It is known that Alzheimer’s disease originates in the part of the brain that senses smell, before spreading to other areas. The “olfactory vector hypothesis” suggests that there may be an environmental agent that could enter the brain through the nose.

It is known that changes in smell may pre-date cognitive decline. So, the theory is: Could changes in smell be used to predict Alzheimer’s disease?

Researchers at the University of Florida designed a test based on the fact that the left side of the brain processes what we smell from the left nostril and the right side processes smells from the right nostril. The experiment involved elderly people and peanut butter. People in the control (non-Alzheimer’s group) were able to smell the peanut butter from 7 inches away through either nostril. Patients with Alzheimer’s could smell the peanut butter on the right side from 7 inches but could only detect in from 2 inches away on the left side. This was only seen in Alzheimer’s disease but NOT in other causes of dementia.


Under current health law, most health plans have to provide care that is recommended by the US Preventive Services Task Force—-without, you the patient, having any out of pocket costs! Apparently this includes SCREENING COLONOSCOPIES. This has usually meant GI fees, but now the government has also included ANESTHESIA fees. Unfortunately, patients are still on the hook for FACILITY FEES and  PATHOLOGY costs. (By the way, facility fees, anesthesia fees and path fees are usually 3-4 times higher than GI fees. Whenever possible always get tests and procedures done at a non-hospital owned facility) Of course this isn’t fair, but the hospitals have a stronger lobby than you do!

So, if you are getting a screening colonoscopy, check your bill and call your insurance company. You might just save your life and some $$$$$.



American Roentgen Ray Society (ARRS) 2015 Annual Meeting: Abstract 1226.

For years, we have used “cardiac calcium” scores to help predict and prevent heart disease. Our biggest obstacle has always been getting insurance companies to cover the test. (There a several radiology practices that will perform this for only $50- at one time it cost over $400).

Radiologists at the Mount Sinai School of Medicine in new York City have discovered that breast arterial calcium scoring done on routing digital screening mammograms were predictive of underlying coronary calcification in 69% of their patients! Even though the actual “calcium scores” were different they were able to correlate cardiac risk when comparing the mammogram to a standard CT scan of the chest.

Let’s hope that our local radiologists will incorporate this in their reports that are sent to the office.




Telomeres are portions of DNA located at the end of chromosomes that serve as protective buffers that prevent chromosomes from becoming attached to each other or rearranging. Every time a cell in the body replicates, it’s telomere gets shorter, eventually causing cell death. Measuring telomere length in the human lymphocytes is an indicator of cellular aging. Research has shown that shortened telomeres are responsible for many processes of aging.

Low telomere scores can alter health and accelerate the aging process. Telomere length can be improved by simple lifestyle changes like stopping smoking, getting regular exercise and maintaining a healthy weight. Nutritional deficiencies and oxidative stress can also contribute to low telomere scores.

If you would like to learn more about telomere testing, more information is available at

If you would like us to check your telomere status and screen for micronutrient deficiencies (a simple blood test drawn in our office), call us at 941-747-2090



There are new guidelines in screening and treating osteoporosis. It is recommended to screen all women over 65 and all men over 70 (of course, there are no codes for men, so insurance probably will not pay). Women who are 50 and are at risk for osteoporosis should also be screened. This would include women who smoke, use alcohol excessively, have rheumatoid arthritis or have a history of chronic or recurrent steroid use or have unexplained fractures. Not everyone with decreased bone mass (osteopenia) needs to be treated. If your bone density shows decreased bone mass, it has been suggested to be rechecked in 5 years. Women with normal bone density scans can wait 15 years before being tested again. The big question is what exactly does a bone density scan measure? It appears to have limitations as it does not tell us anything about BONE STRENGTH-which is what we try to achieve when treating. Even those taking medications may not show improvement although fracture risk is diminished! Supplements like calcium and vitamin D have no EFFECTS of bone integrity after menopause! (Supplements should only be used if you have a deficiency. Also, both Magnesium and vitamin K2 are necessary to drive calcium into the bones).

