Q&A 4/27/23 Eustachian tube dysfunction, Recommended HRT, Toe Neuropathy, Glaucoma/ Cataracts and Boosting Immune System


Eustachian tube dysfunction. Is there something you recommend for hormone replacement for males and females? Toe neuropathy – Signs, symptoms and causes. Please discuss glaucoma, cataracts and macular degeneration. How can we avoid stop cure them when diagnosed? best ways to boost immune system


00:00 Introduction

01:11 Eustachian tube dysfunction

09:17 Is there something you recommend for hormone replacement for males and females?

19:07 Toe neuropathy – Signs, symptoms and causes

22:14 Please discuss glaucoma, cataracts and macular degeneration. How can we avoid stop cure them when diagnosed?

28:09 Boosting immune system

Transcript from Webinar:

Ask Dr John 4-27-23 Webinar

Howdy. Welcome to another episode of Ask Dr. John here on a Thursday afternoon at 330. Today I’m going to go through questions that have been submitted over the last few weeks. And I don’t know what order yet, but let’s see here. So a couple of reminders, books coming out soon. They’ve said April 30th. I always doubt those dates. It’s like getting your house remodeled. Right? Just add a little time to that. But I do expect it out within two weeks. So we will let you all know and hopefully you’ll check it out and leave us a review. Another reminder that our cardiology class has started. Class number two is tomorrow, which is the real, real, real causes of cardiovascular disease and kind of the introduction about what to do about that. So tomorrow, I think, is an important class. If you’re interested in cardiology. And this although there will be a little bit of biochemistry, a little bit of technical stuff, mostly it’s stuff that is really appropriate for almost anybody to watch.


So let me see what I’ve got here. First one is we’d love to hear you speak about Eustachian tube dysfunction; causes, symptoms, treatments. Thank you.


Eustachian tube dysfunction is interesting, you know, I’m a broken record about this. The key is always to get to the source. Now there are a couple of drugs that can be used to help with Eustachian tube dysfunction, particularly if it’s from allergies. But really the key is to get to the root of it and see what you can do. So basically, when they when the word dysfunction is used, it really isn’t pointing to one specific thing. If you have a heart dysfunction. That’s not one thing, because many things can cause heart dysfunctions.

But the most common type of Eustachian tube dysfunction that’s talked about is a condition where the tubes the eustachian tubes that connect your middle ear to your throat become blocked. And of course if it connects it to your throat, it’s also connecting it to your nose. That’s why we have ear, nose and throat doctors. Because they’re dealing with all of these things that can certainly affect each other. So that blockage will cause, you some discomfort.

This blockage can also cause hearing difficulties, particularly where it sounds like your ears are underwater, but it can cause other hearing problems also. Including tinnitus where you get a ringing in the ear because the blockage causes a differential between inside and outside air pressure which presses on the nerves and you’ll get tinnitus. You’ll get a feeling of fullness in your ears. Typically like you might get if you were flying and you weren’t chewing gum, et cetera. When you landed you’d get this pressure in your ears. That’s what’s most commonly called Eustachian tube dysfunction.

Now this blockage can happen when the mucosal lining of the tube is swollen or when it doesn’t open and close properly like it would with the airplane example. Symptoms of this condition can be muffled hearing, you can get tinnitus reduced hearing, pain, a feeling of fullness in the ear, and sometimes even some balance problems can occur. So, I can’t say it enough, we need to get to the source. So let’s go over a list of a few possibilities here.

zOne is allergies. When you get an allergic response, many times we don’t notice it. But there is swelling. If you get hives like on your skin from an allergic response or if your throat starts swelling from an allergic response. Those can easily close off the eustachian tubes, which are actually very tiny little tubes. In babies they’re amazingly small. That’s why they get blocked so easily. often doctors will give Afrin or any of a dozen other antihistamines or other categories of drugs to kind of resolve or lower the allergic response.

