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View Full Version : Installment 80 - Ask the Doctor with Dr. Jeffrey A Lee, NMD



Jeannine
06-02-2015, 11:51 AM
About Dr Jeffrey A Lee, NMD

Dr. Jeffrey A. Lee completed his Regenerative Medicine Stem Cell education in 2014 with Dr. Todd Malan, a pioneer in stem cell therapy. Previous to stem cell therapy Dr. Lee was educated in a variety of complimentary alternative medicine disciplines in addition to traditional medicine, interventional pain management and minor surgery. He has applied this training to develop an expertise in the diagnosis and treatment of complex musculoskeletal and neurological pain conditions. Dr. Lee has also worked with world renowned endocrinologist and adipose tissue disorder specialist at the University of Arizona, Dr. Karen Herbst to develop protocols for the treatment of Lipedema and Dercum’s Disease with Stem Cell Therapy. At the Center for Regenerative Cell Medicine Dr. Lee is involved with the IRB safety study for fat derived stem cell therapies. Dr. Lee recognizes the incredible benefits of stem cells for his patients whether due to acute injury or chronic disease. Dr. Lee’s goal is to provide personalized, high-quality care to his patients encompassing both traditional and alternative medicine to help them achieve their optimum health.

Jeffrey A. Lee, NMD
Medical Director
Center for Regenerative Cell Medicine
Phone:480-998-7999
Fax: 480-998-7999
Web: www.mystemcelltherapy.com

Questions & Answers

Q: Is it more effective to have stem cells injected directly into the heart for heart disease or by catheter into the pulmonary artery for lung disease? It seems far riskier than an IV. The cost also seems to be higher when this is done.
A: Data collected from clinic trials has shown direct injection of stem cell into the heart for heart disease yields better results when compare to intravenous infusion alone. Intravenous infusion can be helpful and less expensive. Specialized equipment and training is necessary for the direct injection process. This would also imply a greater expense for the therapy and greater inherent risks. Nebulization and intravenous infusion of stem cells is still the preferred method of delivery for lung related diseases.

Q: I use Symbicort and take Prednisone for my COPD. I am hoping to stop using these steroids. Can they have a negative effect on stem cell treatment? If the answer is yes, how far in advance of stem cell treatment is advisable to try to discontinue use of Prednisone? What if my doctor doesn't want me to discontinue it?
A: In vitro and animal in vivo studies demonstrate that corticosteroids similar to prednisone and contained in Symbicort reduce the regenerative and immunomodulary effects of stem cells. If possible, I recommend that under the direction of their prescribing physician that patients systematically reduce their dose and discontinue the medication. A patient should be off of the corticosteroids for a minimum of two weeks before receiving stem cell therapy. Because some patients rely on these medications to breath, discontinuance, even temporarily, may not be possible. In such cases, the patient should work with their prescribing physician to achieve the lowest effective dose before attempting stem cell therapy.

Q: Can I bank my adipose stem cells for future treatments or does the liposuction procedure have to be performed each time I decide to get treated? I find the procedure uncomfortable to say the least. It would be far easier to be able to just call up and make a withdrawal from my "stem cell account" to get subsequent treatments.
A: Within the United States it is necessary for the liposuction and therapy of autologous adipose-derived stem cells to occur on the same day. Currently the use of cryopreserved autologous adipose-derived adult stem cells is not permitted in the United States. An exception to this would be the participation in a IND/clinic trial with cryopreservation built into the study, but I am unaware of this type of study within the United States.
The ability to “make a withdrawal from (your) ‘stem cell account’” is very appealing. Receiving stem cell therapy when the body is not healing from a liposuction procedure could theoretically produce better results. However, the downside to cryopreservation is loss of viability of the stem cells due to the freezing process.

Q: Do you treat rheumatoid arthritis? If so, how and with what results? Are repeated treatments needed?
A: Yes, we treat rheumatoid arthritis (RA). This is an autoimmune disorder, which causes chronic inflammation that typically affects the small joints of the hands and feet. RA patients receive their autologous adipose-derived stem cells through intravenous infusion and sometimes directly into individual joints. The stem cells can calm the damaging immune response, decrease inflammation, decrease tenderness and help improve function of the affected joints. The results of the therapy vary depending on the severity of the degeneration, lifestyle and other factors. Some patients return after several months to repeat the procedure to build on the success of their first treatment.

Q: Gordie Howe, famed hockey player, had stem cell treatment in Mexico after suffering a stroke. He got almost immediate results. Some members of the scientific community were up in arms claiming it was the placebo effect, risky, a natural recovery that would have occurred anyway, completely anecdotal, etc. What are your thoughts on this and the treatment of stroke with one's own stem cells?
A: Stem cells accelerate the healing processes in the body on multiple levels. They can replace damaged cells, increase circulation and oxygenation to damaged tissues and reduce inflammation. Typically the first two processes require many weeks to occur, but the anti-inflammatory effects can happen relatively quickly. All diseases and injuries involve inflammation in one form or another. When a patient experiences a relatively quick improvement it is usually due to the reduction of inflammation. In the case of Gordie Howe, it is possible that his body would have achieved the same result over time. However, knowing anti-inflammatory and regenerative effects of stem cells his recovery was most like accelerated because of the therapy.

