My book on alternative medication - A Nutritional Approach to a Revised Model for Medicine

Is Alternative Medicine the Answer We Need? Are we poisoning ourselves with the foods we eat? Dr. Derrick Lonsdale, M.D., provides the nutritional and health care answers we need in his no-nonsense book A Nutritional Approach to a Revised Model for Medicine: Is Modern Medicine Helping You? Can a simple change in our diet make all the difference? Are we eating too much sugar? Could the obesity epidemic, diabetes, and a host of other diseases be the result of our present dietary mayhem? This is the view expressed in the illuminating book by author Derrick Lonsdale M.D., who draws attention to the dangers of the prolific ingestion of sugar that is so widespread today. The book cites case reports to illustrate these dangers and to emphasize the ease with which symptoms may be stemmed in the early stages. However, if symptoms are left unrecognized and behavior is unmodified, these symptoms become less treatable, giving rise to chronic diseases and serious health problems. This is one house call you won’t want to miss! A NUTRITIONAL APPROACH TO A REVISED MODEL FOR MEDICINE: IS MODERN MEDICINE HELPING YOU? (ISBN: 978-1-61897-092-3) is now available for $13.50 and can be ordered through the publisher’s website: http://sbpra.com/DerrickLonsdale or at www.amazon.com or www.barnesandnoble.com. WHOLESALERS: This book is distributed by Ingram Books and other wholesale distributors. Contact your representative with the ISBN for purchase. Wholesale purchase for retailers, universities, libraries, and other organizations is also available through the publisher; please email bookorder@aeg-online-store.com. About the Author: Derrick Lonsdale, M.D., was born in Lancashire, England, and earned an MB.BS. at London University. He worked in medical practice for 64 years, retiring at the age of 88. Dr. Lonsdale is a Fellow of the American College for Advancement in Medicine (ACAM), an international professional organization that represents the alternative medicine field. He has written two previous books on alternative medicine and published over 100 medical papers. Strategic Book Publishing and Rights Co, LLC www.AuthorMarketingIdeas.com www.PublishOnDemandGlobal.com www.StrategicBookClub.com ABOUT: Strategic Book Publishing and Rights Co, LLC provides book publishing, book marketing, and e-Book services to over 10,000 writers around the world, employing 150 people who live throughout the US and work virtually through telecommunication. Strategic Book Publishing and Rights Co, LLC is experiencing over 30% growth per year, having published approximately 3000 authors with almost 100 new releases per month. Our books are available through Ingram, the largest book distributor in the world, as well as in bookstores, through Amazon, Barnes & Noble and all online channels. Strategic Book Publishing and Rights Co, LLC attends and exhibits at the major book expositions in London, New York, China, and Germany each year. To follow us on Facebook: http://tinyurl.com/2cwerv7 To follow us on Twitter: http://twitter.com/#!/SBPRA To follow us on Linked In: http://www.linkedin.com/groups?mostPopular=&gid=3690863

THE THREE CIRCLES OF HEALTH

I was particularly struck by an article in a Canadian magazine by Inge Hanle “Why are Pharmaceutical ‘psycho-drugs’ mandated- and Orthomolecular Remediation shunned and even outlawed”? She put her finger on it by saying that “Health is not the driving engine of ‘health care. Money is and money talks. I have failed in laboring against this ignominious fact for years after my eyes were opened to the truth. The fact is, however, that we cannot ever give up”. Then what is the truth? I was told by a friend that he could not understand my previous posts. They were “too technical” so I am going to try to put all of them in a “nutshell” and say that all I am trying to do is to deliver a message. Each of the earlier posts actually depend on understanding the principles outlined here. This blog is not for entertainment, it is trying to educate the public, based on 64 years of medical practice. Neither does it cost a dime to read. An ounce of prevention is worth a pound of cure. It seems that few people ever give the slightest thought to why we breathe and what we do with the oxygen that we inhale. It is likely that when the use of oxygen (oxidation) in the body goes haywire, even fewer people associate it with illness. So let me make it as clear as I can in supporting the words of Inge Hanle. “Orthomolecular remediation” means that every cell in the animal body, including humans, requires fuel (calorie producing nutrients).Naturally occurring food includes a whole series of nutritional substances (orthomolecular) that must “ignite” (oxidation is a form of chemical combustion) to create energy. It applies to every one of the 70 to 100 trillion units (cells) that are stuck together to make a human body. Each cell has a special function that contributes to the enormously complex activities of the whole brain/body union. “Remediation” implies that this complement of nutrients is not being met by modern diet and must be provided for normal health, or even its retrieval. When a person has been consuming high calorie