Pollution, just simple old pollution. After the fires that we had for several years here, I had a lot more patients coming in with ear and eustachian tube problems. Now just being around smoke, if you were somewhere where people are burning wood fireplaces or around smokers, that can irritate also. Or it can be infection. That’s infection in the ears themselves, or in the eustachian tube or in the nose.

lot of staph, for example, Staphylococcus. when several hospitals in Scandinavia stopped doing prophylactic antibiotics with their patients before major surgeries and started instead using nasal swabs with antibacterial, their infection rate went way, way, way down, even though they weren’t using antibiotics topically. This is because that repository of usually staph but it can be other bugs then could not spread during the surgery and did not get into the wounds.

So it can be bacterial, it can be viral, it can be fungal, anything that can affect any part of your body and cause irritation and swelling could be in the nose and/or the ears. Or it can be caused by damage to the tissues. It could be a genetic malformation where one of the eustachian tubes or both are too small. It can be mechanical as in it could be caused by some type of trauma. Or you could have vein problems. For example, if the veins are not draining properly, then fluids will back up in the lymphatic system. Then the lymphatic system can cause pressure and damage to those tissues.

This is a lot more common than people realize in treating even autistic kids one of the major problems is the inability for lymphs to drain down through the tonsils and the tonsillar tissues. It’s very complex. There’s not just one set of tonsils. There are multiple tonsillar tissues. And those can get enlarged again from bacterial infections, fungal, viral, but mostly bacterial. So then the tonsillar tissue swells can directly press on the Eustachian tubes or it can swell and not let the lymph drain into the lymphatic system.

So each one of these requires a different remedy obviously. Sometimes it can just be as simple as mucus that gets trapped up in the eustachian tube. You know, you try to blow your nose and the mucus gets stuck in the eustachian tube. each of those has different problems, different ways. I’m a big fan of propolis inhalers, which are very good for the air pollution and somewhat for the allergies.

If it’s infection, I often or if I think it’s an infection, I’ll send my patients into their doctors and try to get them to get mupirocin, which is a nasal swab that can be used if it’s vein problems. We have a video on massaging the neck and using a red-light therapy on it to open the veins and the lymphatic system. so those are all things that can cause be symptoms of and potential treatments of Eustachian tube dysfunction.

this is really common in kids. I’ve probably saved 20 kids from getting ear tubes just by getting them off of dairy because dairy is so mucous forming, particularly the dairy we have in the United States. It causes massive amounts of mucus. A mother’s little baby starts crying and pulling on their ears and everybody says, “Oh, it’s an ear infection.” well, 88% of the time It is not an ear infection. It’s inflammation where fluid gets stuck behind the eardrum, which hurts and it’s not draining down the eustachian tube.

And we know this because 88% of the time the antibiotics are not helpful, about 12% of the time they are. So this is really common in little kids. Okay. I think that’s all I’m going to say about that right now. If you have follow up questions, go for it.


Is there something you recommend for hormone replacement for males and females? We no longer have health insurance but have been on testosterone shots for my husband and estrogen cream for me. Is it worth paying for it still or is there a better route to go that is healthier?

That’s a way complex question. Now, I did an entire show on this in January, and I probably did it more justice than then I’m going to do today. I mean I’m going to look into it with you. So, there are many types of true hormone replacement, either with estrogen and/or progesterone or testosterone with women, depending on exactly what you’re trying to treat in women. If it’s more hot flashes, usually it’s going to be estrogen. If it’s more lack of sex drive and libido, it’s more likely testosterone. And then sometimes it’s progesterone. So, it can be any of those.


Now, oral hormone replacement is by far my least favorite when you look at these studies historically showing increases in breast cancer, liver cancer, gallbladder cancer in women. Almost 100% of those studies were on oral hormone replacement. And the reason for that is when you’re doing it orally, ingesting it, then it has to be broken down by the liver. Be conjugated broken down so your body can use it and you have to use about 20 times more of the hormone than if you deliver it through some other methodology where it doesn’t have that first pass at the liver. So do not like oral bioidentical oral is better than non-bioidentical but is much more pricey and you’re probably not going to get those from your general medical doctor.


Topically is generally pretty bioavailable and much safer because you’re using much smaller amounts and this can be rubbed into, you know, a variety of spots on the body where it’s generally, you know, again, pretty bioavailable and very few side effects for that. The best is probably pellet insertion where they put a little pellet under the skin and it causes very, very few side effects.


