of these properties work to keep heart disease at bay.

Nutritional supplementation with high dose vitamin B6 and magnesium is one of the most popular alternative medicine choices for autism.

B12
Vitamin B12, which isalso called cobalamin, is a water soluble vitamin with a key role in the normal functioning of the brain and nervous system and in the formation of blood. It is normally involved in the metabolism of every cell of the body, especially affecting DNA synthesis and regulation as well as fatty acid synthesis and energy production. This vitamin was discovered from its relationship to the disease pernicious anemia, which is an autoimmune disease that destroys parietal cells in the stomach that secrete intrinsic factor. Intrinsic factor is crucial for the normal absorption of B12, which means that a lack of intrinsic factor causes a vitamin B12 deficiency. Vitamin B12 deficiency can potentially cause severe and irreversible damage, especially to the brain and nervous system. At levels only slightly lower than normal, a range of symptoms such as fatigue, depression and poor memory may be experienced. B12 is often given to lower the cardiac risk factors such as homocysteine. Some individuals may have a an enzyme defect so the type of B12 may require methylation.

Folic Acid
Folic acid is also called tetrahydrofolate. A folate deficiency may result in the body’s inability to synthesize DNA. In addition to folate supplementation with regards to homocysteine, it has been researched, proved and studied that folate needs to supplemented in pregnant females to prevent neurological birth defects, especially of the spinal cord. The RDA requirement for folate is 400 – 800 umg. Physicians now prescribe a pre-natal with 1 mg folate. I usually prescribe folate at 2.5 mg (2500 umg) and 5.0 mg (5,000 umg). Doses above 2.5 mg require a physician’s prescription.

There are some individuals who cannot use regular folic acid to decrease homocysteine. This is a genetic defect in an enzyme, which is now identified in the blood. For those individuals, I prescribe methylated folic acid.

B6, B12 and Folic Acid
In 1969, Dr. V. McCully studied these three vitamins in relation to a bad amino acid, homocysteine. He postulated that homocysteine derived from a good essential amino acid, methonine, and that it can be reduced by increasing the dosage and requirement of B6, B12 and folic acid. Homocysteine can cause premature vascular damages of the arterial system and is now postulated to be a risk factor for Alzheimer’s Disease

There are four reasons why you might a high level of homocysteine:

Increased consumption of poultry (as poultry contains more methionine)
Decreased consumption of green vegetables
Decreased amount of folate
Lack of nutrition from food or supplements

C
Vitamin C is known as the anti-cancer, immune system booster and anti-heart disease vitamin. Mega doses of this vitamin range from 15,000 – 40,000 mg (15 – 40 grams). Historically, the lack of vitamin C was termed scurvy. Scurvy is characterized by edema, hemorrhage, weakness, softness in bones and teeth and lesions of the skin. Sailors who ate fruits such as limes were able to prevent this deadly disease. The functions and importance of vitamin C is seen in collagen biosynthesis because it is an essential cofactor for enzymes that synthesize collagen proteins. Collagen helps you form strong bones, teeth and connective tissue. There are more and more studies on the role of vitamin C in cancer. It does augment the activity of the immune system against cancer. There are few studies that state that higher doses than normal (Linus Pauling doses) can cause growth of cancer cells and if taken while a patient is undergoing chemotherapy or radiation, then can lessen the benefits of these conventional treatments. Eating berries, which are high in anti-oxidants and low in sugar, are rich in vitamic C. Oranges, grapefruits, lemons and limes are also rich in vitamin C but they are acidic and moderately high glycemic fruits. In heart disease, vitamin C may control the damage of free radical in the blood system. These free radicals cause all diseases and can cause the oxidation of LFDL cholesterol, thus causing plaques and cardiovascular disease (CVD).

D
Vitamin D, which is fat-soluble, is known as the Decade Nutrient. Increased levels of this vitamin can increase serum calcium levels. It is not only a vitamin; it has been found to be a pro-hormone and can be expressed in the brain, heart, skin, prostate and even the mammary glands. Everyone associates Vitamin D with bone. Prior to new studies, the recommended RDA requirements were only 400-800 mg but today’s average is 1000-1200 mg. I have been using more than 2000-5000 mg for the past decade and have used higher, depending on the patients serum vitamin D 25 level (calcidiol). The average (optimal) level ranges from 32 – 100 ng/ml, depending on the lab. I prefer someone having a level of 50-60ng/ml. Someone who is severely deficient would have a range of 0-15 ng/ml and someone who is mildly deficient would have a range of 15-31 ng/ml. If you do not like to take supplements, then you may be wondering about what food source can give you vitamin D. One tablespoon is equivalent to 1,360/serving–salmon (3oz sockeye) is 794 IU/serving and milk (nonfat, fortified with D) is 115-126 IU/serving. If you are willing to take supplements, then capsules or liquid form would be best.

Vitamin D can decrease your risk of cardiovascular disease, osteoporosis and cancer. Those of us who sun bathe in the summer will get vitamin D2, which will convert to D3 (the vitamin D required), but one should increase his or her D dosages in the winter months. One needs to walk in the sun three times/week for 15 minutes to get adequate levels of vitamin D. It is important to note that not all sunlight vitamin D2 will convert to D3 unless your small intestines, especially the villi, are free to absorb and make vitamin D and the good bacteria in the colon are plenty. The good bacteria such as lactobacillus and bifidum can be taken as pro-biotics. Other conditions, which predispose one to low vitamin D levels, are kidney (renal) patients, those with mal-absorption syndromes (celiac disease) and even certain drugs.

Our approach at Fratellone medical treatment center is to provide our patients for extensive ongoing conventional medical care, while providing the most effective integration with alternative treatments.