Other articles by Andrew Weil:

Ask Dr. Weil : Nail-biting 'cure' is unproven; try hypnotherapy Ask Dr. Weil : Forget lymph drainage unless nodes were removed Ask Dr. Weil : Overspending is unnecessary to get antioxidants Ask Dr. Weil : Don't avoid leafy greens because of oxalic acid effect Ask Dr. Weil : Don't refuse medication for infants with latent TB Ask Dr. Weil : A teaspoon of honey at bedtime can ease kids' coughs Ask Dr. Weil : Don't take DCA until research tells more about its effect Ask Dr. Weil : Low bone density, previous fractures are risk predictors Ask Dr. Weil : Normal responses sometimes diagnosed as depression Ask Dr. Weil : Keep cats out of the garden to ensure healthy produce

Health Care
BENSON HOSPITAL
RESPIRATORY THERAPIST Sales and Marketing
Ever-Ready Glass
Glass Sales Health Care
RLM Services, Inc.
Orthopedic Assistant-CMA

Q I have chronic hyperventilation syndrome, which I find most distressing. Have you come across this condition? And, apart from Buteyko Breathing Therapy, what help might I seek?

A Hyperventilation is rapid or deep breathing, usually associated with anxiety or panic. When you breathe, you inhale oxygen and exhale carbon dioxide. Rapid breathing, or "over-breathing," may lower the levels of carbon dioxide in your blood so much that blood chemistry is affected, leading to abnormal neuromuscular function. This is the cause of symptoms you develop if you hyperventilate: chest pains, palpitations, dizziness, numbness or tingling, especially in the extremities and around the mouth. Muscles of the hands and forearms may cramp.

Most episodes of hyperventilation are brief, with no lasting effects. Chronic hyperventilation syndrome is different. Although it stems from over-breathing, this usually isn't readily apparent to doctors or patients. Typically, however, patients sigh or yawn while otherwise seeming to breathe normally. They tend to focus on other physical symptoms — chest pain, feeling dizzy or faint, palpitations, digestive complaints, weakness, irritability and sleep disturbance, among many others. Many suffer from obsessive-compulsive disorders, report sexual and marital problems and have a hard time dealing with stress. What's more, their symptoms mimic those of serious medical disorders, which can lead to a lot of unnecessary medical tests and procedures before the real cause of the problem is found.

Patients diagnosed with chronic hyperventilation syndrome who have the best outcomes are those referred by their physicians for breathing retraining and those who learn to better manage stress. You mention Buteyko Breathing Therapy (BBT), developed by a Russian, Konstantin Buteyko, who linked hyperventilation to asthma and developed a technique to address it. BBT became known in the United States and Europe after it was introduced into Australia in the 1990s. BBT hasn't yet been well-studied — I saw only 18 citations in a search of the medical literature, with inconsistent findings. But I would say it's worth trying.

Another option is the RESPeRATE device, which is approved by the Food and Drug Administration for over-the-counter sale. This device is used to help patients lower their blood pressure by pacing their breathing. I haven't seen any evidence suggesting that it can be helpful for chronic hyperventilation syndrome, but, again, I would give it a try. I would also urge you to listen to my audio program "Breathing: The Master Key to Self-Healing" and to practice the 4-7-8 Relaxation Breath that I teach (more information on my Web site: www.drweil.com). Both have helped people with severe panic disorder, generalized anxiety and many other problems.

Q What are the benefits of vanadium, which is included in your daily vitamin/mineral supplement? I've read about potential toxicity, even at low doses, and also that high blood levels of vanadium are noted in people who have manic episodes or suffer from depression. Should I avoid taking this as a supplement, as I already suffer from mild depression?

A Vanadium is a micronutrient found naturally in mushrooms, shellfish, black pepper, parsley, dill, grain and grain products. It exists as both vanadyl sulfate, the form most commonly used in supplements, and vanadate. We're not sure exactly how much vanadium the body needs; the typical diet provides less than 30 micrograms daily. In the past, vanadium was promoted as a cure for various illnesses at doses ranging from 15 to 100 mg of vanadyl sulfate daily — that's 1,000 times the dietary dose. But no scientific evidence supports the use of these large amounts, which may be toxic. The small amounts contained in most multivitamin/ mineral products — 10 micrograms in my formula — are too low to raise concern about toxicity.

A few small studies have indicated that higher doses of vanadium can improve insulin sensitivity and reduce blood sugar in people with diabetes; however, the dosage and long-term safety of this strategy has not been established.

Some animal studies have suggested that vanadyl sulfate may help lower blood pressure, but no human studies have been done. Unless a benefit is proved, I see no reason to take vanadium for this purpose. Nor is there any evidence demonstrating that vanadium can improve athletic performance and increase muscle mass, even though vanadium supplements are widely used for these reasons.

As far as manic depression (bipolar disorder) is concerned, some evidence suggests that blood levels of vanadium may be elevated during manic episodes and also high during depression, particularly when it is accompanied by delusional thoughts or other symptoms of psychosis. I've seen recommendations that a low-vanadium diet may be helpful for those with bipolar disorder, but considering that the body absorbs only about 5 percent of the vanadium in the food we consume, I'm not sure how you could get intake any lower. In any event, I'm not convinced that there's a connection between vanadium and mental disturbance. Even if there were, I do not think the small amounts of vanadium in multivitamin/mineral supplements are an issue for those with mild depression.