foods that do not have enough vitamin content, the cellular machinery begins to decline. The symptoms generated are so common that they are either ignored by family and physician or given the label “psychosomatic”, or “functional”. At this stage it only requires simple recognition of dietary error as the cause. If it continues for years, however, the damage gradually becomes irreversible and results in classic diseases such as rheumatoid arthritis, ulcerative colitis, many different brain diseases in adults, and autism from bad nutrition in pregnancy. As we all know now, there are genetically determined diseases, but we will show shortly that such a handicap can be helped by nutrition and lifestyle--------a new science called epigenetics. The brain and the heart use more energy than any other tissue in the body. That is why the high calorie intake of white rice (fuel) without vitamin B (spark plug) caused thousands of years of terrible neurological and heart disease in millions. This disease, known as beriberi, is one of the classical vitamin deficiency diseases. White rice (the grain without the vitamin containing husks) is starch and was the staple food for the peasants in China. This is broken down to glucose in the body and is the primary fuel for our cells, particularly the brain. The high concentration of carbohydrate yielding calories without vitamin B caused the disease. The “fuel” was not being efficiently oxidized, resulting in lack of sufficient energy for the affected cells to function properly. It is a perfect example of high calorie malnutrition. Because modern diet is believed to have adequate vitamin enrichment, beriberi is considered to be only of historical interest. But starch is a carbohydrate and in our present culture sugar in ALL its different forms substitutes for white rice. Thus high carbohydrate calorie malnutrition Is common. The effect of this , known from experimental studies in human subjects in 1942, is to make the brain more irritable, producing “psychosomatic” symptoms. Examples are; heart palpitations, an intermittent form of relatively mild chest pain, IBS, PMS, excessive sweating, pins and needles or numbness, recurrent nausea and vomiting, fibromyalgia, sudden bursts of emotional reactions such as might follow a trivial incident and even allergic manifestations from food or external influence such as a mosquito bite. The brain/body is always alert to defend us from hostile aspects of nature. If, however, it has been made too responsive by high calorie malnutrition, it fires excessive signals that provide discomfort in the form of these symptoms. A full belly is not necessarily good nutrition. I have repeatedly referred to “high calorie malnutrition” in previous posts. It has been said that any complexity must be reduced to simplicity to be of general use. So I have provided an hypothesis to show how the complexity of modern medicine can be reduced to relative simplicity. By drawing three interlocking circles you can easily understand the mechanisms of health and disease. They all interlock at the center. Circle 1: Genetics. Modern medicine is looking deeper and deeper into our genetic mechanisms. They are trying, I believe falsely, to explain every disease on genetic grounds alone. It is true that genes come into our individualized construction and our DNA is never perfect. But many of the “mistakes” are minor and fortunately, by themselves, make little clinical difference. Some form of stress may initiate their action. Even major mistakes in DNA can often be helped b y the science of epigenetics. This is based on the discovery that our genes are indeed influenced by diet and lifestyle. Circle 2: Stress Stress is defined as “pressure or tension or compulsion (times of s.when much energy is needed)”. It is the part in italics that matters in the interpretation of its effect on health. People fail to be aware of the slow health deterioration that they can suffer both mentally and physically as a result of prolonged stress from all the complexities of modern lifestyle. They often fail to realize the energy consumption required for recovery from an infection or surgery. Because we have to adapt constantly to both physical and mental stress, the energy consumption can be enormous. If the energy producing biochemical mechanisms fail to keep up with the increased expenditure, cellular energy deficiency results in dysfunction that depends on locality and the aggregate number of affected cells. Circle 3: Nutrition. If a car gets the fuel for which it has not been designed, its performance is either reduced or it ceases. That is also true for us and so it behooves us to study the nature of the right fuel. Since we would not have survived as a species if the food had not been present when we arrived on Earth, it is obvious that naturally occurring food is the fuel that fits our design. Any substitute is essentially wrong, even though our “engines” are remarkably adaptable and many people “get away with it”. It should be obvious that the highest power car engines require the fuel most closely suited to its design and I have come to realize that the most superior people are in greater danger from poor nutrition. The observations made over many years indicate that