Thursday, December 15, 2011


Readers of this blog must have noticed repetition of certain features surrounding the role of sugar in the American diet. It is well known that repetition ensures that “something sticks” in a reader’s mind. So here is some more information on this subject. I had been aware of the writings of Dr. John Yudkin for many years and I was able to obtain a copy of the 4th printing by Bantam Books of his book entitled “Sweet and Dangerous” from the local library. This amazing book, nearly forgotten, was published originally by Peter H. Wyden, Inc. The first edition appeared in April 1972 and a second printing in July of 1972. A Rodale Press Book Club edition was also published in 1972 and Bantam Books produced 4 printings. It was published simultaneously in the United States and Canada. It obviously made news at that time and it is indeed sad that his work is so little known in the sick world of today. On the back of the Bantam Book there is a short passage as follows:

”In this controversial headline-making book, Dr. John Yudkin, the renowned physician, biochemist and researcher whose pioneering studies of sugar have been acclaimed throughout the world, offers his never-before-published findings about sugar and explains clearly and concisely why ordinary table sugar is a health hazard for all ages”.

The text of the book would be startling to the uninitiated and would be ridiculed by many readers. How on earth could sugar, the very fuel that drives our cells and enables us to function, be dangerous? It begins with

”Why this book is necessary for your health” and continues by saying:

“[First], my research on coronary disease has convinced me beyond doubt that sugar plays a considerable part in this terrifying modern epidemic”.

His experimental work was performed at Queen Elizabeth College of London. Yudkin, together with the professors of botany and chemistry of the College, organized a symposium:

“that brought home to the three of us the enormous versatility and unique properties of the substance that is such a commonplace in all our lives”.

He goes on to say that:

“these properties tie in all too neatly with the increasing evidence pointing to the involvement of sugar in many diseases, not just the coronary epidemic”.

It is impossible to provide all the data that are supplied in this book but on page 5 Yudkin makes two “key statements that nobody can refute”.

”First,there is no physiological requirement for sugar. Second,“if only a small fraction of what is already known about the effects of sugar were to be revealed in relation to any other material used as a food additive, that material would promptly be banned”.

There is no greater difficulty than giving people advice about food, drinks and so-called recreation drugs. How many people in today’s world do not know the danger of tobacco? In spite of this fully accepted danger, thousands still smoke, knowing full well that they might be committing slow suicide. It is extraordinarily difficult to get people to understand that their recurrent illnesses and many common symptoms are sugar related. We encourage our children from infancy to become “sugarholics” and very few physicians believe it is dangerous or plays any part at all in disease.
I have repeatedly stated that sugar is being used as a “drug” that, like salt for many people, gives a jolt of pleasure that is perceived by the brain as the result of a signal from the tongue. Thus, it should be clear that artificial sweeteners like aspartame(Nutrasweet) have the same effect as sugar. The Nutrasweet Company published a study years ago that refuted medical claims that this sweetener was responsible for migraine headaches. The Nutrasweet was given to the experimental subjects in capsules that they swallowed, thus bypassing the taste mechanism. Perhaps they showed that it was not poisonous in the usual and customary sense of poison, but they missed the point completely. All “God made” food provides permutations and combinations of sweet, sour, bitter, salt, astringent and metal. This is how the brain is programmed, in much the same way that we are adapted to full spectrum white light made up by a mixture of red, orange, yellow, green, blue, indigo and violet. We are designed to consume natural food under the sun. Picking out a solitary signal of “sweet” or “salt”, (or living in partial spectrum, e.g. blue light), without the other signals that make up flavor, deviates the interpretation and processing by the brain, hence the potentially addictive quality of both sweet and salt, a phenomenon that I have witnessed in hundreds of my patients. Sugar is extracted from sugar cane or beet and is processed quite differently without the fiber that would be consumed if the whole plant source is eaten. That is our biological inheritance and the further we stray from it, the greater the risk of causing functional deviation in the way that our brains signal our adaptive responses to the constant changes in our environment. Hans Selye, the great (but controversial) Canadian investigator concluded from his extensive studies in animals on the effects of “stress” that human diseases were “the diseases of adaptation”. His conclusions, published under the title of “The General Adaptation Syndrome” took up an entire issue of the prestigious Journal of Endocrinology as long ago as 1946. I have read it and reread it over the years and believe that it provides clues to disease that are being constantly neglected in this era of “high tech” analysis. Sugar, in its "astronomical" concentration in so many "man-made" foods is a very important cause of "diseases of maladaptation".

Monday, November 7, 2011


Many of my previous posts have dealt with the problems surrounding the efficient use of oxygen in brain/body function. I am going to tell the story of a highly intelligent lawyer to illustrate that medicine is simply on the wrong track in much of its therapy.
The lawyer in question was a 56-year old woman who had an onerous job as a law professor. She had the main complaint of “digestive problems”. She was taking a host of digestive agents that were gradually becoming less effective. The focus of treatment elsewhere had been on the problems associated with bowel dysfunction only.
Of extreme importance, she said that she had “always had some symptoms that might be classified as Attention Deficit Disorder (ADD) and they were becoming more noticeable”. Conventionally this would be regarded as two different conditions, one under the care of a gastgroenterologist and the other under the care of a psychiatrist or neurologist. In my view they are actually symptoms arising from a cause that is common to both.
The fact that the bowel has an automatically governed nervous system has been known for a long time. We now have information that for every signal that goes from the brain control mechanisms to the bowel, there are nine signals that go from the bowel to the brain. This nervous system is so complex that it has been termed “the second brain”. It is therefore easy to see how our emotions, generated in the same part of the brain from which the signals to the bowel are sent, can affect the digestive system. Previous posts have discussed the lower part of the brain as a computer that oversees and controls all automatic organ functions in the body. Emotions are not thought processes; they are “computerized” brain reactions to appropriate stimuli. I have indicated previously that emotions represent the result of incoming messages from physical and mental stress.
The whole point of all this is that function depends on cellular energy and the ADD in this patient was evidence that the requireed energy was inadequate to meet the challenges of an active brain. The digestive or absorption problems could have been related to energy deficit in the cells that carry out this function or they could be a result of inadequate brain/bowel communication. Either way, the solution depended on solving where the biochemistry of energy metabolism had lost its efficiency. Cellular energy is generated by the consumption of oxygen in the process of oxidation, as discussed in a number of previous posts. Anyone reading this should review some of them or the explanation given here will not make sense.
I began this post by describing the patient as very intelligent and working in a stressful profession. That does not mean that she disliked her situation. On the contrary, she loved what she was doing and was very good at it. Just as a high powered car requires the appropriate fuel, oxygen for combustion and an efficient spark for ignition, so do our brain/body systems function on the same principles. It is the details that differ and the synthesis of cellular energy is extremely complex. The highly intelligent brain consumes oxygen at a greater rate than one of lesser functional capacity. The oxygen consumption is proportional to its activity, so an intelligent, brain using person is at greater risk for energy deficiency than a person of lesser intelligence who does not require as much mental work. The early death of Mozart has been argued and discussed over the years. We know that his music publication in the last years of his life was prodigious. I have hypothesized that his brain energy consumption exceeded his ability to generate it. It can never be proved but it is something to be kept in mind, particularly if abnormal fatigue is a leading symptom. Symptoms are really “alarm bells ringing” in a complex system and they have to be interpreted. What we need is the symptom equivalent of the Rosetta stone that enabled us to read the writings of ancient Egypt.
Perhaps we can begin to see that so much modern disease is induced by an inadequate diet that represents the consumption of excess fuel (food) containing an inadequate vitamin/mineral concentration (spark plugs), causing loss of efficiency in oxidative metabolism. I have referred to this as high calorie malnutrition. For those readers that need a little more information, look back at an older post that discusses the “choked engine”.
As I have repeatedly tried to emphasize, it is the brain that suffers most, since it is the organ that is most highly dependent on oxygen consumption. The lower brain, referred to as” the computer”, works 24/7 and it is hardly surprising that it is most at risk. The functional confusion in brain control mechanisms that results from this gives rise commonly to the symptoms that are usually designated as “psychosomatic”, a diagnostic category that is totally inadequate and insulting to the patient.
When vitamin B1 (thiamine) was first synthesized in 1936, nobody knew how it worked in the body. As I have previously discussed, we know now that its deficiency causes beriberi and in 1936 Sir Rudolph Peters did the research that led to our understanding of its vital actions. At the time, the animal model for studying beriberi was the pigeon. Without providing the details, Peters found something that is of great importance in our understanding of this vitamin. The study involved the biochemical activity of thiamine deficient pigeon brain cells compared with cells that had adequate thiamine. There was no difference in the activity of the thiamine adequate versus thiamine deficient cells until glucose was added in the experiment. It was immediately apparent that the thiamine deficient cells remained inactive whereas the thiamine sufficient cells became active. Modern research has shown very clearly that the processing of sugar in the body, and particularly in the brain is tied to the presence of an adequate thiamine ingestion.
I am not suggesting that thiamine is the only component that matters in our approach to a problem of this nature. It can, however, stand as a model for what happens to us when oxidative metabolism is compromised. It must be more than obvious that our food is the equivalent of gasoline in a car, but it also requires chemical components that are the equivalent of the spark plugs and other components of adequate “engine” function.This is the kind of approach required for thousands,if not millions,of people and it particularly applies to those who have been labeled "psychosomatic".

