Consensus Builds on High-Dose Vitamin D for Breast Cancer Prevention
By Janet Gulland / Contributing Writer - Vol. 11, No. 4. Winter, 2010


NEW YORK ⎯ The role of vitamin D in cancer care was the subject of considerable attention at the recent Society for Integrative Oncology 7th annual assembly. Researchers and clinicians gathered at the meeting seemed to be moving toward a consensus that high-dose vitamin D supplementation has potential to markedly reduce risk of primary breast cancer as well as breast cancer recurrence, with minimal risk of toxicity.
Data presented at the meeting--held just two weeks before the Institute of Medicine’s Nov. 30 consensus statement dismissing the potential of vitamin D beyond bone health—indicate that women with serum levels under 20 ng/ml are at significantly increased risk of breast cancer, that raising levels to 50 ng/ml mitigates that risk, and that oral doses upwards of 10,000 IU/day are safe for women at risk of breast cancer.
While there are still many unanswered questions about the role of vitamin D in cancer prevention and treatment, speakers at the conference were largely in agreement that the standard Recommended Daily Allowance of 400 IU/day is grossly inadequate and has little scientific basis. The Institute of Medicine’s new recommendation of 600 IU for adults—including post-menopausal women won’t likely change anything.
A 40% Risk Reduction
Some of the strongest recent data comes from the Long Island Breast Cancer Study Project, which involved 1,026 women with breast cancer diagnosed between 1996 and 1997 compared with 1,075 matched controls. Vitamin D deficiency, defined as a serum level under 20 ng/ml, was common in both groups, but more prevalent among the women with cancer, reported Katherine Crew, MD, an epidemiologist at Columbia University College of Physicians & Surgeons, and lead investigator on the study. Thirty-three percent of the cancer cohort was frankly deficient versus 28% of the cancer-free controls. But the real message is in the analysis of odds ratios. The women who had blood levels of 40 ng/ml or greater had 40% lower odds of breast cancer versus those with serum levels of 20 ng/ml or lower. There was even a small 16% odds reduction among the women with serum levels of 20-29 ng/ml, which is low but not technically deficient. Dr. Crew noted that the data were adjusted for age, race, parity, family history of breast cancer, and other key variables (Crew KD, et al. Cancer Prev Res. 2009; 2(6): 598-604)“Higher levels of 25-hydroxy-vitamin D confer lower risk of breast cancer. This was consistent for both estrogen receptor-positive (ER+) and negative (ER-) breast cancer, which is important because we really don’t have effective chemotherapy for ER- breast cancer,” Dr. Crew told attendees.
The study turned up several other interesting findings, including the fact that vitamin D deficiency correlates with obesity, which also increases cancer risk. The researchers found deficiencies in 36% of the women with body mass indices over 30, but only 23% of those with BMI’s under 25. The explanation is not yet clear, but Dr. Crew suggested that there may be a fat sequestration effect wherein vitamin D is being stored in adipose tissue, thus lowering serum levels in the obese women.
Sense in Supplementation
The Long Island data are compelling, but Dr. Crew urged caution in drawing definitive conclusions. “These are observational findings based on one measurement of serum vitamin D status; we don’t know from this study if raising the vitamin D level would lower breast cancer risk, and even if it does, we don’t know the best and safest method for doing this.” Other studies, however, are pointing the way toward clear risk reduction strategies. For example, the Women’s Health Initiative’s 2007 report, while showing no significant risk reduction from vitamin D at the standard 400 IU/d dose, did show a 20% reduction in breast cancer incidence among the women who reported taking additional vitamin D, on their own, beyond the “official” 400 IU dose. The biggest incidence reduction was for ER- cancers. Dr. Crew said the findings are definitely significant though they have been largely overlooked. Also in 2007, Lappe and colleagues published a study of 1,179 post-menopausal women showing that those taking 1,100 IU/d of vitamin D plus calcium (1,500 mg/d) had far lower incidence of breast cancer versus those taking placebos (2% versus 6.8%). A third subgroup, taking calcium alone, also had fewer breast cancers but the incidence reduction was not as great (3.6% versus 6.8%) (Lappe et al. Am J Clin Nutr. 2007; 85(6):1586-91). Looking at the best available data, it seems that breast cancer odds ratios begin to drop significantly as serum vitamin D levels get over 50 ng/ml. According to Garland and colleagues, you see a 50% risk reduction right around a serum level of 52 ng/ml (Garland et al. J Steroid Biochem Mol Biol. 2007; 103(3-5): 708-11). Progressive, nutrition-oriented oncologists agree that 40-60 ng/ml is the target range.