Most of the doctors that would do this would be doing bioidentical hormones. One of the biggest problems is that progesterone can’t be patented. It’s a naturally occurring substance. And so, they give progestins, progestins are artificial progesterone and they are very dangerous. It’s the primary thing that was damaging women in the Brigham Hospital Health study and in other studies was actually the progestins. It wasn’t so much the estrogen.


Vaginal, topical is great. It’s my first or second favorite drug that I refer people out for. I mean I’m calling it a drug because you have to get a prescription. But I find that the number except in women who have already had breast cancer, I can find no increased risk in doing the vaginal estrogen cream. That’s because it mostly stays local. It’s magical for keeping the tissue healthy. often women as they get up into their 60s will have a lot of pain. It feels like a urinary tract infection, but it’s not. It’s a symptom of dry and inflamed tissue and a little bit of urine gets stuck in the urethra, and it feels like a urinary tract infection.

So that’s the order that I like to see these done. whether it’s for men or women. So, it would be oral, topical (that can be a cream, or it can be a patch), and Pellets in that order are my favorites from worst to best. Then vaginal I think is always great. Now, one way to get the hormones if you’re if you’ve been using hormones is go to Mexico. You’re go into their equivalent of CVS, and you see huge stacks of hormonal treatments, including topical testosterone. It’s amazing. You can just walk in and buy it Now, getting it back into the country, maybe a different issue, but very easy. You can get it all over the place in Mexico.


The pellets are the best in my opinion because the delivery system is very stable. One of the problems with testosterone injections is you get a big surge in testosterone immediately and then it wears off often at an uneven rate. Because of those big changes in the amount, it can actually turn to estrogen. Often men that have been doing testosterone shots will develop what are often called “man boobs” because testosterone will turn into estrogen. So, I’m not wild about that that way of dispensing it. I really prefer the pellets or a cream that you use more regularly. If you use it daily, you’re going to get a fairly constant level of testosterone.


Tons of supplements and herbs that can be very helpful. So, herbs, we have a formula called Venus, which should be kind of obvious what that does. It’s more for the estrogen side of things. We have other dozens of other formulas, probably more than that for hot flashes, night sweats. et cetera. But Venus is more for tissue quality. Then you can get Muira Puama, which causes pretty dramatic increases in sensation in the genital area. But anyway, tons of choices.


There are a variety of things for men. Which one you use is going to depend on other general symptoms. A ton of formulas for men. The Chinese developed hormone replacement therapy over a thousand years ago. Have a recipe here. You take 150 gallons of urine from young men, you put in a particular type of container, you heat it, and you drive off the water. What’s left is going to be this, I don’t know what to call it, like a jelly. you put that in date paste and give it to old men. Well, that temperature is exactly the temperature that will drive off the fluid without damaging the hormones and the enzymes. It was quite brilliant, actually. So, these old men that were taking those pills were getting testosterone and human growth hormone treatments. Pretty wild.


Kathryn and I had a patient come in last week that I’ve seen for quite a few years. She was just bubbly and happy. Happier than I’ve seen her in years. She had found a particular supplement that she said for the first time, and I think I don’t remember how many years. But it had been many, eight, nine years. She actually had libido. She was actually interested in sex. She had been very dry vaginally. And now she was lubricating like crazy. that formula was female enhancement from ancestral supplements. We don’t sell that, but it’s fascinating. After I heard that from her I looked at the ingredients and it made perfect sense to me.


When I was in school, most of my teachers were Chinese, and in my nutrition class, you’d walk in the school and it was sometimes overwhelming because they would be cooking organs from sheep, cows, whatever. For heart problems, they cooked heart. For kidney problems. They’d cook kidney. For libido problems, they would cook either ovaries for women or testicles for men. That makes perfect sense because the building blocks for these organs are going to be found in those animal organs and it was very successful.


Now this company, ancestral supplements has put together combinations of organs that meet a variety of needs. The female enhancement really, really would be at the top of my list. For men. I don’t remember male optimization formula; I think is what it’s called. When you look in the ingredients, it’s like, whoa, I can see why that’s going to work. That’s what I would try for men. Now they’re are little pricey for supplements, but I think it would be worth a try. They’re probably a little cheaper than herbs overall. So I would start with those two supplements from Ancestral Supplements and see how they work.