Saturday, October 8, 2011


Case histories are usually despised by the medical profession, particularly if they are so called “anecdotal”. Every now and again, however, a physician will see something that is extraordinary, often not even attempting to report it because of lack of definitive data. A few years ago a lethal illness called Reye’s syndrome occurred in young children, often in relation to an outbreak of “flu”. Its cause remained a mystery for years and the treatment was usually futile. Initially thought to be caused by the “flu” virus, it was eventually tied to the administration of aspirin given to the child “to bring down the fever”. In fact it was this common home treatment that was, in the majority of cases, the cause of an unnecessary death. The word was promulgated widely and the disease is now uncommon, if not rare but there are still occasional incidences, unassociated with aspirin administration. So I am taking this opportunity to describe the case of an eighteen-month old girl who was admitted to our hospital with a diagnosis of Reye’s syndrome. In a post 0f March 16, 2011 I wrote an article entitled “A remarkable nutritional supplement” . To review this briefly, this agent is a derivative of thiamine (vitamin B1) that actually gives increased power to the vitamin and it has some remarkable therapeutic attributes that are almost completely ignored in America. This is because it is made in Japan and is regarded as a drug by the FDA. It would therefore require the expensive new drug studies by an American company to import it, even though its action is merely by an easy and fast introduction of thiamine into body cells. It is a prescription item in Japan under the trade name of Alinamin and is also known as Fursultiamine elsewhere. It has a rather long chemical name, so I will call it TTFD. I had an Independent Investigator license to study it in clinical situations and have sent in annual reports to the FDA indicating its lack of toxicity and the kind of patients treated. For technical reasons involving biochemical knowledge, I reasoned that the case of this child would be an ideal test of its therapeutic potential, particularly as I had not found the slightest evidence of toxicity from its use. The brain and particularly the lower, more primitive part, is highly sensitive to thiamine deficiency and this is associated with many dietary mistakes, the most common being the ingestion of sugar in all its different forms.
Without going into the details, the peculiarity of the disease could be seen clinically as a gradually descending paralysis of lower brain function that eventually affects the brainstem where the controls for life sustaining reflex mechanisms are situated. In most cases of Reye’s syndrome there is a huge increase in the concentration of ammonia in the blood. Although ammonia is a byproduct of liver metabolism it is toxic to the brain when it builds up. It is therefore evidence of a collapse of normal metabolism. When this eighteen-month old girl was admitted to the hospital she was comatose. Her jaw was clenched, she grunted as she breathed and there were random movements of her limbs. Her pupils reacted sluggishly to light and there was minimal response to pain. She rapidly progressed to becoming totally unresponsive to pain with little or no movement of her limbs. Her blood ammonia was extremely high and laboratory markers were observed that indicated liver toxicity. She was treated by a neurologist by a complete exchange of blood, the usual and customary treatment at that time, based on the idea that it was due to whatever toxic agent was deemed to be causative. It made no difference to her rapidly worsening status. On the following day her clinical condition had deteriorated and a respirator had to be used to control her breathing. She merely survived. One week after her hospital admission she was judged to be in a terminal state. I well remember the neurologist in charge of the case showing the child to a visiting colleague and indicating to him that there was clearly no hope of recovery. I hypothesized that the collapse of normal metabolism reflected damage in the complex mechanisms of energy synthesis and that therapeutic doses of thiamine might work since it is roughly equivalent to a spark plug in a car. It must be remembered that no conventional treatment was available and the child had been given up as hopeless.
Each tablet of TTFD contain 5o milligrams and it is also prepared in 25 milligram vials that can be given intravenously. So I started treatment with TTFD on April 21. In a 24-hour period she received 100 milligrams of crushed tablets every 4 hours by stomach tube and 150 milligrams intravenously, a total dose of 750 milligrams a day, an incredibly large dose. The Recommended Daily Allowance of thiamine is about 1 to 1.5 milligrams for a healthy person and it was long thought in Western cultures that 10 milligrams was the limit of intestinal absorption. This was in spite of the fact that it was known in Japan that beriberi, the mostly Eastern disease caused by consumption of white rice as a dietary staple, required as much as 300 milligrams of the vitamin a day for months. On the following day, April 22, the clinical situation was unchanged but there was some flushing of her cheeks and the lip vermilion was notably pink rather than the former dusky blue. This indicated that oxygen was being delivered to the tissues by the arterial blood, suggesting that oxidation (its use in creating cellular energy) had improved. By April 24 there was some response to pain and on the next day there was some relaxation of her limbs and some spontaneous movement. Her pupils responded to light. On April 26 the intravenous TTFD was discontinued and the oral dose reduced to 50 milligrams every 4 hours, a total dose of 300 milligrams a day.
Then a remarkable thing happened. She went into a state known as “coma vigilum”. This is a peculiar state of the patient who appears to be conscious but this is only superficial and responses are automatic and below conscious level. There was eye contact and she responded to sounds. She started to take jelly from a spoon and was beginning to show primitive emotional responses. By May 8 voluntary movements were appearing and she had some head control. By May 12 she was able to chew food and could support her own weight standing. Full consciousness had returned. On May 12 she was able to walk with a nurse holding her hand. She was beginning to feed herself and attempting to speak. She was discharged from hospital on May 21 and TTFD was discontinued on July 31. Muscle tone improved over the following year but never became normal. She was not seen again until the age of 8 years because of the onset of seizures. She was mildly overactive and had some intellectual and motor dysfunction. She had repeated kindergarten and was in first grade, so there was unfortunately a presumed legacy from her illness. The surprise, however, was that she survived.
I tell this story because I insist in stating that our overall approach to disease is on the wrong track. Drugs are simply not the answer because our brain/bodies are equipped with marvelous mechanisms that depend on sufficient cellular energy to carry out the process of healing. The research performed by Hans Selye on the effect of stress had shown that an injection of thiamine given in an emergency room to a patient in shock helped recovery. What was so remarkable about this case was that not a single colleague ever brought up the subject. It should have been discussed in case conference, the usual and customary sharing of information and seeking the right path in medical approach to diseases, particularly as there was, at that time, no idea of the cause of Reye’s syndrome. It might have lead to a better understanding of the cause of the increase in blood ammonia that occurs in other conditions besides this one. The Dean of Harvard said to a new batch of medical students: “Ladies and gentlemen, I regret to tell you that fifty percent of what we teach you here will be wrong. The only trouble is that we do not know which fifty percent”. History shows that it matters little whether something new is revealed in any shape or form. It is automatically despised. It applies to any profession and sometimes it takes years before someone catches up with something that confounded an issue occurring a long time before. It appears to be predictable of human nature. It may be that it is a good thing since it may very well weed out hypotheses that are erroneous and allow time and further contemplation by others to sanctify a new phenomenon outside contemporary experience.
There is no doubt that vitamin therapy is now coming into its own and that holistic medical methods will eventually be standard practice. All of these methods address the synthesis and flow of cellular energy where oxidation is the key factor. Perhaps that is why the FDA is beginning to clamp down on health freedom allowed by our ability to purchase supplements. It must, however, be acknowledged that the use of nutritional supplements requires some knowledge of their actions and potential toxicity from excess. The vast use of pharmaceuticals affects the economy and it is that which seems to be protected rather than our health. Watch out for the draconian methods advised by “Codex Alimentarius” coming from Europe.

