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".
Thursday, December 15, 2011
Monday, November 7, 2011
MORE ABOUT THE BRAIN/BODY ACTION
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".
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
AN UNUSUAL RECOVERY
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.
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
WHAT IS ELECTROGENESIS?
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
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
MORE ON------BACK TO THE FUTURE
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”.
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
BRAIN/BODY DISEASE: BACK TO THE FUTURE
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.
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.
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