Email clinic


  Dr. Sally Boyd writes on health topics that poke about in her brain and won't let go.  Many of these posts are triggered by her unusual experiences in the wild and wonderful world of rural, tropical, 'barefoot doctoring', which she practices in lush, lovely, volcanic Pahoa, Hawaii. 

Aloha & Welcome to the Vitality Clinic in Pahoa!

Hormone Therapy over 60. . .
To Stop or not to Stop – That is the Question

/June 16, 2017 by Dr. Sally Boyd

Dr Sally Boyd thanks  Kathy Lynch, PharmD, at Women’s

International Pharmacy for this great article! She says it

better than I could. . .

Two recent studies have focused attention on cardiovascular disease (CVD) in menopausal women. The first study is a systematic review of 11 studies with a total of 19,667 subjects. The researchers assessed the relationship between vasomotor symptoms (VMS), which included hot flashes and night sweats, and CVD risk factors, i.e., blood pressure, cholesterol, body mass index (BMI), and carotid artery measurements. They found that women with VMS had significantly higher blood pressure, BMI, and total cholesterol than women without VMS. The authors concluded that women with hot flashes and night sweats, as compared to women without these symptoms, may have unfavorable risks for heart and blood vessel disease.

The second study evaluated the likelihood of cardiac or stroke death among 332,202 Finnish women who stopped hormone therapy (HT) between 1994 and 2009. Within the first year following HT discontinuation, the risk of death from any cause was significantly elevated. The risk of dying specifically from heart problems or stroke during this first year ranged from 26%-66%. This increased risk was decidedly higher in women who began and then discontinued HT before the age of 60. Contrary to current medical belief, women who started HT after the age of 60 did not seem to be at an increased risk for cardiac death within one year after stopping HT. Current medical guidelines recommend that practitioners encourage discontinuation of HT at annual office visits. The study authors believe the safety of this practice should be reevaluated in light of their results. Further studies are needed.

What conclusions might we draw from these 2 studies? Hot flashes and night sweats are the primary reason women seek menopause-related health care. If women with VMS tend to have more risk factors for CVD, and women who start and then stop HT before the age of 60 are at a significantly increased risk for cardiac and stroke death within the first year, continuing HT might be beneficial for a subset of women with hot flashes, night sweats and CVD risk factors. As always, a thorough medical examination and health history, along with an open-minded discussion with one’s trusted health care professional, can help women decide whether continuing the use of HT might be beneficial for them. References

  •  “Vasomotor symptoms in women and cardiovascular risk markers: Systematic review and meta-analysis” by Oscar H. Franco, Taulant Muka, Veronica Colpani et al; Maturitas; 2015; 81: 353-361.

  • “Increased cardiovascular mortality risk in women discontinuing postmenopausal hormone therapy” by Tomi S. Mikkola, Pauliina Toumikoski, Heli Lyytinen et al; J Clin Endocrinol Metab;

Gluten for Punishment / June 1, 2017 by Dr. Sally Boyd

Even if you are being ‘good’ there are sneaky ways gluten can still bring you down (and what to do about it)