Tuesday, September 13, 2011


Few people ever consider the fact that every one of our 70-100 trillion cells has to generate energy to function. The title of this blog is “Oxygen, the Spark of Life” and all previous posts have dealt with the chemistry generated by its consumption in oxidation. Those that consider energy synthesis as the mainspring of what “makes us tick” have wondered whether it is chemical or electric energy that provides physical and mental function.
We know, of course, that electricity is indeed generated in the body since we get information from tools such as the electroencephalogram and electrocardiogram. But how is this electric energy generated and does it play a part in thinking or physical activity? Is it a result of function or is it a driving force?
Well, we can get some biologically important information from the research that has been performed in the electric eel, electrophorus electricus. This animal can produce an electrostatic charge of 500 volts to stun or kill its prey. The electric organ is formed by a neuromuscular junction where the message delivered by the nerve is passed to the organ that is being signaled. In the electric eel, this junction has been evolutionally adapted from a mechanism similar to that which we possess. A nerve arising from the brain carries a message that results in the formation of a chemical called acetyl-choline. This is a neurotransmitter, so called because it is released into the neuromuscular junction and takes part in the activation of the organ to which the message is being sent. Without going into the technical details, acetyl-choline is used in the human brain and in many of our nerves in the nervous system. In the electric eel this neuromuscular junction has been adapted to form a condenser, an instrument well known to electrical engineers. That means, of course, that chemical energy, represented in acetyl-choline,in some way enables the transduction of chemical to electric energy. Since this kind of nervous system mechanism is on the same basis in all higher animals we can extrapolate the concept that our nervous system does indeed generate electrical energy, but it is only measured in microvolts since it has not been adapted in the same way as in the electric eel.
We now know that energy is constant. When it is used to perform active function, it is transduced to another form. A simple example is a car. The engine generates energy from the combustion of fuel. The energy is guided through a series of levers (the transmission) to the wheels, enabling the energy to be used in moving the car. At each step of the process, some of the energy is wasted in friction, heat and noise, thus making a car about 30% efficient. That means that about 70% of the energy from fuel is wasted. In Newtonian physics, the chemical energy is transduced to kinetic energy (i.e. movement of the car). The human body has exactly the same problems to overcome but the details are widely different. Chemical energy is generated from food and some of it is transduced to electric energy as noted above. We are, in fact, hybrids like some of the newer cars. Efficiency of the brain/body is assessed at about 70%, very different from the huge loss of energy that occurs in a modern car. We know that acupuncture works and it is quite probable that it is because it stimulates the flow of energy that has been called “chi” for thousands of years. Perhaps this is electromagnetic energy or even a form of energy not yet discovered. The ancient Chinese had developed the concept that “chi” flowed through the channels that they called meridians and that this was the driving force for function. It is beginning to look as though they were dead right. We can begin to understand why some of the therapeutic methods used in Complementary Alternative Medicine use low volt electric tools. It has already been published that low volt electric currents can be used to help fractured bones to heal and various forms of electrotherapy were used by many physicians in the late 19th century.
Another important fact to note is that acetyl choline, a major neurotransmitter as I have already indicated, is generated from the "engines” of our cells. This “engine” is known as the citric acid cycle. Without going into the technical details, the fuel used for this remarkable “engine” is glucose, the sugar that is produced from our foods. It is this that has given rise to the idea that eating sugar is a way to produce “quick energy”. Unfortunately this requires extremely complex chemistry by which the glucose is extracted from food and processed into the “engines” of our cells. That is the reason that we never find sugar in its free form in nature. It is always wrapped up in a root, a stem or a leaf and the fiber is an important part of the processing to create the fuel in its required presentation to the “engine”.
In a previous post I have discussed the fact that eating foods that are high in calorie production and devoid of the vitamins and minerals that enable oxidation (combustion) can be compared with a “choked engine” in a car. The fuel is incompletely burned because the ratio of fuel to oxygen is high. The incomplete combustion produces black smoke from the exhaust and represents unburned hydrocarbons. The same thing occurs if the spark plug is not functioning efficiently. Thus, glucose is to gasoline what vitamins and minerals are to the spark plug and the cylinders. Vitamins “ignite” the fuel and cylinders guide the energy to the transmission. This is achieved by complex chemistry in the body and needs to be understood and used by physicians in order to solve the problems of disease.We defend ourselves from the hostile nature of our environment and that requires energy.
Finally, I want to point out that loss of efficiency in the citric acid cycle “engine” can easily result in a dysfunctional production of acetyl choline. Both branches of the autonomic nervous require this neurotransmitter and I have reason to hypothesize that eating simple sweet carbohydrates is a major cause of dysfunction in this automatic nervous system. Its constantly balanced reactions provide us with the ability to adapt to both phyhsical and mental environmental changes that constitute "stress". I have called the resulting dysfunction “Functional Dysautonomia” and because I have seen so much of it in my practice, I have reason to believe that it is one of the commonest presentations of chronic disease in our culture. It causes a huge number of symptoms and because of our present approach to specialization among physicians, the gastro-intestinal symptoms are referred to a gastro-enterologist, nervous symptoms to a neurologist, and heart symptoms to a cardiologist etc. By recognizing that a patient with Functional Dysautonomia is basically maladapted to the inevitable physical and mental environmental stresses encountered daily, we can begin to see that "psychosomatic" disease really does not exist. It is fundamental biochemistry that requires our attention and as I have pointed out in post after post, oxygen is the key!
It seems to me that an understanding of energy metabolism and the proper use of nutrients is the next paradigm shift in our concepts of health and disease. It is paradoxical that the great Louis Pasteur gave us the first paradigm in the discovery of disease causing micro-organisms. He may well have given us the next paradigm since he said on his death bed “ I was wrong: it is the body defenses that are more important