How Much?
So, how much vitamin D does a woman have to take to get up to the cancer-prevention range? At least 3,000-4,000 units per day, depending on the extent of the deficiency. This is almost an order of magnitude higher than the Institute of Medicine’s new RDA of 600 IU, but within range of the new Upper Limit. What about toxicity? The most worrisome potential adverse effects of excessive vitamin D would be hypercalcemia, bone demineralization, nephrocalcinosis, and cardiac arrhythmias. However, these problems don’t really arise until serum levels get above 150 ng/ml, said Dr. Crew. Someone would have to take a lot of vitamin D over a long period to get the blood level up in that range. Back in 2004, Vieth and colleagues studied daily doses of 10,000 IU for up to 5 months, and found no evidence of toxicity (Vieth et al. J Steroid Biochem Mol Biol. 2004; 89-90(1-5): 575-9).
Safe at 30,000 IU per Week
Dr. Crew’s group at Columbia is assessing the effect of cholecalciferol (vitamin D3) at high doses of 20,000 IU and 30,000 IU per week, in vitamin D deficient pre- and post-menopausal women at high breast cancer risk. The women will be treated for a full year. Breast-specific outcome measures include tissue changes on biopsy, imaging of breast fibrodensity, as well as urine and serum markers. If looked at in terms of daily doses, these weekly dose levels—roughly 2,800 IU and 4,300 IU per day---are considerably higher than the IOM’s new recommendation of 600 IU per day. However, Dr. Crew said in an interview with Holistic Primary Care that they do fall close to the IOM’s new safe upper limits for women in this age bracket. According to Julie Campbell, a research fellow who presented preliminary findings at the SIO conference, the study will ultimately involve 80 women in total. So far, 20 pre-menopausal and 14 post-menopausal women have completed the trial, with no evidence of any adverse effects at either dose level. “There have been no cases of hypercalcemia so far, and only one woman has show high urine calcium levels,” said Ms. Campbell. She pointed out that that high-dose supplementation leads to rapid correction of deficiencies. Among the pre-menopausal women, mean levels were up in the 50-60 ng/ml range within 3 months, with the 30,000 IU weekly dose giving larger rises than the 20,000 IU weekly dose. It is important to note that even at these high doses, none of the subjects got up into the potentially toxic 150 ng/ml serum range. The study is ongoing, and investigators have not yet completed analysis of vitamin D’s effects on breast tissue. However, the available data indicate that two of the 20 pre-menopausal women receiving 30,000 IU per week had a 15% reduction in fibrodensity, a surrogate marker for cancer risk. “These are pilot data but they are compelling,” Ms. Campbell said. “High dose vitamin D supplementation can successfully raise serum levels to target range within a year, without significant toxicity. Based on imaging and biomarkers, there are possible preventive effects.” Though the IOM report seems to dismiss the potential anti-cancer benefits of vitamin D supplementation, while raising a specter of alarm based on little evidence of actual toxicity incidence, the Columbia experience suggests little downside to supplementing in the range of 10,000-30,000 IU per week. The only major caveat being that one needs to watch calcium closely. Raising the serum vitamin D level will tend to increase calcium absorption, so if a patient is taking a lot of calcium the vitamin D boost could potentially increase risk of kidney stones. The role of vitamin D in primary breast cancer prevention should become more clear on publication of a new Phase IIB intervention trial by the Southwest Oncology Group. The study involves 200 high-risk women randomized to placebo or 20,000 IU per week and followed for a year.
Improving Survival, Preventing Recurrence
There’s growing evidence that serum vitamin D level is inversely correlated with risk of recurrence in women who’ve already had breast cancer. Researchers in Toronto studied 512 women diagnosed with early-stage breast cancer from 1989-1996, and followed them for an average of nearly 12 years. The women had a mean vitamin D level of 23 ng/ml at baseline, with 37.5% in frank deficiency (<20 href="http://www.ncbi.nlm.nih.gov/pubmed/19451439">Goodwin et al. J Clin Oncol. 2009; 27(23):3757-63