the greatest danger is in high intelligence brains. I will give an illustration of the necessary interaction between these three circles from the history of beriberi , now accepted by all as an excess of simple carbohydrate without vitamin B 1. Its cause from dietary deficiency has been known for less than one hundred years. The peasants in China, where beriberi affected thousands, worked in factories made up of ranks of buildings, separated by relatively narrow corridors. In the early spring/summer months, the workers would take their lunch in the corridors. At first they would be in the shade but after a short while the sun would shine onto them. Some of the workers would develop their first symptoms of beriberi as they continued to sit in the sun. It was this kind of phenomenon that made the doctors think that the disease was due to infection since a few individuals succumbed at the same time. Now that the cause of this disease is an open book, the explanation is quite different. Why, for example, would only a few workers succumb? They were all eating the same diet. Genetic risk always comes into the picture in health and disease because we are all uniquely different in detail. Sunlight is stressful to the body. That is why we tan because it is a form of defense against the physical stress of sunlight. Granted that the nutrition circle was (and still is) the most important circle but sunlight initiated symptoms in those who were either more at risk genetically or diet wise. I imagine the workers most at risk were “sitting on the edge of a metabolic cliff”. The “stress factor” knocked them off the “cliff”. If we think this way, it becomes much easier to understand why a disease like diabetes can make its first appearance after a simple infection, a business crisis or a divorce. Geneticists have never been able to fit this disease into the classic concepts of genetics because that is only one circle in “The Three Circles of Health”

CHILD ABUSE

Since the title of this blog is “Oxygen the Spark of Life” a reader might well ask why I am addressing the subject of child abuse. In all my posts I have tried to show that normal brain activity depends on normal energy metabolism induced by efficient oxidation. It is obvious that child abuse can be simply a lack of love and we know that people are capable of cruelty but I have had an unusual experience with child abuse. The nature of the extreme cruelty is hard to explain as coming from a parent with a normal brain function. I am going to recount the history of three unusual cases. They were so awful that it resulted in a symposium at Cleveland Clinic Foundation where every member of the many public organizations in the city dealing with children’s welfare were invited. Many years later, I met a woman that told me that it had led to the establishment of the “hotline” that operates in Cleveland today. They all happened so many years ago that identification would be impossible. Perhaps the most tragic case was Charlie who was brought for medical consultation “to explain all those scars on his body”. The point is that the correct nature of the cause of the injuries is never given. It is “this strange disease” or “he fell off a wall” etc. So a physician has to be a detective as well as a sympathetic listener. It turned out that the real cause of Charlie’s scars was repeated cigarette burns perpetrated by his mother. This has been reported in other cases. I imagine that it is “you do that again and I will punish you with another burn”! It comes from the mind of a parent under extreme stress, especially as the father had the nickname ”Killer”. Then there was Vicki, aged four, who was admitted to the hospital with an obvious case of Kwashiorkor, the typical appearance of protein starvation seen today in children of third world countries. Vicki quickly began to flourish, even with “hospital food” and it turned out that it was a case of attempted homicidal starvation. Although this could not be proved, the mother was ordered to appear with the child at regular intervals. Each time that she made an appearance the child was clothed in a new outfit, each one being of a different color. One day the child appeared with three bruises on her forehead and this was explained by a fall. I must add here that all this was before the Child Abuse law was established in Ohio. At that time it was necessary only to report a suspicion to the police. Later, Vicki was brought into the emergency room in coma and was passed immediately to neurosurgery where the brain tissue was found to be abnormal in appearance and substance. When she died, nothing could be proved but I suspect that she was smothered. The last case I want to describe was a 6-month old infant referred by a pediatrician who had found an enlarged liver in the child. He was scheduled for liver biopsy but with TLC from the nurses he began to sit up by himself for the first time and to my great surprise, I found that the enlarged liver could no longer be felt. I cancelled the biopsy and told the mother what the findings were and that she would need to follow up with the pediatrician. As I was reporting to her, there was a sudden and dramatic dilatation of her pupils. I became suspicious that she was on the verge of