Sunday, August 14, 2011


Looking at the history of the young woman with rheumatoid arthritis, it must be obvious that there is something wrong with the treatment offered by the conventional medical approach. It is, of course, true that it is directed at controlling and subjugating a terrible inflammatory action directed at the joints, thus producing the diagnostic name of rheumatoid arthritis. But the drugs are aimed at damping down the inflammation where it is producing the damage in joints. In the post, it was pointed out that an inflammatory action is initiated by reflex action from the “command center” in the brain and the physical examination described the simple way in which this was shown to be involved in this patient. The conventional approach is not even attempting to locate or treat the initiating mechanism. In fact, it abhors the idea that the brain is involved in any physical organic disease because it is thought to suggest that the physical condition of the patient is “psychosomatic”. This is a diagnostic category that seeks to blame faulty psychology for the production of physical symptoms. The idea that a patient with widespread laboratory evidence of inflammation and deformity of the affected joints as a “psychosomatic” condition would be absurd.
The problem is that the part of the brain that initiates these important adaptive reflexes is not generally thought of as a computer that relies on efficient oxidation for these reflexes to function normally. Neither is there a concept that these adaptive reflexes become exaggerated when the cellular oxidative metabolism in the brain becomes compromised. As I pointed out, no inflammation means that the reflex mechanism is not functioning at all and I called it Yin. At the other extreme there is an excess of signaling that produces an inappropriate and vicious unwanted inflammation that I called Yang. Everything in the brain/body communication system is in a state of balance---- not too little and not too much. As the ancient Chinese pointed out, the state of balance is midway between a deficiency and an excess. Their explanation of what they called Tao was living in harmony with the natural state of the universe.
The core issue is cellular energy that depends on oxidative metabolism and I have already pointed out that the brain is the most actively metabolic tissue in the entire body and is therefore likely to be affected first where there is this compromise.
To sum this up, it means that our ability to produce ATP (the energy currency referred to in the previous post) must meet its use in driving active mental or physical function. That is why I suggest that this explains the old question of why genius is close to madness and why Mozart may have succumbed to this. We know that his music composition and active participation in many things in the last years of his life was great enough to be beyond our usual and customary understanding. His death has been a mystery ever since it occurred. My suggested hypothesis is that his synthesis of energy was insufficient to meet the functional physical and mental demands he imposed on himself. It may also explain why this young woman with arthritis developed her disease while she was an active athlete in the swim team. Perhaps her partial paralysis in synthesis of cellular brain energy resulted in exaggeration of the reflex action that initiated inflammation. I also pointed out that the target organ remains a mystery that might be solved by a better understanding of genetic risk. It is known that there are different ways in which the brain/body can initiate inflammation through a vast series of molecular messengers. We cannot invent drugs to inhibit each of these mechanisms. I hypothesize that improving oxidative function is the best and relatively simple method. Also, we know from the infancy history in this patient that there was a metabolic abnormality at birth that could even be related to the pregnancy, or to genetic risk. That was never studied at that time and was regarded as a passing phase of no consequence. Uric acid, found in her urine at that time, is as I indicated, from purine metabolism. But purine metabolism, without going into the complex details, is related to the processing of glucose as the major fuel that drives brain metabolism.
My long experience in learning the details and the approach offered by Complementary Alternative Medicine has emphasized for me the wisdom of Hippocrates, when he said “let food be your medicine and medicine be your food”.

Thursday, July 28, 2011


At 19 years of age, a young woman presented with a typical case of juvenile rheumatoid arthritis that began with “muscle spasms” in 2008 when she was a member of the high school swim team. Then more and more joints became painful and swollen and the diagnosis became clear. In March of 2011 she had had both knees drained of fluid. Her treatment had been the usual and customary. All the drugs were aimed at attempts to block inflammation.

It is only by looking at the life time history and the 2011 physical examination that this could be seen as clearly related to the brain/body interplay. A pediatrician always goes back to the birth history and asks questions whose answers have long been forgotten and thought to be past history of no consequence. She had jaundice at birth but did not receive the conventional blue light treatment. Further history revealed that she had become dehydrated in the first few days of life and required intravenous fluids. Pink crystals were reported to have been found in her urine and these are known to be from uric acid that has crystallized out. Uric acid is a metabolite of purine metabolism and is not normally found in urine in enough quantity to crystallize. It is therefore a signature of an abnormal state of metabolism. She remained jaundiced for at least a month and was known by the family as “a yellow baby”. She was also said to be “unusually sleepy” for the first few months of life. We now know that the relatively common neonatal jaundice has been published as the first evidence of oxidative stress. There was clearly a biochemical problem existing at birth. At the age of 6 years she had a series of acute attacks of asthma. In 2007-8 she had a long series of upper respiratory infections where it was difficult to see when one ended and another began. By this time she was an excellent student and was, as mentioned, on the high school swim team when the history of muscle spasms and joint inflammation began.

A physical examination in June 2011 revealed the expected facial pallor, the usual signature of chronic illness, together with the swollen and painful joints. There were, however, some other signs that are seldom recognized for what they represent. Her tongue looked superficially like the surface of a raspberry, so it is referred to as “raspberry tongue”. In my experience, this is usually related to the quality of diet. More importantly, she had no evidence of knee reflexes induced by the customary rubber hammer used by physicians. This was further tested by what is called “reinforcement”. The patient was asked to clasp her hands together and give a quick pull on request. As the rubber hammer descended to elicit the reflex she was given the sharp request to “pull”. Without further explanation, this usually will enable the knee jerk to react. There was still only a tiny flicker of the reflex. By gently stroking the leg with a finger tip, I was able to cause a white stripe to appear slowly in the wake of the finger stroke. This is known as “dermographia” or “skin writing” and it is an easy way to detect that the control mechanisms of the autonomic nervous system are functioning abnormally.

Without complicating this further, these simply elicited phenomena in the examination of the legs clearly indicated that the “command center” in the limbic brain was involved. We have now much evidence in the medical literature that inflammation and immune responses in the body are initiated from the lower brain. The body/brain communication is a new way of thinking about disease in general (Blalock J E. The immune system as sixth sense. J Internal Medicine 2005;257:126-138.) To call it a “command center” is no exaggeration. This part of the brain has a high demand for efficient metabolism depending on rapid consumption of oxygen. It consumes huge amounts of available energy and works 24 hours a day throughout life as does the heart. That is why the vitamin B1 deficiency disease, beriberi, affects the heart and brain, because vitamin B1 is a major catalyst in the oxidation mechanisms that process glucose to synthesize adenosine triphosphate (ATP), the “currency” of energy chemistry. Thus, in this case, the history showed that metabolic efficiency was compromised even at birth and culminated eventually in unwanted signals from the control centers in the brain to initiate inflammation in excess.

How can all of this be fitted together to make sense that the brain and body are but two parts of the same “machine”? There is no mental illness without an effect in the body and no physical body disease without brain involvement. We can think of the body as being like an old fashioned fortress. The “soldiers” that act as defensive agents are the white cells that are sent to the appropriate area where an attack is being recognized by the “command center”, alerted by reflex input from the area under attack. This results in inflammation and is a normal defensive response. If, however, the command center is out of order, an inflammatory response might be haphazardly ordered in excess and we then see what we recognize as inflammatory disease. It is the Yin and Yang again--- not too little and not too much. There must be an appropriate and balanced command. By doing a library search, I was able to find plenty of evidence that the limbic brain (“command center”) becomes much more responsive to incoming information supplied by the sensory system if its oxidative metabolism is compromised. All brain function is tied to this and it goes a long way to explain why a high IQ increases risk and why the “command center” gets into the picture. An intelligent, athletic, active individual like this patient has a greater demand for efficient oxidative metabolism compared with a less gifted person. With mild to moderate loss of this efficiency the control centers become more reactive to incoming sensory signals that demand an adaptive response. The executive signals may be through a normal neurological system but they are exaggerated and cause too much organ reaction.