I thought I did this one but maybe I didn’t toe neuropathy. Well, toe neuropathy is the same again as any other neuropathy. When people say neuropathy, it means that there’s damage to the nerves. Now many things can damage the nerves. You can have pressure on a spinal nerve, you can have diabetes, you can have vitamin B12 deficiency and a variety of other causes. You can have trauma to the area. The biggest questions are, is it mostly tingling and numbness? Is it mostly pain or is it both? Now again, the four most common causes of neuropathy would be either a physical injury, diabetes, or elevated blood sugars, which causes a problem in the peripheral vascular system so it reduces blood flow, a vitamin B deficiency generally B12 and/or B1, and then nerve compression somewhere between the spine and the toe could be right out the spine or it could be lower on the leg.


So, you kind of have to parse those out and have someone work with you to figure out which one it is. Now, if you know there’s diabetes, then you could suspect that that’s the problem. If there’s a B12 deficiency, you’ll see an elevation and mean corpuscular volume and a lot of labs will say you’re normal up to 100 for lab courses up to 97. But in functional medicine, most people agree that if you get over 90, it’s a problem. So if you’re getting up 95, 96, up to 100 in that range, then I would look at the B vitamin issues and take a good quality, um, methylcobalamin, which is B12 and methyl folate, which is a form of folate. It’s L-5-methyltetrahydrofolate (L-5-MTHF) actually. But just look for methyl folate and then B1. I prefer to get the benfotiamine form because that stays in the system longer. If it’s nerve compression, then you’d need either hands on testing by an expert or you could do a nerve conduction velocity test to determine that.


Now obviously the treatments are different for each of them, but for all of them, I use a methylated B vitamin complex, alpha lipoic acid, and then vitamin no matter what type of problem it is, because those all generally work to restore nerve function and then herbs to consider there are a ton. But I would start with Shen Tong Zhu Yu San. That’s for blood stasis in the periphery of the body.


The question is, I appreciate your Zoom lectures so much. Please discuss glaucoma, cataracts and macular degeneration. How can we avoid stop cure them when diagnosed? Acupuncture, vitamins? et cetera. I also have a hunch that the blue light from the computer monitors by the eye.


A Yes, they do. You should get a blue blocker for your phone and your computers so that they don’t damage the eye so much. Now, fortunately, for the retina and the cataract issues. The treatments are very, very similar. Now, in Chinese medicine, the eyes are related to the liver. So, when there’s an eye problem, we look to the liver and its associated organ, the gallbladder. So, most of the acupuncture points that I use to treat eye problems or on the gallbladder and liver channels. And I’m not going to mention too much about that, but a little bit when I get down to glaucoma, if I remember.


For the retinal or vitreous humor problem and the vitreous humor is that jelly like substance that the cataract hangs down in and makes the eyes so that they can adjust. The muscles cause the focal point to lengthen or shorten and that’s how you focus at different distances. So for the retina, I particularly use vitamin A. You can actually go blind from lack of vitamin A. In fact, there’s some great stories, probably apocryphal, but I don’t know about mountain men and travelers across country who suddenly went blind and a native came up. Indigenous person came up, went fishing, pulled out a fish gave the person the fish liver to eat, and their vision came back. That actually could happen. By the way, don’t ever eat bear liver, polar bear in particular because that has so much vitamin A in it, even a teaspoon would kill you. You guys probably aren’t going to do that though.


So, vitamin A, Zeaxanthin, which most of you are familiar with. astaxanthin, lutein, luteolin, which is different than lutein and is now a new superhero coming on the scene. Green tea or epigallocatechin gallate usually called EGCG, but you can use green tea or green tea extract and vitamin C, those are kind of a standard thing. But the primary problem with retinal issues is blood flow problems. So, if you have big, thick veins under your tongue, then you need to fix the blood stasis.