Dr. Crew said her team saw a similar effect in the Long Island study, with a near doubling in the adjusted hazard ratio of death within 8 years among the vitamin D deficient women compared with those who had blood levels over 30 ng/ml. Interestingly, women in northern latitudes diagnosed with breast cancer in the Summer or Fall have statistically better survival rates compared with those diagnosed in the Winter or Spring. Further, breast cancer has a 25% higher mortality rate in the Northeastern US compared with the Southwest. While there are many potentially confounding variables in epidemiological findings like this, Dr. Crew said there could very well be a vitamin D effect in play. The Sunshine Vitamin is clearly a subject of great interest to cancer researchers these days, and future studies should help clarify optimal treatment strategies. The new IOM report states that for the general population there’s no strong evidence for pushing supplementation beyond the 600 IU range, a conclusion that many are questioning. For women at-risk of breast cancer, the available data suggest a conclusion that runs counter to the IOM’s recommendations. It makes good sense to test vitamin D levels in all at-risk women, and to do whatever is possible to get serum levels into the 40-60 ng/ml range.

A conflict of interest

Vitamin D Report Prompts Conflict of Interest Suspicion

By August West / Contributing Writer

The Institute of Medicine’s Nov. 30 consensus statement claiming most Americans do not need supplemental vitamin D, and that the vitamin has few benefits beyond bone health, has some folks wondering if committee members had preexisting biases or vested interests against supplementation.
It turns out that at least two members of the committee hold patents on synthetic vitamin D analogs used as prescription drugs, or have significant relationships with companies involved in vitamin D drug development.
Glenville Jones, PhD, Head of Biochemistry at Queen’s University, Kingston, ON, and an outspoken member of IOM’s Vitamin D & Calcium review committee, is on the scientific advisory board of Cytochroma, a Canadian specialty pharma company dedicated to “Promoting Health Through Vitamin D Therapeutics."
The company is developing three synthetic vitamin D analogs as prescription drugs initially for the treatment of vitamin D insufficiency and hyperparathyroidism associated with chronic kidney disease. Dr. Jones is named among the “inventors” on several of Cytochroma’s patents.
Cytochroma posted the following in a recent press release: “Cytochroma’s clinical and non-clinical teams continue to achieve important research advances that validate our focus on vitamin D, CYP24 and secondary hyperparathyroidism,” stated P. Martin Petkovich, Chief Scientific Officer. “With existing vitamin D treatments limited by mediocre efficacy and dose-limiting side effects, our therapeutic approach of using vitamin D, yet mitigating the impact of CYP24, may result in superior treatment of secondary hyperparathyroidism in chronic kidney disease patients.”

The company presented three studies of its vitamin D receptor modulating drugs at the recent annual meeting of the American Society of Nephrology.
"Tech Transfers"= Big Dollars