The point is this: the brain has to recognize our defensive capabilities to protect us and enable us to adapt to all physical and mental stress factors that we meet on a daily basis throughout life. It is equipped with a large number of complex reflexes that enable us to survive in a hostile environment. The fight-or-flight reflex is the one that most people are aware of. Inflammation is an obvious defensive reaction to injury and if the brain does not initiate it when it is required, we will not be able to repair the injury (Yin). If, on the other hand, it initiates unwanted inflammation because of confusion in the brain/body signaling mechanisms, there is unwanted inflammation in target organs (Yang). It is not clear why a particular organ or set of organs (e.g. joints) would be targeted. It may be somewhat haphazard or it may be directed because of the particular nature of the individual genome that provides the risk. It must be emphasized however that it is genetic risk, not a specifically genetically determined disease. Epigenetics is the new science of studying how we affect our genes by diet and lifestyle. By far and away the easiest way to induce this brain/body reaction is to ingest empty calories, particularly those from simple carbohydrates.

Since this concept depends on the ability of cells to meet their energy demands, it means that the best and the brightest are more at risk than those with lesser endowments. This concept would perhaps explain the early death of Mozart, the nature of his death having been argued over the years. He simply ran out of the energy currency in its accelerated consumption.

It is an ancient aphorism that “complexity has to give rise to simple solutions to be efficiently effective”. Modern research is discovering more and more detail about the brain/body messenger systems (Oke S L, Tracey K J. The inflammatory reflex and the role of complementary and alternative medical therapies.Ann. N.Y Acad Sci 2009;1172:172-180). The details are so complex that a reader has to have special knowledge to understand the technical terms. One of the conclusions drawn by the authors, however, is that elucidation of this inflammatory reflex has enabled investigation into drugs, therapeutic techniques such as electrical stimulation, and even complementary and alternative medical therapies. The reflex is mediated through the vagus nerve that goes from the brain to many internal organs and they found evidence that acupuncture can increase the action of this nerve.

It is fascinating that healing by stimulation of this nerve has been used by Yogis for centuries and they have advocated several methods that seem to most of us like “mumbo jumbo”. Perhaps the mechanisms were not known and it is amazing that such methods were developed without this knowledge. Acupuncture has been used for at least five thousand years and it may be even older than that.

It seems to me that we must look at the brain/body as an extremely complex “machine” that, for most of us, is complete and works automatically to enable our survival as individuals and as a species. It may be exciting to know the infinity of details but all it requires is energy to drive it. I must emphasize that I am talking about the energy used for cellular function, not the colloquial use of the word in describing a person’s athletic ability. We have to remind ourselves, that is the use of energy. We have to generate that energy in order to transduce it into function. Hippocrates, the “Father of Modern Medicine” said “Let medicine be your food and food be your medicine”. This encapsulated wisdom has been largely ignored and we should be looking hard at other forms of ancient wisdom, rather than the commonly held idea that the ancients were all “left behind” by our modern technology. Perhaps the “Father” is ignored in the same way that our modern era has reduced the impact of parental wisdom on their offspring.

Sunday, June 12, 2011


Everyone is aware that we possess what is called a voluntary nervous system that enables us to carry out actions at will. The control mechanisms are, of course, in the most developed part of the brain. Many people are, however, ignorant of another part of our complex body communication system. This is known as the autonomic nervous system and its controls are in the lower or more primitive part of the brain, the limbic system and brainstem. The sophisticated thinking part of the brain still has many activities that are still unexplained. We do not understand the true nature of thinking or consciousness. Whether it is a computer or not is unknown. The limbic system and brainstem are clearly vital parts of an extremely complex computer. They control our ability to adapt to all the mental and physical sensory input that we experience throughout life. Most people are aware that we have a bunch of glands collectively known as the endocrine system. They release their respective hormones on cue from messages that are sent out automatically by the lower brain control mechanisms. They are really messengers of the brain and as they return to the brain in the blood, their concentration is carefully monitored and controlled by biofeedback. That is why it is virtually impossible to give people hormones that imitate this for we do not know the required concentration of any hormone at any one time in the twenty-four hour cycle

The autonomic system can be compared to two telephone lines, each of which goes to every organ in the body. They are called sympathetic and parasympathetic and they essentially provide messages to the body organs that oppose each other. The sympathetic “telephone line” is the “action system” and it is capable of initiating a number of reflexes that are important to our survival. The best known of these is the fight-or-flight reflex, aimed at “killing the enemy, for example a wild animal, or escaping from it”. It consumes a great deal of cellular energy and is designed for short term action. After the danger, whatever that may be, is over and survival has been accomplished, the sympathetic system is automatically withdrawn and the parasympathetic arm goes into action. Under its guidance, we can “roll a stone over the mouth of our cave” and we can sleep, eat, have sex and do all the things that we can do in a safe environment. Of course, our stress factors have changed dramatically from that encountered by our ancestors. We now have the modern equivalents associated with our civilization. Most modern stress is mental and does not require a physical response as an escape. It is a very different kind of attack and can unfortunately be prolonged, thus exhausting cellular energy. It must be emphasized here that the word “stress” must be used as the “causative physical or mental input”. It is the response that is the important issue. It may explain, for example, why a given child can come out of a parental divorce without harm whereas another child may not, depending on how the stress is handled.

The prefix “dys” means “abnormality of” and so that is how dysautonomia simply means that the system is not functioning as it should. There are genetic factors, as there always are, but the most important cause of this dysfunction (see the prefix again) is inefficient use of oxygen in providing cellular energy. The brain is the organ that is most dependent on a continuous supply of oxygen and its use in oxidation. This particularly apples to the limbic system and brainstem because they compute 24 hours a day and maintain our survival. For example, the brainstem contains vital centers that control automatic breathing. Thus, as we go to sleep, these centers maintain both the speed and strength of heart muscle contraction as well as taking over the control of breathing. An example of this failure is the awful disaster of sudden infant death where the automatic mechanisms in a rapidly developing brainstem have been compromised. The infant stops breathing or his (more common in boys) heart ceases to beat. Published medical literature points to deficiency of magnesium or thiamine as a common underlying cause, even though the positioning of the infant in the crib is now apparently accepted as the only cause. It is well known that SIDS occurs more commonly where there is poverty and where “junk” nutrition is more likely to be a factor.

A condition in adults known as sleep apnea is one way in which abnormal brainstem function is indicated. There is also a lethal condition called "Ondine's Curse" where the automatic life mechanisms fail. Ondine is a mythological "water nymph" who was jilted by her human lover. As a punishment she cursed him by abolishing these normal life controls and hence he died in his sleep. By far the easiest and most common way to produce changes in these vitally necessary mechanism is to take an excess of sugar since its metabolism is tied to a number of essential nutrients, the most important of which are vitamin B1 (thiamine) and magnesium. In a previous post I described the “choked engine syndrome” that used the analogy of a car engine where there is too much gasoline in the cylinder and either insufficient oxygen or a defective spark plug.