Wheat! Gluten! So many people know that this pesky molecule is bad for them. Do you know that gluten is an issue for you- but you have eliminated it and are still having problems?  Maybe you are sensitive to ‘gluten cross reactive’ foods.  Cross reactions occur when a piece of some otherwise benign food looks to your body like the offensive food molecule (allergen). This makes your immune system attack it as if it were the allergen itself.  For example, about 50 percent of those who are gluten-intolerant are also sensitive to dairy. Surprisingly, researchers are also finding that coffee tends to cross-react with gluten and can mimic symptoms of gluten intolerance. What to do?
While following the basic dietary guidelines for gluten avoidance, make note of the foods that you think might be still giving you trouble (e.g., you experience similar gluten intolerance symptoms such as an upset stomach, headaches, or brain fog every time you eat a certain food).  Those foods may be ‘gluten cross reactive’ foods for you.  If you eat the gluten mimic frequently, however, you may not be able to ‘provoke’ an individual symptom that can show you that it is the food that is dragging you down. .  Just to make it more difficult, these ‘cross reactors’ may not show up on a regular allergy test- but still cause you problems.
There are two ways to diagnose gluten cross reactivity.  One is to strictly avoid gluten AND all the foods below for three weeks, see how you feel, then add one food back every three days and keep a record of your symptoms.  Allergic or gluten cross reactive foods will probably ‘provoke’ a symptom, especially after being cleaned out of your system for 3 weeks.  Too hard?  I feel you.  There are also accurate blood tests for all the gluten/gliaden allergies and their cross reactions. These panels cost about $250 or more and you can order them through Dr. Daughtrey.  To get you started, here are common foods that cross react with gluten:
Dairy, Chocolate, Sesame, Hemp
Buckwheat, Eggs, Soy, Sorghum
Millet, Spelt, Amaranth, Quinoa (yes even beloved quinoa!)
Yeast, Tapioca, Teff, Oats
Coffee, Rice, Whey  protein powder        

A note for overachievers: I do NOT recommend just taking all these useful and nutritious foods out of your diet permanently without testing.  Each person’s cross reactive ‘fingerprint’ is unique.  It is interesting that most of these foods are not encouraged on the ‘Paleo Diet,’ which may be a reason that it is gaining a reputation for success with many digestive and autoimmune issues. Before going on any long term medical or restrictive diet consult with a qualified, nutritionally based physician so that you don’t’ solve one problem and create another.                          
Don’t let gluten ‘sneak attack’ you!  There are ways to fight back, and many people don’t realize that there are successful ways to eliminate your allergies for good. Ask us how at 808-965-2233.

The Truth about 'Evidence Based Medicine' / May 25, 2017 by Dr. Sally Boyd 

The truth about ‘Evidence Based Medicine’, wisdom from a conventionally trained MD. . . .
‘Regular’ medical professionals can be quick to dismiss natural therapies as ‘not evidence based’ . . . as if this is the ultimate condemnation and a complete reason to dismiss these therapies outright.  Ironically, Dr. Kevin Pho, MD accurately points out in his blog that a great many conventional procedures and treatments are not proven to the standard of being ‘evidence based’ either!  Even more disturbing, in some cases where the ‘evidence’ is actually in, this evidence shows that the drug/procedure is NOT effective, yet it still continues to be used by the conventional medical community regularly.  One startling example is the routine use of coronary artery stents in patients with heart disease.  This high risk surgical procedure has actually been proven NOT to work in a majority of cases.  So, assuming that physicians are intelligent and well meaning, why do they continue to criticize natural therapies while using so many potentially dangerous ‘non evidence based’ treatments themselves?  
The answers to this crippling double standard lie in the realm of psychology, not hard science.  We are all naturally biased towards things that we like and are familiar with.  So we tend to ‘give a pass’ to things that are accepted in our world view and to be more critical of things outside of our world view.  We often have no idea that we are doing this unless we are educated and aware of the problem. The more training and exposure we have to an idea, the more familiar we are with it and the more we accept it, whether it is true or not.
Another problem is that of selective exposure. Many of the criticisms that I hear about natural medicine come from those who have no actual experience in the field, or, even worse, who have only negative exposure to it.  For example, an MD who sees a single ‘botched’ case resulting from a natural therapy is only seeing that isolated example, but for him it represents all of ‘natural medicine’.  He has no exposure to the many people successfully treated by that therapy and that doctor.  (Why would the naturally healed patients come to see him? They are not sick anymore!)  This happens in reverse in my office all day.  I usually see people for whom conventional medicine has failed, and these people often have a very negative view of all of conventional medicine.   I have to keep an open mind about this bias and not let it get in the way of providing the best approach with the best use of all the medical resources out there.  That is challenging!
            Another problem is the difficulty in gathering ‘evidence’ to create an ‘evidence based’ group of therapies.   The long term, safe historical use of a therapy, such as an herbal remedy, is not considered ‘evidence’ on its own.  But, in our culture, it costs money, lots of money, to fund studies to gather evidence.   Funding for the study of natural substances is relatively limited, as who is to benefit financially from such a study?  Natural substances can not be patented and sold exclusively, however synthetic drugs can be sold that way very profitably.  Therefore natural remedies can be criticized for not having enough ‘evidence.’ This is not because they don’t work, it is just because there are not enough studies.  This double standard is not questioned; it is simply part of medical ‘culture’.  As Dr. Kevin Pho, MD, says of conventional (regular) physicians:
“ The highly regarded Dartmouth Atlas of Health Care has been studying for years how physician culture, not science, substantially determines what they do. . . it may surprise you to read we have solid proof of benefit for a disturbingly small list of things doctors do. I think the main reason for that is we do many, many things in medicine and conducting a controlled trial on all of them, even most of them, is impossible. Evidence-based medicine is fine for those things for which we have evidence.”
            In conclusion, the goal of ‘evidence based medicine’ is a worthy and lofty one for both natural and conventional therapies.  However, there are many factors that influence a Doctor’s opinion of a therapy, and actual ‘evidence’ often takes a backseat to culture, bias, ego,  and simple exposure when making the complex decision of what therapy to use.