Another member of IOM’s vitamin D review team, Dr. Hector DeLuca, Professor of Biochemistry at the University of Wisconsin, Madison, holds a large number of patents on synthetic vitamin D analogs.
Dr. DeLuca is one of the most respected vitamin D researchers in the country. In the 1960s, he and his colleagues were first to recognize that vitamin D itself has no biological activity, but must be transformed sequentially in the liver and kidneys into bioactive forms. His work also led to discovery of vitamin D receptors in many tissues not previously thought to be targets for this vitamin.
The website for Dr. DeLuca’s lab indicates that his research team is expending, “considerable effort dedicated to collaboration with the medical world for the application of the newly synthesized analogs of the vitamin D compounds and of vitamin A compounds for the treatment of disease. The most recent application has been to prevent and arrest such autoimmune diseases as multiple sclerosis and rheumatoid arthritis, and as an anti-transplant rejection drug.”
Among the “technology transfers” from Dr. DeLuca’s lab to the pharma sector was a vitamin D analog called paricalcitol, licensed to Abbott and marketed under the brand name, Zemplar, for vitamin D deficiency and parathyroidism in patients with renal failure.
In a 2004 interview with Wisconsin Technology Network (WTN News), Dr. DeLuca estimated that revenue from vitamin D analog patents he licensed to the University of Wisconsin Alumni Research Foundation, are largely responsible for funding construction of UW-Madison’s $35.6 million biochemistry center.
In addition to his position in academia, Dr. DeLuca is president and CEO of Deltanoid Pharmaceuticals, a company developing drugs based on vitamin D analogs for treatment of a host of disorders including osteoporosis, renal diseases, psoriasis, autoimmune diseases and cancer.
Deltanoid has raised significant venture capital, and according to the company’s website, has “two active partnership agreements in place with QuatRx Pharmaceuticals (topical treatment for psoriasis) and Primus Pharmaceutical (non-FDA approved medical foods for bone health).” According to WTN News, Deltanoid was involved in a deal several years ago allowing drug giant, Pfizer, to license, develop and commercialize certain of its vitamin D analogs.
Suppressed Dissent?

The potential for conflicts of interest among IOM committee members was initially red-flagged in a joint effort by Dr. John J Cannell and the Vitamin D Council, and the Alliance for Natural Health.

These organizations also contend that the IOM committee solicited but then suppressed commentary on the new vitamin D and calcium recommendations from 14 nationally recognized nutrition experts, including Prof. Robert Heaney at Creighton University, and Dr. Walter Willett at Harvard. The Vitamin D Council and the ANH are calling on the IOM to release these 14 comments under the Freedom of Information Act.

The fact that some committee members have direct ties to drug companies is not proof of bias, nor does it completely invalidate the IOM’s report. In fairness to Drs. Jones and DeLuca, and the IOM committee, neither the Vitamin D Council nor the ANH could be considered disinterested and unbiased observers of the vitamin D issue.

Still, these groups are raising legitimate concerns about conflicts of interest and omission of potentially important, possibly dissenting opinions.

The IOM is an independent not-for-profit institution, a division of the National Academy of Sciences. IOM prides itself on objective, non-biased, evidence-based evaluations of key health care issues. Though it is technically “non-governmental,” it’s positions and recommendations strongly influence federal health policy and regulatory standards. Consequently, it is essential for the Institute to provide clear disclosure of industry influences, vested interests or other sources of bias, and to release all information relevant to any of it’s consensus statements.

To voice your views about the IOM vitamin D report and potential conflicts of interest, contact contact study director Christine Taylor ( cltaylor@nas.edu ) or the committee chairwoman, A. Catharine Ross ( acr6@psu.edu ).

Tamiflu does not work

I have rarely recommended Tamiflu for influenza due to the cost, side effects and lack of clinical efficacy. The data is in.... it doesn't work. For me and my patients, I have recommended Vitamin D3, 1000 I.U. per pound of body weigh, once a day for 3 days. This works, is inexpensive, safe and free of side effects.

Here is the latest news regarding Tamiflu, released in The AMA daily web cast.