Of particular interest, it has long been known that the autonomic nervous system controls the body organs asymmetrically. For example, the message received by the heart from the right side of the sympathetic nerve system is different from that received by the left side. One of the curious things that happens in the early stages of dysautonomia (the prototype for dysautonomia is beriberi, the disease discussed in some detail in an earlier post) is that the reflex control mechanisms in the limbic system and brainstem become much more reactive to perfectly normal mental or physical sensory input. Blood pressures in the two arms become widely different when measured at the same time. Since our emotions are generated in the limbic system automatically by the kind of input it receives, (for example, an insult initiates anger) affected individuals become much more emotional. Anger becomes exaggerated and may explode in violence that would not be perpetrated if the emotional reflex was normal and influenced by the thinking part of the brain. That is why I have suggested that the school shootings and otherwise inexplicable human reactions in this modern era are related to high calorie malnutrition. I have never seen anyone interested in the diet for a "school shooter". It simply does not exist as a question. A recent medical paper from Japan reported 17 adolescents with beriberi, caused by the ingestion of sodas in their social relationships. Dietary mayhem may be an extremely important factor that is largely ignored in this modern era that we refer to as civilization. The more that we forget our biologic orgins and how our diet affects our energy metabolism, the greater the danger of abnormal behavior and loss of control under the influence of stress.

Wednesday, May 11, 2011


What did the ancient Chinese philosophers and observers of humanity mean by Yin and Yang and why is it an important philosophical contribution in the modern world? Reading an English translation of Chinese literature, I found no clear definition, although it became obvious that the two words represented extremes on either side of a median, the equivalent of the "bell-shaped curve" which is so popular with statisticians today. Thus, the idea of a “point of balance”, expressed thousands of years ago, is as important today as it was then. It applies to lifestyle and nutrition. If something is good for us, more of it may be better, but an excess is bad. There must always be an optimum state.

It is worth noting the ancient origin of this very important philosophical concept. Genealogies of Chinese dynasties list the Yellow Emperor as the third of China's first five rulers and ascribe to him the period of 2697-2597 BCE. The Age of the Five Rulers is said to have lasted 647 years (2852-2205 BCE) and is called the "Legendary Period". The Yellow Emperor is considered to be the author of NEI CHING SU WEN, the classic treatise on internal medicine, and supposedly the oldest medical book extant. The development of Chinese medical philosophy even predates this and may have been in existence for centuries before the book was written. With our short lives, the wisdom of the ages locked up in books that are rarely read, we have accumulated a vast amount of knowledge that is largely ignored. This is so ingrained that a reference older than about 10 years, provided for a medical article is considered to be “out of date”. We should be building our perpetual gain of knowledge standing on the shoulders of history. But how we access it is extremely difficult, particularly when it is often thought to be the primitive concepts of an age gone by.

The idea of “balance” in the human body is best illustrated by considering the intake of oxygen. We cannot live without it and its excess is lethal, as every diver knows. Another illustration is from the history of selenium, now known to be an essential nutrient. Until 1957, selenium was classified as a poison. Then someone, initially thought to be “crazy”, found that it was essential to life as a nutrient. It is the “dose window” that counts, that amount between too little and too much. We require selenium in a vanishingly small daily dose that is measured in micrograms, one thousandth of a milligram. All the essential nutrients, even water, have their own “dose window”. For example, both oxygen and vitamin C have very large dose windows as do most of the vitamins. Minerals are different and their limited dose windows make it much easier to reach a toxic level. They should always be ingested under the care of a professional who understands the developing art and science of nutritional supplementation.

It is obvious that pharmaceutical drugs all have dose windows and toxicity from their use is disastrous since every person has his/her own tolerance and there are at least one hundred thousand deaths a year in the U.S. in people using such drugs as prescribed according to the published dose “safety” in Physicians Desk Reference (PDR). Nutrient supplements are used therapeutically in doses that exceed the expected daily intake. They are therefore being used as drugs since they influence our physiology. There has never been a report of death from their use in the emerging paradigm of Complementary Alternative Medicine.

I was surprised one day when I found a book that described an animal experiment. The investigators put together a diet that was completely free of lead and they described the difficulty of its preparation. When they fed it to young animals, they failed to grow. When the minute amount of lead was restored, they began to grow. Everyone today knows that lead is poisonous, but the idea of a minute dose being essential, like selenium, is extremely surprising and known by only a few. It may well be that the entire periodic table represents our nutritional requirement. This would make sense of the formula used in the burial service “dust to dust and earth to earth”. Boron has been used clinically to strengthen bones and calcium is known by all as an element of bone. Both are potentially toxic when used improperly. Could it be that even mercury in vanishingly minute doses is essential, like lead? Nobody, to my knowledge, has attempted to find out.

An experiment in mice was published two years ago. Normal mice were overfed and, as expected, they became obese. It was found that a gene for a mechanism in the hypothalamus, the epicenter of the lower brain computer, was silent if nutrition was appropriate. With overfeeding this gene became active and caused obesity and/or inflammation or both. Since the mouse genome is surprisingly close to human, perhaps we can extrapolate from mouse to man. If that is true for us, can we suggest a reason for this apparent anomaly? In times of plenty, it would have been an advantage for our ancestors to become fat so that they could survive on it in a period of food deficiency. It would be a solution that only Mother Nature could invent. Perhaps we have our own solution to the epidemic of gross obesity in America for we know that obese people are more at risk for chronic disease that involves inflammation. Inflammation is a perfectly normal process when it is induced in the body as a defensive mechanism. If we cut ourselves, inflammation brings in the right amount of blood containing the white cells to fight infection and the nutrients and oxygen to provide the energy for healing. But if it gets out of hand and is applied to tissues that do not require it, it becomes a cause of inflammatory disease, the Yin and the Yang of extremism once again. It is an interesting comment on the gross malnutrition that is being experienced in this crazy world. It does no good to say that we should use “this” or “that” diet. I tell all my patients the same thing: eat “God made” food and leave the man made junk alone. The further we go from our biologic origins, the greater the peril. If the food had not been on the Earth when man arrived on it, we could not have survived as a species. It was all natural and all we had to do was to hunt and gather.

Our stewardship of planet Earth has been and continues to be destructive and our source of food containing all the nutrients that we require to remain healthy is compromised. Many people are becoming sick, not so much from 3 meals a day (although that is bad enough) but what they consume between meals in social activities. Sugar is indeed dangerous and the universal accompaniment of high sugar snacks with watching TV is a potent source of trouble for those that are sensitive to its ingestion. The trouble is they have no idea at all that their multiple symptoms are related and keep going to their doctors for medicines that they do not need if they were made acquainted with the real cause. I tell people to stay away from the “hair of the dog that is biting them” and eat only “God made food”. It is well to remember that even some of that is compromised. Cow’s milk was “invented” for calves and is not intended for humans, some of whom get sick from its consumption, a surprise for many when its commercial touting is so common. Unfortunately, proper food has become so expensive that many people are unable to afford it, particularly when they have to trim the budget for a family. I am aware that there will be some that read this that will automatically reject it as nonsense. They will say “If this is so important to our health, why have doctors in general not adopted these simple principles”? Well, even though the inherent dangers of tobacco are now well accepted by all, there are still thousands that still smoke. It would be difficult for them not to know the risks, so why do they continue to commit slow suicide? It is incredibly difficult to pass on wisdom, as illustrated by ignoring the advice capability of elderly people in our modern era. At one time age was respected. Now it is trashed and the young are totally ignorant of what they are missing in their planning for life.