Energy and VOG / Feb 7, 2017 by Dr. Sally Boyd

Aloha all!
Well, the reduction in the trade winds has created a swirling eddy of volcanic emission to sweep over the islands, especially at night.  We have noticed increased effects in many ways.  Strangely, different concentrations of vog affect people very differently.  In addition, there is a lot of variation in HOW the vog makes one feel.  I have noticed that the more chronically or deeply ill a person is, especially with hormonal or adrenal issues, the 'deeper' the vog seems to 'go' in the body.   One person may just get watery eyes from an exposure that gives the next person (a menopausal female, for example) stomach cramps and exhaustion.  Overall, though, vog exposure seems to create a listless irritable brain fog and low energy. 

It s VERY helpful to the body to get a good break from the vog.  Overnight 'breaks' are very very helpful.  Air conditioning helps remove about 60% of the particles from the room (this is an estimate).  That is nice if it is hot enough out for the AC to work.  Also AC is expensive to run.  So what to do?  Commercial HEPA filters are NOT very helpful because the vog (H2S and H2SO4) particles are too small and go through those filters.  But help is on the way!

We at Vitality Clinic have worked with an engineer to come up with an affordable bedroom air filter that removes these tiny toxins (as well as other air impurities)!  They are custom made for the size of your bedroom or house. The cost for one of these amazing filters starts at only $300.  (In contrast, the only commercially available filters that are actually effective for vog are about $1200-$1800 for a bedroom!)  If you or anyone you know would like get one of these made for you just give us a call at 808-965-2233.

Lung Love / October 22, 2016 by Sally Boyd

We here in Puna on the Big Island enjoy paradise.  BUT we also cope with some unique challenges, from which other people can learn.  One of those is our exposure to volcanic plumes of toxic smoke, called 'vog' (short for 'volcanic smog').  VOG contains many small airborne particles, including H2S and H2SO4.  The tiny size of these particles as well as their extreme toxicity makes them devilishly hard on lung tissue.   Those with preexisting conditions such as asthma, dehydration, COPD, pneumonia, chemical sensitivity, or allergies already have inflamed and irritated lung tissue and can react to vog intensely. It also 'drags down' the energy of even those who don't have a lung issue.  Common symptoms include headache, fatigue, dry burning or itchy eyes, muscle pain and cramping, sinus pain or congestion, irritability, brain fog or trouble concentrating, Yuck!  