Researchers find little evidence Tamiflu reduces flu complications in otherwise healthy people.
The AP (12/9, Cheng) reports, "British researchers say there is little evidence Tamiflu [oseltamivir] stops complications in healthy people who catch the flu, though public health officials contend the swine flu drug reduces flu hospitalizations and deaths." In a review of "previously published papers on Tamiflu as used for seasonal flu," researchers "found insufficient data to prove whether the antiviral reduces complications...but concluded the drug shortens flu symptoms by about a day."
The review, appearing online in BMJ, notes that researchers were "unable to conclude that the drug is effective at reducing complications...because they do not have access to key data from eight clinical trials sponsored by the drug's manufacturer, Roche Laboratories Inc.," the Los Angeles Times (12/8, Maugh) "Booster Shots" blog reported. For its part, Roche "said that the data...simply duplicated the results from published trials and did not provide enough information to justify publication."
Bloomberg News (12/9, Cortez) reports that the finding challenges results from a previous study in which researchers concluded "that Tamiflu protects against complications." In an accompanying editorial, BMJ editor in chief Fiona Godlee noted that "the studies originally used to establish the benefits of Tamiflu were written by Roche employees and paid consultants," which "raises questions about how drugs are reviewed, approved, and distributed."
Godlee stated, "Governments around the world have spent billions of dollars on a drug that the scientific community now finds itself unable to judge," HealthDay (12/8, Preidt) reported. Study author Chris Del Marr, a professor at Bond University in Australia, wrote that "governments should establish studies to monitor the safety of Tamiflu" as "previous evidence about" its "effects on flu complications may be unreliable."
But, on its website, CBS News (12/8) reported that the World Health Organization "said data from countries around the world show that when given early, Tamiflu can reduce the severity of swine flu symptoms, though the agency recommends the drug be saved for people at risk of complications." Meanwhile, Godlee called for "new global legislation to ensure...'ready access to the raw data behind any analyses used to license and market a drug.'"
MedPage Today (12/8, Smith) reported that the editorial also "raised a series of issues...including who had access to data from Roche-funded trials, whether ghost writers were used to prepare journal manuscripts, and why some authors were not listed while -- in at least one case -- an author was cited who later said he can't recall performing the study."
From the AMA

A serendipitous moment

This a a wonderful article form Dr. Carl Hammerschlag,


http://www.healingdoc.com/



He is an insightful, kind, caring compassionate in intelligent physician
who regularly posts a blog. I encourage you to look at his site.


The great violinist Joshua Bell, a one-time child prodigy, and now an internationally acclaimed virtuoso, agreed to give a recital in a Washington DC subway station during the morning rush hour. The proviso was that nobody would know about his appearance before-hand; he would be completely incognito.

Bell was 39 years old, tall and mop-haired, and showed up as pretty much every other non-descript street musician in jeans, long-sleeved T-shirt, and a Washington Nationals baseball cap. He removed his violin from the case and left it open at his feet, seeding it with a few dollars and change. He stood next to a trashcan, under an arcade at the L'Enfant Plaza Metro station (the heart of federal bureaucracy), and faced his audience.

Over the next 43 minutes, he proceeded to play six classical compositions that are among the most difficult and evocative violin pieces ever written. During that time, 1,097 people passed by; how many stopped what they were doing to hang around longer
than one minute? Seven people. Twenty-seven people gave him some money, which totaled $32.17, most of them dropping it on the run. 1,090 people passed by without even turning to look. This boggles my mind, but it doesn't really surprise me.

We are so focused on multitasking that every activity from walking to exercising or reading is accompanied by watching TV, listening to music, cell phone conversations or instant messaging. We are so inundated with stimulation that it's hard to be in any moment or respond to anything spontaneous. In the case of Joshua Bell, there is also the preconception that no great violinist/musician/thespian is going to be playing the subway circuit. Finally there is a general contemporary attitude of mind your own business and don't get involved. So instead of finding yourself by some stroke of magic in the right place at the right time, you can't recognize it because you are someplace else.

It is said the Messiah will arrive at the gates of Jerusalem dressed like a beggar and that he will not be recognized because no one will stop to listen. Unless we step away from all our ordinary preoccupations, we will never appreciate the magic of the serendipitous moment when something awesome is made visible.

Take a break from what you think you have to do, and you may find that the best seat in the house is only four feet away.

It could change your life.

H1N1 vaccine?

CDC plans early roll out of H1N1 vaccine.