Wednesday, March 16, 2011


I want to tell you something about one of Mother Nature’s gifts. I am sure that some people taking the trouble to read this blog have tried to get information on garlic. It has been used, of course, in food preparation for centuries. In about the middle of the last century a group of medical researchers in Japan were studying it and they found something that alerted their curiosity. When the inside of a garlic bulb is exposed to air by cutting or crushing it, vitamin B1, also known as thiamine, is worked on by an enzyme that exists in the bulb. It converts thiamine to a disulfide derivative that they called allithiamine. This name was given because they found it in other plants within the allium species that includes garlic. Garlic also contains about twenty sulfur containing compounds called thiols that are important in the normal use of cellular oxygen. Originally the investigators thought that this newly discovered substance had lost the biochemical properties that are known to be initiated by thiamine in animal cells, including humans. Further study in animals showed that it had biologic properties that actually exceeded those exhibited by the original thiamine. In order to understand why this was an important discovery I have to remind you about the action of thiamine in the body.
The human adult body is made up of between 70 and 100 trillion cells. Each has to use oxygen to create the energy that enables it to function, as has been discussed in previous posts. Thiamine is the “spark plug” that “ignites” glucose, the fuel of all our cells and it is particularly important in the brain, heart and nervous system. Its absorption from the foods that contain it, its journey in the blood to the cells that require it and its delivery to those cells, involves complex biochemistry. It has long been thought that the RDA of thiamine is sufficient and that any form of megadose would be of no physiological value. This is because the enzymes that require it cannot be accelerated in their function by introducing an excess of the vitamin. Remember from an earlier post that most vitamins are cofactors to enzymnes. This is essentially correct in healthy people whose diet has remained excellent over the years of life. We know from history that it required months of huge doses of thiamine to cure advanced beriberi and sometimes it was too late since there was permanent damage. The enzymes that require thiamine to function to full capacity begin to deteriorate when there is an overload of glucose and an insufficiency of the vitamin, as discussed in the “Choked Engine Syndrome” in an earlier post. In order to recuperate this efficiency, the enzyme needs to be “hit” with much larger doses of thiamine. The normal physiological mechanisms for absorbing dietary thiamine are inadequate for large doses and that is where allithiamine comes into the picture. Further research showed that this disulfide form of the vitamin did not need the complex biochemistry to absorb it into body cells.

A Vitamin B Research Committee was formed in Japan because of their vested interest in beriberi that was still seen quite commonly in 1965 when they published their work in Tokyo in a book entitled “Thiamine and Beriberi”. I was lucky to receive an English translation from one of the members of the Japanese committee. It has within its pages a cornucopia of information that is of vast importance in our modern era. The discovery of allithiamine sparked a long period of research that led to synthesis of a huge number of thiamine derivatives that can now be separated into a group of disulfides and non disulfides. The most efficient derivative is thiamine tetrahydrofurfuryl disulfide (TTFD). It is sold as a prescription item in Japan as Alinamin and also known elsewhere as Fursultiamine. The best known of the non disulfides is Benfotiamine. Alinamin is capable of entering the brain whereas it has been shown by a researcher in Belgium that Benfotiamine does not cross the blood brain barrier. This barrier is a normal physiological mechanism.

I want now to concentrate on TTFD since I have been studying its benefits for 38 years and have written many papers in the medical literature. It is not approved by the FDA in the United States in spite of its enormous therapeutic value because it is considered to be a drug. For an American drug company to import it, it would involve the millions of dollars for testing. The present model of disease demands that the drug must be virtually unique in the cure of a specific disease to warrant the expenditure and its recuperation in profits. The trouble with that is that the model itself is outmoded as indicated in an earlier post and the therapeutic properties of TTFD have biochemical implications that do not fit the model. The reason is that it addresses energy metabolism that is the underlying root of many (if not all) diseases and particularly those involving the brain.

We know that depletion of thiamine is the equivalent of oxygen deficiency since they are both essential ingredients of cellular energy production. Published material has shown that thiamine is involved in many brain diseases and that its administration as TTFD has shown some benefit in autism and even in Alzheimer disease. Japanese investigators have shown that it improves muscle function (I have treated Duchenne muscular dystrophy with partial success) and that it shortens the recovery time from post surgical paralysis of bowel function known as “post operative paralytic ileus”. Animal studies have shown that it removes lead and mercury from body tissues and also has anti-inflammatory properties. Amazingly,pretreatment of mice with TTFD partially protects the animal from cyanide death and liver damage from carbon tetrachloride administrations. Beriberi is the prototype of dysautonomia in its early stages and this category of disease is very common in America because of the huge ingestion of sugar as already discussed. It is my view that TTFD could easily be introduced to the United States under GRAS rules (generally regarded as safe) but our bureaucracy is stiffer that the proverbial poker. If there is a substance available in this cruel world that helps so-called untreatable disease, should we not welcome it? Even a 10 percent improvement, achieved cheaply and without toxic risk, is better than the status quo and we should be trying hard to find its full value in medicine. If it has indeed rendered the medical model outmoded, there is nothing more constant than change!

Monday, February 28, 2011


A choked engine in a car is achieved by an excess of gasoline with insufficient oxygen and/or an inefficient spark plug to ignite the gasoline. The result is loss of engine efficiency and decreased performance. Although the details are different and more complex in our bodies, the result of eating empty calories (“junk food”) is confusion in the brain/body dialogue, resulting in diverse symptoms. Hence the “The Choked Engine Syndrome” is caused by an excess of calories without the vitamins and minerals that enable the calories to be used as cellular fuel to produce energy. I want to describe a typical case and any reader might easily recognize his/her own symptoms.

A 14-year old boy had the major complaint of abdominal pain. It is natural to think that abdominal pain is caused by changes in abdominal organs and we shall see that this can sometimes be misleading. Generally speaking, a physician might focus his attention on the major symptom, thus dictating the investigations that are initiated. This is insufficient and other symptoms are only revealed by direct questioning. He had constipation alternating with diarrhea and the pain occurred after ingesting anything that tasted sweet. He had had suicidal thoughts, suffered frequent headaches and “panic attacks”. He complained of frequent nausea, sometimes accompanied by vomiting. He had been admitted to a hospital for three weeks for depression and seven different drugs had been prescribed. He had noted occasional dizziness, was regarded as emotionally unstable, suffered unusual fatigue and insomnia. He ground his teeth, talked in his sleep and suffered periodic attacks of “pins and needles” in his hands and feet, as well as leg pain while walking. He had noticed an occasional brief pain in the chest and, on questioning he reported that nasal congestion affected his right nostril only. Studies elsewhere reported that he suffered from fructose intolerance and all forms of fresh fruit had been withdrawn from his diet.

His facial appearance was typical of the many children and adolescents that I have seen over the years with this syndrome. There was a zone of pallor around his mouth, together with unusual flushing of the cheeks, producing a “clown-like” imitation. His tongue was badly coated a dirty brown with little red spots on its surface. He had the signs of mitral valve (a heart valve) prolapse by listening to his heart with a stethoscope. His blood pressures in the two arms, when measured at the same time, were widely different. Knee jerks were excessively reactive and a white stripe could be elicited by gently stroking the leg with a finger tip, a phenomenon known as dermographia or “skin writing”. There was a family history of one relative with diabetes.