Another interesting finding is that only 40% of women with hip fractures ever regain 100% strength and function back.

And now, even the benefits of weight bearing exercise is being debated.

The only way I know of to build muscle and bone strength and be able to measure it is with the bioDENSITY machine we use in our office ( It is the only exercise program ever to be analyzed and accepted for publication in an osteoporosis journal. And the great thing about it is that it is safe, easy and only requires 5-10 minutes of your time/week.




One of the most complaints that I hear in the office involves sleep-either trouble falling asleep or staying asleep. There are many medical and psychological causes of insomnia but more and more, we are looking at micronutrient deficiencies as a cause of sleep disorders. In the past, one had to guess what supplement to take to help with sleep. The problem with this is that it involved guesswork and some vitamins and minerals might be contraindicated due to certain medications or diseases.

The most common nutritional causes of sleep disorders include deficiencies of:

Vitamin D







Many people who take medications for heartburn will be low in calcium and magnesium. The most common diabetes medication, Metformin commonly causes Vitamin B-12 deficiencies. Other diseases like kidney disease and inflammatory bowel disease are often associated with nutritional deficiencies.

Routine blood tests are inaccurate as they only measure nutrients in the bloodstream and not the cells of the body. This is why we check for FUNCTIONAL DEFICIENCIES in the lymphocytes (white blood cells). This gives us a 4-6 month snapshot of how your body actually uses vitamins, minerals and amino acids and lets us customize a repletion program that is scientific and not guesswork. It also allows us to make adjustments to prevent medical complications.




Methyl-TetraHydroFolate Reductase is an enzyme responsible for methylation of every cell in the body. Faulty methylation, which may occur in 70% of the population is responsible for nutritional deficiencies at the cellular level. This means, that although BLOOD LEVELS of vitamins and minerals (especially the B-vitamins) may be normal, your body may not be able to utilize them.

Normal methylation is responsible for:

Cellular repair

Detoxification and Neurotransmitter production

Healthy immune system function


Here are some conditions that may be associated with MTHFR gene mutations:


Addictions: smoking, drugs, alcohol

Down’s syndrome

Frequent miscarriages

Male & female infertility

Pulmonary embolism and other blood clots

Depression & anxiety


Bipolar disorder


Chronic Fatigue Syndrome

Chemical Sensitivity

Parkinson’s disease

Irritable Bowel Syndrome


Spina bifida



Breast cancer



Multiple Sclerosis

Myocardial Infarction (Heart Attack)

Methotrexate Toxicity

Nitrous Oxide Toxicity

Fortunately, testing for MTHFR deficiencies are easy and we now do this in the office, along with other micronutrient testing. And treatment is just as easy!


Diabetic autonomic neuropathy

Neurological side effects of diabetes are very common. Most people suffer from PERIFERAL NEUROPAHTY which may cause pain, numbness and burning in your feet. However, the AUTUNOMIC NERVOUS SYSTEM, which controls involuntary systems such as heartbeats, respiration, blood pressure and sweating can also be affected by diabetes. This complication is much more serious, and harder to diagnose and treat. We almost bought a computer that screened for this but NO insurance company would pay for it! It was a simple 15 minute test that we were going to do in the office.

There was a study in the United Kingdom presented at the annual meeting of the Diabetic Neuropathy  Study Group of the European Association for the Study of Diabetes that showed a connection between the corneal nerves and disorders of the autonomic nervous system by using corneal confocal microscopy . Since every diabetic should see their ophthalmologist yearly,  this may become a standard procedure along with retinal screening, and become a major tool in preventing deaths due to diabetes.

A simple and free test to predict hip fractures in women

American Society for Bone and Mineral Research (ASBMR)-2014

The inability to either squat down to reach the floor, stand on one foot for 10 seconds or weak grip strength have all  been associated with an increase fracture risk in women.

