The Devon Allergy Clinic

I'm pleased that some patients have been in to the Surgery to further discuss their Allegies having been tested at The Devon Allergy Clinic. One of the franchised locations is the Arcturus Clinic in Totnes.
They use what seem to me to be some dubious testing techniques.
"The patient holds an electrode in one hand that is connected to the testing unit and a probe is placed on an acupuncture pressure point on a finger or toe on the opposite side of the body, thus placing the patient in a circuit with the machine. Samples of the potential allergen are placed in the diagnostic unit which will then indicate whether there is any resistance from the patient to the substance in question." 
They use a machine called a Med-Tronik RM10. (We do use some machines in medicine made by a company called "Medtronic", which should not be confused with "Med-tronik").
Their website says: "The electro-acupuncture according to Voll is based on the ancient tradition of Chinese medicine. By means of acupuncture it searches for overriding, impaired  regulation principles that could possibly be the cause of an illness.

 In electro-acupuncture the therapist employs a "pressure measuring stylus" which he positions at the acupuncture points to measure the organism's electric resistance. Thus he gains information on a patient's bio-energetic condition"

The machine looks impressive of course (see above) with buttons and a big dial- one of the hallmarks of Quackery. Their "Mora" machinery claims to offer holistic testing against a number of substances, based not on the substances themselves, rather "the complete digitally stored  information spectrum of a substance is transferred  into its original analogue oscillations to the MORA - device"  That is to say, loaded off a CD! Funny, almost.

The allergy clinic website makes some discussion about food allergies being IgE mediated, which can be true, but doesn't then seem to explicitly state that their testing is based on no such science, though does later say that skin prick tests and specific IgE tests are available.

I haven't been able to ascertain the cost of this testing, but don't suppose it is cheap.

I don't particularly mind if people want to get their allergies tested there, but feel I ought to express my concerns about the testing because of its highly doubtful scientific basis and that if people do choose to have tests done there using this machinery that it is probably a waste of their money.

Home Births

One of the more lucid, balanced views of the evidence of safety of home births that I have read...
"How safe are home births?

Cholesterol and Primary Prevention

I’ve suddenly developed a new interest in cholesterol.
Not particularly because of a new academic research paper or anything.
Just that I’ve discovered what mine is. And it’s a little high. 8.2 if you are interested.
We are all being told now that our cholesterol needs to below 5, but that’s not really the whole story.
HDL levels are very important too.
Remember, we aren’t actually too excited about the cholesterol itself: it’s the implications of a high cholesterol that are really important. For example having a heart attack or a stroke.
Predicting the risk of that happening depends on several factors- cholesterol is one, but the amount of that cholesterol that is of the HDL type is very important too.
It is the proportion of the Total Cholesterol that is HDL which is most strongly statistically associated with risk of stroke. (TC/HDL). A low ratio is good regardless of the total level of cholesterol. 3 or 4 is good.

Adding in TC/HDL to your blood pressure, age, whether you smoke of have diabetes and so on can be used to come up with an estimated risk to the individual of developing heart disease or stroke over a 10 year period. In this country we have been using an American equation to do this for years, but we now have our very own English equation. See www.qintervention.org to have a look. This is good because it also shows some “what if?” scenarios… such as  “what if I were to stop smoking?”
I plumbed all my figures in to this website, including my Cholesterol at 8.2, HDL at 1.5 (ratio 5.46), BMI of 30.5, Systolic BP of 116 and got a 10 year risk of 2%.
So even with a cholesterol a bit high and being just a little tubby, my risk is actually ever so slightly lower than average for my age.
Phew.
BUT, my risk of developing Type2 diabetes looks a little high. So perhaps I’d better lose a little weight anyway

Questions.
Should I go on a statin?
Will losing weight help my cholesterol?
What can I eat to improve my cholesterol?

Well, I don’t feel the need to rush onto simvastatin. In prevention of heart disease and strokes etc in healthy individuals the benefits are hardly measurable for men, and arguably not there at all for women. We do discuss their use once someone seems to have a risk in the order of 20-30% over 10 years.

Losing weight should lower my cholesterol, but it seems that what you eat can have a strong effect too.
Walnuts and almonds, soluble fibre, olive oil, plant stanols; and of course cutting down on animal fats.
(Apparently Pasties aren't good. Damn!)
Drinking just a little alcohol might boost my HDL cholesterol.

So all in all I come out quite encouraged. I know I’m going to die anyway one day, but the risk doesn’t seem imminent. I shall try to eat appropriately and lose a little weight. Perhaps just a beer or two on a Friday night as well.

The Government has started a bit of an agenda with GPs to start looking at this area of primary prevention of heart disease and stroke. We are being asked to use our computer records to estimate which of our patients who appear healthy might actually be statistically at increased risk. Once we have found them though, what to do with them? We do appreciate that every individual patient will have a different response to being told they might be at high risk. Probably then we’ll end up writing to you if you might be at high risk and leave it to you to decide whether to come in and discuss it further or not.