Research at Seegarten Klinik
As one of the few practice-based clinics, we carry out our own research: we analyse our own treatment data and use it to test common assumptions in medicine. What we find feeds directly into assessment and treatment – and into our lectures.
A selection of our topics:
Osteoporosis: bone density in relation to body weight
The question: the diagnosis of osteoporosis is usually based on the T-score from bone density measurement. It takes age, sex and height into account – but not body weight. Is the diagnosis then right for slim people?
The finding: bones carry weight; the heavier a person, the denser their bones. In our analysis of 47 measurements from the practice, 40 fell within the range of osteopenia or osteoporosis by the usual reading. In 20 of these the bone density matches the body weight: these people have light bones for a low weight, not diseased ones.
What follows from it: we assess bone density in relation to weight, using the B-score (“bone score”). Anyone within its normal range does not need osteoporosis therapy, even if the T-score says otherwise.
Iron deficiency: replenish slowly rather than in high doses
The question: at what ferritin level do the symptoms of iron deficiency disappear, and what is the best way to replenish the stores? For more than 20 years we have been researching and treating iron deficiency, including iron deficiency without anaemia.
The finding: the lower limit of the normal ferritin range is not a yardstick. In most women the symptoms only disappear in the upper normal range; every person has their own ferritin comfort level. And: high single doses such as 500 mg cause ferritin to overshoot and increase the risk of phosphate deficiency. The body needs phosphate for its energy molecules (ATP) – if it is lacking, the infusion may be less effective.
What follows from it: we replenish slowly, with 200 mg per infusion at roughly weekly intervals, and are guided by the personal comfort level rather than the lower limit of normal.
Acid–base balance: not everyone is over-acidic
The question: “over-acidification” is widely regarded as a cause of chronic illness, and what is usually measured is the pH of the urine. Is this picture right?
The finding: acids and bases are equally important for life. Acid makes our activity possible; bases give us structure: build-up, regeneration and healing. Chronic illnesses are therefore associated not only with acidosis but also with alkalosis. The pH of the urine says little about this: it captures only the free acids, and excreting acids is precisely the job of the kidneys.
The measurement: for a long time we determined the acid–base balance by venous blood titration; many of our data and findings stem from it. A study at the Technical University of Munich led by Prof. Melchart confirmed the method. Today we measure using venous blood gas analysis.
What follows from it: we look at the acid–base balance of each person individually and treat both specifically, acidosis as well as alkalosis. Alkalising preparations for everyone are not the answer.
Publication: Dr. med. John van Limburg Stirum, “Moderne Säure-Basen-Medizin. Physiologie – Diagnostik – Therapie”, Hippokrates Verlag (Georg Thieme publishing group), 2008. The edition is out of print; the extended version is available online as a course (in German).
To the acid–base medicine course on health.sgk.swiss (in German)
Energy and mitochondria: is the oxygen actually used?
The question: where do exhaustion and poor performance come from when heart, lungs and blood count are unremarkable? What matters is whether the mitochondria, the power stations of the cells, actually make use of the oxygen on offer.
The finding: the performance of the mitochondria shows not in a single laboratory value but in the body’s response to exertion. We therefore combine three measurements: the exercise test (ergometry), the lactate curve and venous blood gases. If oxygen saturation in the venous blood stays high although exercise capacity is low, oxygen is being offered but not used. If lactate rises even at low output, the body is falling back on energy production without oxygen. Values that are unremarkable at rest can become deranged under exertion – a pattern we see in various chronic illnesses. From acid–base medicine and venous blood gas analysis we have developed a formula with which mitochondrial activity can be calculated.
What follows from it: we measure not what is there but how well it is used. With the calculated value, measures to strengthen the mitochondria can be applied in a targeted way and their progress monitored. This helps with unexplained poor performance, chronic exhaustion and metabolic disorders – and in guiding training.
Teeth and chronic illness: looking inside the mouth
The question: chronic illnesses are usually investigated without looking inside the mouth. Can inflammation of the gums, root-treated teeth or dental materials place a burden on the whole body?
The finding: for periodontitis, the association with cardiovascular disease, diabetes and premature birth has been described in many studies. A root-treated tooth is a dead tooth: bacteria can persist in its fine dentinal tubules, where antibiotics can hardly reach them, and produce harmful substances. Such teeth react slowly. It can take years or decades before one becomes a burden – and many never do.
The assessment: our experience shows that the very teeth that cause the greatest burden usually cause no pain. We therefore proceed step by step: panoramic radiograph and, if needed, a 3D image (CBCT); inspection of teeth and gums; tenderness to pressure compared between the two sides; contactless temperature measurement; probing of the gums; in the blood, RANTES and reactivity to mercaptans and thioethers; and finally a test for bacterial toxins at the individual tooth (OroTox).
What follows from it: with chronic complaints that lack a sufficient explanation, dental status is part of the assessment. We check whether a tooth may be acting as a focus and coordinate the next steps with your dentist.
Guide: how do I recognise teeth that burden health? (health.sgk.swiss, in German)
Studies and scientific papers on the subject on health.sgk.swiss (in German)
New methods: testing before we offer them
The question: new methods are constantly coming onto the market in medicine. Does a method deliver what it promises?
The finding: not every one. Some offerings attract many followers and yet do not stand up to scrutiny.
What follows from it: we examine new methods critically before offering them. If a method does not meet our internal quality standards, we do not introduce it – or we drop it again after a trial phase.
Lectures and publications
We pass on what we find out: in the lectures of the SGK Academy for patients and professionals.