While bone-mineral-density tests and other measures provide essential information on when a patient may need  osteoporosis prevention, research on signs of physical deterioration that can predict hip fracture has been lacking. The researchers looked at 2700 women and compared those who could perform these maneuvers with those that could not and found that there was a significant increase in fractures, especially those who could not stand on 1 foot for 10 seconds.

The good news is that this can been dramatically improved with physical therapy/balance therapy which we offer in our office through our KAIZEN TOTAL WELLNESS programs.

Try the test at home, and if you need help, please let us know.

Harvey S. Mishner MD


Make Major Breakthrough In Depression Detection and Treatment

By Rachel Dinh & NoCamels Team July 01, 2014

Doubts about the effectiveness of antidepressants have been raised since they were invented, but now new research pinpoints why existing treatments don’t entirely work as they should.

According to the World Health Organization, mood disorders such as depression afflict about 10 percent of the global population. With so many people affected, the scientific community has invested much time and effort in understanding these diseases. Yet the molecular and cellular mechanisms that underlie these destructive ailments are still not fully understood.

While there are medications available to patients experiencing mood disorders, the existing anti-depressants are hardly sufficient: Some 60-70 percent of patients experience no relief from them. For the other 30-40 percent, that relief is often incomplete, and usually only comes after patients take the drugs for a prolonged period of time. In addition, there are many psychological and physical side effects associated with these drugs. New and more effective medications are clearly needed — an undertaking that requires, first and foremost, a better understanding of the processes and causes underlying the disorders.

Serotonin, colloquially known as the “happy chemical,” is a neurotransmitter that helps relay messages from one area of the brain to another. Many researchers believe that an imbalance in serotonin levels may be responsible for causing depression and other mood disorders.

In order to examine the veracity of this assertion, Weizmann Institute Prof. Alon Chen and Dr. Orna Issler researched the role of tiny molecules called microRNA molecules (molecules that regulate cellular activity) in the nerve cells that produce serotonin and made some surprising findings. They succeeded in identifying, for the first time, the unique “fingerprints” of a microRNA molecule that acts on the serotonin-producing cells. Through further experimentation, Chen and his team were able to find a connection between this particular microRNA (miR135) and two proteins that play a key role in serotonin production and the regulation of its activities. The findings recently appeared in “Neuron.”

The scientists noted that in the area of the brain containing the serotonin-producing nerve cells, miR135 levels increased when antidepressant compounds were introduced. Mice that were genetically engineered to produce higher-than-average amounts of the microRNA were more resistant to constant stress: They did not develop any of the behaviors normally associated with chronic stress, such as anxiety or depression. In contrast, mice that expressed low levels of miR135 exhibited more of these behaviors; in addition, their response to antidepressants was weaker.

Harnessing the influence of miR135 on depression

The conclusion of the findings is that the brain needs the proper miR135 levels – low enough to enable a healthy stress response and high enough to respond to serotonin-boosting medications to avoid depression and anxiety disorders. When this idea was further tested, the researchers found that people who suffered from depression had unusually low miR135 levels in their blood. Upon closer inspection, the scientists discovered that the three genes involved in producing miR135 are located in areas of the genome that are known to be associated with risk factors for bipolar mood disorders.

This discovery is especially promising for the future of mood disorder detection and treatment. Blood tests for mental illnesses were previously regarded as impossible. But following this discovery, blood tests for conditions like depression and bipolar disorder may be made available in the not-so-distant future.The researchers hope that the miR135 molecule can be used to serve as an indicator of the disease through simple blood tests. In addition, the molecule could serve as a target whose levels might be raised in patients suffering from these disorders. Yeda Research and Development Co. Ltd., the technology branch of the Weizmann Institute, has applied for a patent connected to this research and licensed the rights to miCure Therapeutics to develop a new diagnostic method and medication based on these findings.


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