a nervous breakdown and wrote to the pediatrician asking him to watch out for possible child abuse. The mother was referred to a psychiatrist who reported that she was perfectly normal. A month or two later, this child was in an emergency room with a skull fracture, still accepted as “an accident”. The next event proved the underlying truth when the child was found drowned in a bath tub. I later received a letter from the pediatrician telling me of the final event and adding, “ I wonder how we could have prevented this”? I was unable to explain how something as important to an infant as TLC could rapidly lead to a return of an enlarged liver to normal. It did, however, lead me toward the importance of “mind over matter” in consideration of health and disease. Had the simple charm of loving care turned on the placebo effect? Doctors are trained to accept the complaints of a patient and at this relatively early era in mid 20th century, child abuse was not as well known as it is today. Other pediatricians thought that I was cruel and unsympathetic, reflected by the presence of only three or four pediatricians at the symposium. I have suggested in previous articles and papers that murder can occur in blind rage (seeing red), even on the spur of the moment. A crime can be accepted in Ohio as “temporary insanity” if it can be proved that the criminal “knows what he is doing but is powerless to stop himself from doing it”. This, totally different from cold blooded planned crime, was illustrated very well by Dostoyevsky in his novel, “Crime and Punishment”. The trouble is that it is virtually impossible to prove. In the case of child abuse, the abusive actions often occur impulsively and seem to be well beyond the powers of reason. The extraordinary love of motherhood is an icon of human behavior. I hypothesize that the brain of an abusing parent is biochemically abnormal and the child, in some way, irritates her/him to release a physical action known to be wrong, but beyond the power of reason. Although child abusers, like wife abusers, are more commonly from the lower socioeconomic members of society, it is certainly not confined to them. Alcohol and/or poor diet may well enter the picture in many cases, thus introducing biochemical changes that cause excessive irritability that overwhelms the power of reason. For this to be explored and researched, it would be necessary to accept the possibility. Our society and our medical thinking is very far from that.

MICRO-ORGANISMS ARE OPPORTUNIST

As a brief prelude, those who know a little about English history will remember that Henry VIII “dissolved” the monasteries so that he could grab their cash. My teaching hospital, St Bartholomew’s, was founded by a monk named Rahere in 1123 as a monastery in “the smooth field”, now known as Smithfield in the City of London. Thus “dear old Henry” dissolved it! Later when he became sick from syphilis he wanted somewhere that would treat him so he refounded it and became known paradoxically as the founder. Thus there is a statue of him over the entrance gate to this day. As a young intern in this, my teaching hospital, I had an experience that I have remembered through 64 years of medical practice. One night I was confronted with a middle aged man with pneumonia. This was before the days of antibiotics: the first sulfonamide had just been synthesized. The patient was known to have chronic tuberculosis and the pneumonia was an additional factor. There was little that we could do for him. In the morning I was standing in the ward entrance. The hospital was made up of wards for males and females separately and each consisted of about 30 beds. The only privacy was a curtain that was used to surround each bed as required. Each ward was presided over by a head nurse who was called Sister. Her flowing cap and the name Sister were inherited from the time when monks were the doctors and lay sisters were the nurses in monasteries. Every physician in an English hospital and especially young interns listened to Sister at his peril. She ruled the ward with an iron rod. She is truly a historical figure. The next morning, while I was standing in the ward entrance, my “chief” had entered and was standing behind me. He said “O, I see you have a dying patient” and of course, I asked him how he knew. “Well,” he said, pointing to my patient with pneumonia, “you see how that patient’s fingers are picking at the edge of the bed-sheet, occasionally pointing at the ceiling and picking at thin air: that is consistent with what we recognize as a toxic brain”. Well, of course, he died and the autopsy showed that his entire body was infiltrated with micro-abscesses filled with staphylococci. The lab work before he died showed nothing that would even hint at disease. The white cell count was normal: he had no elevated temperature and other blood tests were all normal. Laboratory tests are used really to see how a sick person is responding to any form of “stress”, including any form of infection. They really demonstrate how the body defenses are responding to an attack. It was clear that he had not put up any kind of defense at all. In fact, due to poverty, poor diet and the ensuing tuberculosis, his defense mechanisms were simply not