There are many things that can damage what’s called the glycocalyx. The glycocalyx is the substance that lines the inside of the arteries and veins. You’ve got a one cell thick layer called the endothelium inside that is the glycocalyx. That’s what protects you from foreign invaders from cholesterol build up. et cetera. And so I would use a glycocalyx supplement for blood flows. At some point, I’ll give you some ideas about what to use for that. Acupuncture is helpful. It’s not my primary treatment for those conditions. Pulsed electromagnetic fields are very helpful because that gets the blood to flow better. And then we use red light and infrared light to lower the inflammation. We actually have many red lights treatment devices in our clinic, but we have one that’s a handheld device, very inexpensive that we use for red light therapy around the eyes. The research on it is very good.


Now for glaucoma, it’s a little different story. Glaucoma is high pressure in the eye and the glaucoma rates are very consistent with high blood pressure rates. And high blood pressure is very often caused by high uric acid levels. And uric acid is one of those things that gets about 1% of the attention that it should. If you have gout, if you have kidney stones, maybe they check your uric acid, but uric acid is the big player in stroke, cardiovascular disease, heart attacks, diabetes, high blood pressure and a hundred other things that I could name or probably couldn’t name, but a hundred other things. So, we always have to look at uric acid levels and the level that you see on a typical, “standard range” is way too high. It should never be over 5.5. And the lower it is, the better. So that’s the first place I would look for glaucoma issues.


The VA is now doing a study on, I believe, they were talking about it, on an acupuncture formula that I put together for one of my patients. They were stunned. They called me and said, hey, whatever you’re doing, don’t do any more of it because his pressure’s getting too low. And his had been very high. So, you need again to look at blood vessel health here. If there’s high blood pressure, you have to get that down. If it’s damage to the vessels, then again, we look back at the glycocalyx. So, if you have more questions on that, let me know. I think I mentioned vitamin C, also important for the eyes.


Okay. Here’s another question. Since the government is now ignoring the pandemic. (I’m assuming she means that as a negative. I don’t know) I’m hoping John can talk about the new variant coming in from India and what we can do to boost our immune systems for it. It seems a bit different than the previous ones.


One of the things that is incredibly consistent about viruses is that they constantly mutate, and their goal is to live. And in order to live, they need to be highly infectious. So, they in fact a lot of people, but can’t cause a very high death rate because then people can’t pass it on. So, each of the variants is a little bit different. However, the same basic rules always apply when preventing viruses. Now, literally thousands of studies from all over the world that showed what worked in the pandemic. And the FLCCC, and I’m just quoting Don’t shoot the messenger said that the pandemic in the could not have been handled any worse worldwide, but particularly in the United States, that everything that was done was wrong.


These are the top physicians, 1700 of them from around the world Harvard, Yale, Johns Hopkins, et cetera. But they didn’t have a voice. They were not allowed to speak out. But there are those documents out there. My point is, the same as this person is the key is to boost your immune system. That’s what works. That’s what worked with the Spanish flu in 1918, 1919. That is what has worked with every influenza outbreak since then. It’s what worked with Covid. That’s the key. Now, there are certain specific things that seem to be extremely effective at dealing with these variants. One is vitamin D, it is the master hormone for immune health. The death rate from Covid and people with high vitamin D levels was a fraction of the death rate in people with low vitamin D levels.


One Spanish hospital study, I think it was 176 people that showed up saying, I think I have COVID, and they were tested and were found to have COVID. About half of them were given vitamin D less than I would have given them, by the way, but a significant dose. And the other half weren’t. Of the half that got the vitamin D, the hospitalization rate was about 2% of the people. Same symptoms selected randomly that did not get the vitamin D, the hospitalization rate was close to 50%.


So that’s a 25 times higher hospitalization rate with low vitamin D. So, if you were going to do one thing on the planet, that’s it. Now, also you want to do zinc. High zinc levels in the cells prevent the virus from replicating. So, you want the zinc and then you want a zinc ionophore that’s something that draws the zinc into the cells. Doesn’t do you much good in the bloodstream. It really has to be in the cells. What I use is quercetin, which is a zinc ionophore. We use fairly high doses 4′ to 500mg. And by the way, as kind of a base dose I have people do 30 to 40mg of zinc if they think they’ve been exposed or they become sick, I would have them do more like 60 vitamin D, A typical dose for me is 5000 units a day. If someone feels like they’re coming down with an infection, I have them do much higher levels.


