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Q: I have been checking VEGF levels as a marker associated with infection (vascular inflammation) on the suggestion of a rheumatologist I respect very much. Some people's VEGF results come back quite high, which can be a marker for cancer as well (angiogenesis). What would people do with such a result, assuming no gross reason to suspect cancer?

Robert J. Hedaya MD, FAPA
Hedaya Clinic and National Center for Whole Psychiatry, Chevy Chase, Maryland Clinical Professor of Psychiatry, Georgetown University School of Medicine http://wholepsych.com

A1: This can represent a "pre-cancerous" state due to excessive tissue estrogen effects and a lack of sufficient inflammation to allow the body to alert itself to excessive growth and insufficient anti-growth activity. Usually this is due to chronically elevated cortisol from chronic stress states with excessive anti-inflammatory activity. In light of the recent large scale studies showing increased mortality for high doses of Vitamin E, it's important not to routinely recommend that all patients be on large doses of anti-inflammatory supplements, although many people will indeed benefit from them.

I use the biology of functions lab tests developed by Drs. Durrafur and La Praz (MD's) of France. It's a very precise algorithmic analysis of physiologic activity based on the endocrinologic effects on common indices such as neutrophils, leukocytes, alk phos, TSH, osteocalcin, etc. It looks not at endocrine levels from a quantitative level, but from the qualitative aspect of how hormones interact with each other at the cellular and sub-cellular level. I think all of us have had patients with normal thyroid function tests but had sub-clinical hypothyroidism, or polycystic ovarian disease with normal levels of estrogen and testosterone, but an abnormal ratio of one to the other.

The biology of functions really helps the practitioner understand precisely what their patient's total neuro-endocrine state is and how to best address it because it is looking at functionality, and not merely serum levels of hormones.

There are currently two clinics with MD practitioners of the endobiogenic system of medicine in the US. Myself, and Dr. Jean Bokelman in Idaho. You can learn more about the biology of function lab tests at (http://www.endobiogenics.com/liste_services.asp and choose the demonstration option on the right). You can contact Dr. Bokelman at http://www.eimcenter.com/ or, 877-470-8400.

I'm in the process of relocating my clinic.

Sincerely,
Kamyar M. Hedayat, MD

A2: Usually inflammation is an immune response to a non-self antigen. In humans this is normally fungus or some other opportunistic infection that seeks out an aging,putrefying,poorly oxygenated body. What seems to reverse that ecology is comprehensive hormone replacement,getting grains and sugar out of the diet,and incorporating produce that is high in the polyphenols that reduce microbe counts. Some of the supplements other members will undoubtedly recommend for inflammation have anti fungal properties also,but the primary goal is to put your body back in self-regulating mode.
Dr Roby Mitchell

A3: Don't forget to ask if the person has had an operation or injury recently, in which case VEGF will be raised. The larger the 'cut' of the surgeon's knife, the more VEGF will be produced to heal. Patrick Kingsley, MD.

A4: How does one check VEGF levels?

Thanks,

Douglas Hopper MD