ABC World News (8/25, story 3, 2:05, Gibson) reported, "A presidential panel of scientists is projecting that as schools open, the number of infections could grow by tenfold every couple of weeks. In order to stem a rapid spread of the virus, the government is considering a radical move. Distributing a vaccine, even if testing on the vaccine is not yet complete."

HHS Secretary Kathleen Sebelius explained that H1N1 "is scarier than some issues we've seen before, is that no one has a built-in immunity to this virus." She said, "We think it's wise to get some vaccine ready to go as quickly as you possibly can. That probably outweighs the waiting to gather all the evidence." ABC noted that "early test results have been encouraging," with Dr. Frank DeStefano of the CDC's Immunization Safety Office saying, "The risk from the vaccine itself, right now, from what we can tell this should be a very safe vaccine."

In a following story, ABC World News (8/25, story 4, 1:35, Gibson) reported that expert "opinion is divided" as to whether using vaccine early is a "prudent course." On its website, ABC News (8/25, Childs) noted that Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, is confident of the "early roll-out of a vaccine against the H1N1 swine flu virus." Dr. Schuchat said, "We certainly feel that based on everything we know about seasonal influenza and H1N1... the risks of the disease are much higher than the risks of the vaccine." While "some infectious disease experts said that given the circumstances, the plan is warranted," others called the early roll-out "premature."

A BMJ survey indicates nearly half of healthcare workers may refuse H1N1 influenza vaccine. The AP (8/26, Cheng) reports, "About half of Hong Kong's health workers would refuse the swine flu vaccine," and experts believe the trend "would likely apply worldwide," according to a study in BMJ. Researchers "polled 2,255" health workers and found that "even during the height of global swine flu panic in May, less than half were willing to get vaccinated" due to the lack of established safety and efficacy on the vaccine.

Still, the WHO "recommends countries vaccinate their health workers." George Annas, a bioethics expert at Boston University, said, "A good argument can be made that health workers have an ethical obligation to be vaccinated, not to protect themselves, but to protect their patients." Notably, officials say that "among the few thousand people" who received test H1N1 vaccinations, "no one [thus far] has reported anything more serious than a sore or swollen arm."

Bloomberg News (8/26, Gerlin) notes that a similar survey "of almost 1,500 readers of Nursing Times" found that "30 percent didn't plan to get vaccinated against swine flu and 37 percent did. The remainder were undecided." Moreover, "most studies show that less than 60 percent of healthcare workers" accept seasonal influenza shots, according to the BMJ report. Meanwhile, the latest WHO data show "H1N1 has infected at least 182,166 people and killed at least 1,799 around the world as of Aug. 13."

CDC downplays White House panel's swine flu death estimates. The New York Times (8/26, A12, McNeil) reports that after a White House advisory panel issued a report Monday estimating the US could see "up to 90,000 deaths from swine flu" and "up to 1.8 million people hospitalized," the CDC, "the agency with the most expertise on influenza pandemics, [on Tuesday] suggested that the projections should be regarded with caution." Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, said, "We don't necessarily see this as a likely scenario." Meanwhile, a CDC press officer, "speaking carefully to avoid a feud with the White House press office," told the Times, "Look, if the virus keeps behaving the way it is now, I don't think anyone here expects anything like 90,000 deaths." The Times notes a lack of coordination among public officials "for a report with such striking figures."

So, will I get the vaccinatioon? I don't know as of this date. Right now the similarity of rushing out a vaccine for H1N1, that has very limited testing, and what happened in 1975 rush to vaccinate for H1N1 concerns me.

I don't want to be a guinea pig for a "rushed" vaccine. It is rather difficult to recall from the market place, something that has been injected into the human body.

Stress Management 101

A lecturer when explaining stress management to an audience,
Raised a glass of water and asked
"How heavy is this glass of water?"

Answers called out ranged from 20g to 500g.

The lecturer replied, "The absolute weight doesn't matter.
It depends on how long you try to hold it.

If I hold it for a minute, that's not a problem.

If I hold it for an hour, I'll have an ache in my right arm.

If I hold it for a day, you'll have to call an ambulance.

In each case, it's the same weight, but the longer I hold it, the heavier it

becomes."