Now some zinc ionophores other than quercetin are hydroxychloroquine, ivermectin and artemisinin. Each of those has been used extremely effective at countries outside of the United States. I just had a couple of patients who went to India, and they wanted some information on what to do about Covid. So, I printed out a document from the Indian health agencies where they said, first thing you do is go to the drugstore and get hydroxychloroquine and ivermectin and take it. So that’s what they’re saying. Artemisinin is also effective. Again, the zinc ionophores. They pull zinc into the cells. You want to do vitamin C to bowel tolerance. So that means to the point where you start getting diarrhea, split it into three doses because it’s only in the bloodstream at high doses for 8 to 12 hours after you take it. So, I’m doing these in order that I think they’re important.


I’d do antiviral herbs and there are many there are dozens of antiviral herbs. My favorites are Andrographis or Chuan Xin Lian. That just wipes out the flu virus and most cases. Also, Da Qing Ye and Ban Lan Gen. Those are three of the primary strong antivirals that I use. Then you want immune boosting herbs and again there are dozens and dozens of these, but a few of them are Eleuthero, which is Siberian Ginseng, Echinacea, Berberine, Ashwagandha ginseng. So, these are some of the immune boosters. Huang Qi (Astragalus). So, yeah. So those would be next on my list for immune boosting.


Then if I thought I had high exposure or I started getting sick, I would do the antivirals and then high dose melatonin. There’s a huge disagreement over what high dose means. If you’re doing it orally. It’s different than if you’re doing it as a lotion. I do 200mg as a lotion most days and I put it on a bad knee that I have, and it really helps my knee and helps my immune system. Or you can do it as a suppository. We have 200 and 400 milligram suppositories that we’ll have patients take when they’re really inflamed, or we’re concerned about infection.


So those are a few things that can be done. Um, then on a mechanical side, a lot of people swear by nose irrigation irrigators so you can get something like water pick. In fact, you can actually get water picks with nasal attachments and so you irrigate your nose and there are different people suggest different things to irrigate with. So, you want to do research on that one. We use something called Xlear, which is a xylitol, grapefruit seed extract. That’s just a squirter you just squirt it in your nose. Then if people are really at risk, we’d have them do a propolis inhaler. So, this is. It’s like a diffuser, but it has a mask on it. And you can inhale propolis, which is the magic substance that are in is in beehives.


So those are some of the things that you can do. And of course, sleep well, eat well. Here’s a well-known doctor who I’m not going to name because I don’t have her permission and she is looking at dosages for long Covid, which is now called Pasc. She has it by weight. So, if you weigh 120 pounds, She’s recommending 2947mg of melatonin. Now, I have never dosed melatonin that high, but that’s what this person who’s really well known and has some very interesting things to communicate on the radio. If I think it’s appropriate, I’ll give you her name soon. But just think about it. So, people are really hesitant to do five milligrams of melatonin and she’s doing 3000mg of melatonin. We know that melatonin is perhaps the primary antioxidant in the body. It is almost certainly the primary antioxidant in the brain.


Hey, all right. So, I ran a little bit over time. I want to thank you for your questions. And that pretty much catches us up to date. So, I need more questions. You’re on the spot now. Okay. Send me some really, really fun questions about any aspect of health, health care. et cetera. That you’re interested in, and I’ll be happy to take a bit of time to go over it with you. So, until next Thursday or tomorrow, if you tune into the cardio cardiovascular program, which is to be found, by the way, on the you can click on our newsletter and that will take you to a site called the Net of Knowledge. And you can sign up there. So, either tomorrow or next Thursday, hope to be seeing you or hope to be you seeing me.

In the meantime, be happy. Be healthy. Thank you.

Dr. John Nieters L.Ac, DAOM, is an acupuncturist, Chinese herbalist, functional medicine, writer, teacher, and leader in the community.

Check out Dr John Nieters latest book “The Sweet Spot” on Amazon

Disclaimer: Dr. John Nieters received his Doctor of Oriental Medicine and Acupuncture degree from Five Branches. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Nieters is a licensed acupuncturist in California. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Nieters and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. TheBalancingPoint.net, Alameda Acupuncture, and Dr. John Nieters L.Ac, DAOM are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this video or site.

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