Here at Vitality Clinic we have come up with many ways to help people cope with the vog and thrive here in paradise.  One method we use is inhaled (or 'nebuilzed') glutathione.  Glutathione is an antioxidant molecule already present in the body   It is used in the process of  breaking down toxins inside cells.   As we age we often make less of it.   Glutathione can not be easily absorbed through the digestive system, so we make it into a cool steam and  then have patients breathe it directly into the lungs where it can go to work immediately on the tissue that is suffering the most direct damage from smoke, smog, vog, airborne allergies or pollution  Neat, huh?  It also has the effect of thinning mucus out in the lungs which allows you to cough it out naturally.  So we use it for pneumonia, sinus infections, and flu symptoms with very good results. 

Glutathione is just one of the ways we are learning to help! If you are suffering from effects of air pollution of any kind  and can not get in to our clinic to get glutathione, you can start to help yourself by-

1. Staying hydrated  Lungs excrete water and will 'spasm' if you are low on water to help conserve it.    
2. Avoid sugar, which lowers immune effectiveness.
3. Reduce commercial dairy products, these can make mucus in sinuses and lungs thicker and stickier.  
Mahalo nui loa from Pahoa!

A Tropical Health Concern - MRSA / October 22, 2014 by Sally Boyd
by Dr Sally Boyd, Vitality Natural Medicine Clinic, Pahoa, HI

Uhoh! What’s that sore on your leg, the one that just won’t heal?  Could it be MRSA? Just what is MRSA, anyway?

MRSA stands for a long jumble of words (Methicillin Resistant Staphylococcus Aureus).  You don’t really need to know that. But, especially if you live in the tropics, you do need to know what MRSA is and what to do about it.

 Let’s start with the bug.  Staph Aureus is a common  (‘ubiquitous’) bacteria that lives on the skin.  In fact, it’s quite possible that you have some on you right now.  It seems to be especially common in warm, humid places like much of Hawaii. The most common place for it to hang out is right inside the nose. (Mom was right, it is nasty to pick your nose- and it can spread MRSA!)  Staph causes infection if the body is run down or stressed.  It is commonly found in hospitals and nursing homes for that reason.  Staph can infect skin, lungs, heart, bone, and even the breasts of nursing mothers.  MDs have used antibiotics to kill Staph for a long time.  In fact it is generally recognized that we have overused antibiotics, causing the bug to become resistant to most of them.  The result of that is ‘MRSA.’ The ‘last stand’ drug that is used to kill MRSA is Vancomycin, which is often dosed via an IV for 2-8 weeks!  Even scarier, there are now “Vancomycin resistant’ strains of staph out there.

MRSA is spread rapidly in hospitals and places where a large number of people with weakened immune systems live in close proximity, such as nursing homes and homeless shelters.  Ironically, the places we turn to in crisis can actually end up spreading the disease.  The doctors, nurses and staff are not to blame,  rather, the systems set up to care for our sick people cause the problem.   This is a sad reflection on our health care system.  Rather than focusing on disease prevention and strengthening the body, we can end up ‘chasing our tails’ trying to treat disease once the person is already very ill.  This crisis care system comes at  a high personal, social and economic price.

Naturopathic physicians focus on prevention and strengthening the immune system as a whole, therefore hopefully preventing MRSA in the first place.  While we can prescribe antibiotics, we do so as a last resort.   By strengthening your bodies’ immune system, you can often eliminate infectious agents yourself.  Simple examples of ways to do this include reducing sugar and ‘refined’ carbohydrates from the diet, increasing intake of well grown fresh fruits and vegetables and getting enough exercise.  Beyond this, Naturopathic doctors are trained to examine the body and lifestyle to look for ways specific to the individual that can keep infection at bay.  NDs also use natural topical treatments for MRSA infection on the skin.  Natural treatments are effective as part of a plan to treat MRSA because the bug  has not developed immunity to them like it has to antibiotics.  However, true health means creating a body so strong that MRSA can’t get a foothold in the first place!