He continued,

"And that's the way it is with stress management.

If we carry our burdens all the time, sooner or later,

As the burden becomes increasingly heavy,

We won't be able to carry on. "

"As with the glass of water,

You have to put it down for a while and rest before holding it again.

When we're refreshed, we can carry on with the burden."

"So, before you return home tonight, put the burden of work down.

Don't carry it home.

You can pick it up tomorrow.

Whatever burdens you're carrying now,

Let them down for a moment if you can."

So, my friend, Put down anything that may be a burden to you right now.

Don't pick it up again until after you've rested a while.

Here are some great ways of dealing with the burdens of life:

* Accept that some days you're the pigeon,
And some days you're the statue.

* Always keep your words soft and sweet,
Just in case you have to eat them.

* Always read stuff that will make you look good
If you die in the middle of it.

* Drive carefully. It's not only cars that can be
Recalled by their maker.

* If you can't be kind, at least have the decency to be vague.

* If you lend someone $20 and never see that person again,
It was probably worth it.

* It may be that your sole purpose in life is simply be kind to others.

* Never put both feet in your mouth at the same time,
Because then you won't have a leg to stand on.

* Nobody cares if you can't dance well.
Just get up and dance.

* The second mouse gets the cheese.

* When everything's coming your way,
You're in the wrong lane.

* Birthdays are good for you.
The more you have, the longer you live.

* You may be only one person in the world,
But you may also be the world to one person.

* We could learn a lot from crayons... Some are sharp, some are pretty and
some are dull. Some have weird names, and all are different colors, but they

all have to live in the same box.


*A truly happy person is one who can enjoy the scenery on a detour.

Happiness: Beyond Worry

By Justine Willis Toms



Have you noticed the power and magical quality we give to worry? For many people, not worrying is equated being uncaring or naïve. Michael, my partner, has told me on many occasions, "Don't worry; it will all work out." I would always reply, "Yes, but how?" He would say, "I don't know, but I know it will."

Worry has been the bane of my existence. During a spiritual practice that I recently engaged in with two friends, I realized that worry disconnects me from the happiness and serenity that are in my heart.

Our practice consisted of ten life-affirming statements. Starting with one statement each day, we repeated the process four times, thus doing forty rounds in ten days. Each day we wrote out one statement and then meditated on it, journaled about it, and shared with one another what came up.

We wrote about what we understood about the statement, what we didn't understand, what we accepted, and what we were struggling with. There were days when I felt quite resistant to the statements, but over time I noticed my heart opening to the practice of being more relaxed and in the flow of a loving, divine presence.

Through this practice I found two powerful antidotes to fear and worry. The heart of happiness is curiosity and optimism.

Curiosity is an antidote to fear. When I truly want to know more about something I feel alive, looking into the future with a question on my mind. I'm occupied by a state of wonder rather than worry. It is like taking a deep breath of fresh air. Curiosity has lightness to it; it lets in the light. The deep breath of curiosity oxygenates my blood which brings oxygen to my brain and helps me think more creatively and be more imaginative. Curiosity helps me be a pilgrim of possibility.

When I start to catch myself spiraling down into fear and contraction, I say to myself, "Pull, up, pull up, be curious, not afraid." I remind myself not to waste time or energy wallowing in the paralyzing force of fear. Moving into a state of curiosity is where I can more effectively deal with the daily challenges that pop up.

Optimism is a perfect partner to curiosity and is an antidote to worry. If the in-breath brings oxygen into my body, optimism is like the blood that carries the oxygen. If I am worried, I become tense. In fact, worry has a negative physiological affect on my body as well as my mind and spirit. Through time this can be quite debilitating. Optimism, on the other hand, is the life-blood of my soul.

These two keys, curiosity and optimism, keep me healthy and happy. Being in a state of fear and worry is like contracting pneumonia. It stops my breath, which, in turn slows my blood flow, deprives my brain of oxygen, and my blood becomes stagnant.

Experiment with taking a deep breath of curiosity and optimism.