One of the posts in this blog describes a “two-brain model” that emphasizes that the lower brain, known as the limbic system and brainstem, make up a very obvious computer, organizing our daily adaptation to environmental factors, sensed and data processed by the computer. If this part of the brain is poorly nourished by the ingestion of empty calories, its energy is affected and its loss of efficiency causes it to behave in exactly the same way as it would with a mild to moderate deficiency of oxygen.

The brain computer has a heavy oxygen requirement and a curious thing happens when energy production is mildly to moderately limited. It becomes hyper-reactive in its adaptive response to environmental stimuli, conveyed to it by sensory input. It is not the stomach that causes nausea, it is the brainstem. Vomiting occurs as a result of a signal sent to the stomach from the computer. This boy’s headaches, abdominal cramping and all his abnormal emotional reactions were produced by faulty and unnecessary executive action within the computer and its subsequent messages to body organs. It is the limbic system of the brain where our emotions are initiated. Emotions are reflex and although we are conscious of their action they are not developed from a thought process. Modifying the response to anger, for example, requires dialogue between the upper and lower brains. Road rage is an example of lack of this modifying effect. It was not fructose intolerance that was the defining issue. It was sensitivity to sugar that is extracted from the plant where it is naturally produced. To deny him fresh fruit was unnecessary because that is the natural way that sugar should be ingested. When we extract the active principle from a plant we turn it into a drug. Our taste mechanisms in the brain are programmed to receive permutations and combinations of six stimuli that provide flavor. By tasting sugar as a solitary stimulus it stimulates pleasure perception and it is the root cause of its addictive nature. The fiber in the fruit modifies the way that its sugar content is absorbed and processed and should remain the source of our sugar ingestion.

. Another clue to his sugar sensitivity was a relative with diabetes, a condition that is well known to be related to sugar metabolism. As the “Three Circles of Health” describe in a former post, there is always a genetic influence in the outcome of health and disease. It is the lower, primitive brain that organizes our adaptive mechanisms and panic attacks are nothing more than fragmented fight-or-flight reflexes that were being fired much too easily and unnecessarily. The autonomic nervous system, that is the two channel “telephone line” to all body organs, controls the two halves of the body separately, so this asymmetry is normal. When the brain controls become excitable in the way that I have described here, its asymmetric reflex mechanisms, including the blood pressures, become exaggerated. The nasal congestion confined to the right nostril only was an abnormal representation of this asymmetry, for there is a phenomenon known as the nasal cycle (Yogis have known this for centuries) when the nostrils receive signals from the autonomic nervous system asymmetrically. The periodic chest pain is like “a warning bell ringing in a complex system” and is a common symptom in this syndrome Out of great complexity, it is possible, with our present knowledge of how the human body functions, to distil out a simple solution that does not require seven drugs. All it does require is knowledge of the diet that God intended us to consume. After all, we could not have survived as a species if our food had not been present. All that this boy had to do to get well was to remove all forms of sugar from his diet except in the form of fresh fruit. He also required a few vitamin/mineral supplements to catch up with his normal metabolism.

Monday, February 7, 2011

Chronic Fatigue

Fatigue is one of the most common symptoms in patients that consult me. It is usually the presenting symptom but is invariably associated with many other symptoms, many of which are not volunteered by the patient. Modern clinical visits are usually quite short and focus on the presenting symptom without due consideration of the importance of the whole picture. Thus, it is mindful of the parable of the “blind men and the elephant”. A group of blind men were asked to describe an elephant. One found the ear, another the trunk and so on. Each described the elephant in terms of the small area examined and was certain that he had described the elephant. It led, of course, to accusations of inaccuracy of observation between them. Each was guilty of missing the “big picture”. Diagnosing disease is sometimes like that.
For this reason, when a person seeks an appointment with me through my office, a questionnaire is automatically sent to the ‘would be” patient, who is asked to fill it in and bring it for the office visit. The most important part of the consultation is the history and I begin by asking the patient the main reason for coming. Then, I ask “When were you last quite well”? It is often surprisingly difficult to pinpoint this and I frequently find that the very first symptom experienced goes back many years and even back to childhood.
So let me describe a typical hypothetical case of a person reporting with the major symptom of fatigue. The patient is a 35-year old married woman with two children. On questioning, she states that she cannot remember when her very first symptom appeared but she had a lot of colds and “flu-like” episodes in childhood and received many antibiotic treatments. She had some academic problems through school and missed a lot of school days because of illness. Her fatigue began in high school and became an added problem through college. As the years passed, she gradually accumulated other symptoms and her questionnaire reveals many more.
She has difficulty in getting to sleep and keeps awakening through the night and does not feel rested in the morning. She grinds her teeth, has some nightmares and her husband reports that she talks in her sleep and snores. Occasionally she stops breathing and starts again with a gasp. Her hands and feet are cold and she gets “pins and needles” in them. When getting out of bed or standing up from a chair she becomes “dizzy” and has even blacked out once or twice. She has sensitivity to changes in ambient temperature and barometric pressure and develops a headache with an approaching thunderstorm. She consumes two cups of coffee on awakening and takes one with her in the car on her way to work. She claims that she is so fatigued that she could not get to work without it. She has nasal congestion in the morning and, on questioning, notices nasal congestion in the left nostril when lying on her left side. When she turns over in bed the left nostril clears but the congestion shifts to the right nostril. She also claims that she is allergic to many things, each of which causes her to develop nasal congestion and asthmatic wheezing.
Her menstrual periods are irregular and are associated with emotional instability. She has severe cramps and develops a craving for chocolate and salty food snacks. She also notices abdominal pain on the left side at mid cycle that alternates with the same kind of pain on the right side with the next period. She has what is so often thought of as a disease for the gynecologist, premenstrual syndrome (PMS) that is believed to affect as many as 30 million women in the U.S. alone. In fact, it is so common that many women accept it as normal. The causative factors are always multiple, involving genetic risk and the stresses and strains of contemporary lifestyles. By far the most important aspect is diet. Americans do not damage their physiology with breakfast, lunch and dinner. It is what they do between meals and at social gatherings where their intense desire for sweet tasting substances is assuaged. It goes without saying that smoking is the most dangerous of all. I have also noted that coffee comes into this, perhaps in genetically susceptible people, because of its caffeine content and in spite of its content of antioxidants that has been promoted widely. Previous posts on this blog have tried to outline the danger of sugar. Chronic Fatigue Syndrome, Chemical Sensitivity Syndrome, PMS, and Fibromyalgia Syndrome are related in their causative factors and the present medical approach to them is only symptomatically helpful but does not address the underlying cause. I have two sayings that I give to my patients. Eat only “God-made food” and get rid of “the hair from the dog that is biting you”. That refers to the popular things that give us a jolt of pleasure such as sweet and salty things. I once saw a woman that developed her symptoms from just two cups of coffee a day. She thought that I was crazy to suggest that she remove coffee and I told her that she would never know whether I was right unless she tried it. She suffered an agonizing headache that kept her in bed for 48 hours. Then the headache disappeared and her health rapidly improved.
This blog is called “Oxygen, the Spark of Life” and I must again emphasize that the oxygen is useless unless it is consumed in the complex process of oxidation. Yes, it is indeed complex but the human body/brain physiology has evolved and the species has survived as a result of food that was provided by Mother Nature. All we have to do is to obey the rules. Since we know those rules, we are each responsible for our own health unless there is an underlying genetically determined weakness. Even then, the new science of epigenetics tells us that we can indeed manipulate our genes, at least partially, by dietary means and the addition of vital nutritional supplements.