Q: What do you see as the biggest challenge facing physicians in the U.S. who are administering adult stem cell therapies? There seems to be an ever present discussion on regulatory guidelines as to what kind of treatments can actually be done legally in the U.S. Japan, on the other hand, seems to have a vision for stem cell research and clinical use that has brought the country together to help patients. As a doctor, are you making your voice heard in Washington for regulatory change or are you satisfied with the status quo?
A: The biggest challenge is the approval of autologous adipose-derived stem cell therapy as a viable treatment option for multiple medical conditions. In the United States approval is attained through well designed studies demonstrating safety and better outcomes compared to placebo. We, like many other clinics, are participating in FDA approved IRBs to help prove safety and eventually efficacy. I am not fond of the “status quo” or the time required to achieve approval, but currently it is necessary for it be done correctly.

Q: I am skinny as a rail. How do you get fat out of someone with no fat? Does age matter as well? Is any part of the treatment at your clinic covered by insurance?
A: Patients with less body fat can present as a challenge when harvesting their adipose (fat) tissue. For most people, increasing their daily caloric intake and reducing their activity or the amount of calories they burn in a day will allow them to increase their weight. Consuming “healthier fats,” like those found in avocados, walnuts, almonds, organic nut butters, flax seed oil and wild caught salmon can help. I do not recommend trying to increase your weight by consuming ice cream and other sweets because the pro-inflammatory effects they have on the body.
For a subset of patients their disease, genetics or metabolism make it difficult for them to gain weight. In these cases other strategies, such as an appetite stimulant, may be warranted. Other individualized approaches may also be necessary. Ultimately, the desire is to harvest a sufficient quantity of adipose tissue to achieve the highest stem cell count, but minimize the trauma and inflammation created through the harvesting process.
For the purposes of harvesting adipose tissue for stem cell therapy a BMI between 22-27 kg/m2 is ideal. A BMI greater than 30 kg/m2 is not healthy for anyone or any condition.
Studies have shown that the quantity of stem cells derived from adipose tissue do not appear to decrease with age. However, the amount of degeneration or damage caused by a disease process can potentially effect the outcome of the stem cell therapy. In general, it is better to treat a condition in the earlier stages as opposed to the later stages.
As for insurance, so far they may cover pre-operative labs.

Q: How is it that some patients with COPD seem to get a lot of improvement and some don't feel much of anything? Is it due to the type of emphysema that patients have or what might this be attributed to? Will stem cell therapy help with the scarring that was caused by several bouts of pneumonia?
A: Typically most of our patients will experience an improvement, but the degree of improvement can vary from patient to patient. We do not fully understand why some patients have better outcomes than others. Some contributing factors include the severity of the disease/degeneration, genetics, medications, lifestyle and habits. Stem cells can help with the scarring caused by pneumonia, but it is important to prevent future lung infections by building your lung constitution or vital force. Homeopathy, botanical medicine, constitutional hydrotherapy and acupuncture can be beneficial.

Q: When you treat neurological cases, how do you infuse the cells to get them through the blood-brain barrier?
A: A small percentage of the stem cells will naturally cross the blood-brain barrier. We can increase that percentage by infusing a dose of mannitol, which temporarily increases the permeability of the blood-brain barrier, prior to the administration of the stem cells.

Q: What role do cytokines play in the inflammation process and is there some way to suppress them?
A: It is important to minimize inflammation in the body. We need a little inflammation to promote certain processes and healing pathways in the body. Too much inflammation causes pain, degeneration, advanced aging and acceleration of disease processes.
Cytokines are small secreted proteins released by cells that have a specific effect on the interactions and communications between cells. There are both pro-inflammatory cytokines and anti-inflammatory cytokines. Cytokines are made by many cell populations, but the predominant producers are helper T cells and macrophages. Pro-inflammatory cytokines are produced predominantly by activated macrophages and are involved in the up-regulation of inflammatory reactions. Some of the pro-inflammatory cytokines include IL-1, IL-6, IL-8, TNF-alpha and IFN-gamma. Some of the anti-inflammatory cytokines include IL-4, IL-10, IL-11, IL-13.
IL-10 has potent anti-inflammatory properties, repressing the expression of inflammatory cytokines such as IL-1, IL-6 and TNF-alpha. In addition, IL-10 can up-regulate endogenous anti-cytokines and down-regulate pro-inflammatory cytokine receptors. Thus, it can counter-regulate production and function of pro-inflammatory cytokines at multiple levels. Stem cells inhibit the release of pro-inflammatory cytokines and have potent immunomodulary properties. Adipose (fat) tissue that is harvested for stem cell therapy contains high concentrations of endothelial progenitor cells and T regulatory cells that express up to 100-fold higher levels of cytokine IL-10.
Certain supplements can help reduce the presence of pro-inflammatory cytokines and/or generalized inflammation. These include bromelain, omega 3 EFAs, ginger, curcumin, boswellia, polyphenols, flavonoids, cat’s claw and devil’s claw.