functioning. The important factor that I learned the hard way was that the part of his brain that acts as a computer below conscious level was “sick” and that it had failed to organize any kind of defense. The next time I saw this phenomenon was when I was an assistant in a family practice in Leicester, a Midlands city. One evening two young women came into the surgery (office) at the end of evening hours and said “we want you to come and see our Dad”. I asked whether it could wait until morning and they said “no—we want you to come now. He’s got a cough”. When I entered the bedroom I saw a middle aged man who was kneeling on a bed with a single blue light bulb over the bed as the only lighting. He was looking at me with sightless eyes, pointing at me and “picking at thin air”. He proved to have meningitis caused by a pneumococcus, an unusual organism for meningitis but a common one for pneumonia. The family had failed to call me for his “cough” that was due to pneumonia that had preceded the meningitis. Because of his extreme disability through poverty, lousy diet and poor living conditions, the organism that had caused pneumonia had spread to the spinal tissues to cause meningitis. He had the same situation as the one already described. It has been a vivid memory that has guided me to see how the brain is responsible for our body defenses in any sort of attack, whether it be an infection, an injury or virtually any form of “stress”. So, it is fascinating now to see that research has indeed shown how the brain “gets into the act”. It has recently been found that the lower part of the brain, the computer, receives information that an organism is attacking. It then dictates what has come to be known as the “inflammatory reflex”. It organizes this vital defensive mechanism because of messages from the attacked tissue to the brain through an important nerve called the vagus. This nerve runs from the lower part of the brain to many organs in the body, carrying signals from and to them. Thus it turns on the inflammatory reflex, controls the right degree of inflammation and then turns it off. We need inflammation as a defense but it has to be carefully controlled. If something goes wrong with it, an important part of our defense is compromised. The mechanism depends on chemistry (and probably electricity) derived from food that supply our cells with the ingredients to synthesize cellular energy that enable this vital reflex to function. Both these unfortunate patients were killed by organisms that quickly overwhelmed their depleted natural defenses. Thus, you might say that the attacking organisms were opportunists. They “cashed in” on an easy opportunity to win what is essentially a war between us and our environment. We are bombarded with stressors that we cannot see, against which we have to mount a defense. As Darwin theorized, it is the survival of the fittest. The term “opportunist” is officially reserved for organisms that attack us only when our ability to defend ourselves has been damaged severely enough through disease to threaten death. For example, candida albicans is a yeast, known as “opportunist” since it is generally considered never to launch an attack unless serious illness has prevailed. We all know, of course, that Louis Pasteur introduced us to the fact that organisms that could only be seen with a microscope could kill us. This was really the first paradigm in medicine that led us ever since to seek ways and means to “kill the enemy”, whether it be bacteria, virus or cancer cell. I find it fascinating that Pasteur is said to have remarked on his death bed “I was wrong! It is the body defenses that matter”. Thus, perhaps Louis Pasteur indicated the next medical paradigm. I think that we should consider all pathogenic micro-organisms to be potentially “opportunist”. In recent years I have seen many children with autism who commonly develop yeast infections and although they are certainly biochemically compromised, they are not by any means “near death”. We are seeing diseases caused by infections with organisms like chlamydia that appear to be classified as “opportunist” but I believe that our profligate diet, the air we breathe, water and food pollution are all combining to weaken our defenses so that organisms that do not usually attack are being given a better opportunity to win the war. I believe that we should regard any pathogenic micro-organism as an opportunist, because it is much less likely to win a war when our bodily defenses are well organized. Think of the body as like an old fashioned fortress. There was a central control in the shape of a commander and the defenders obeyed his orders. If the commander was asleep or otherwise out of commission, any attack on the fortress would be potentially doomed. I have been engaged in answering patient’s questions on a new website called ”Health Tap”. This is where a great deal of free answers are provided by a large group of doctors who give some of their time to this beneficial connection between doctor and patients. What surprised me was that the answer I have had to give to so many of these questions has been “diet”. It was so common that I must look like a “broken record” to some. The fact is, however, that the nature of our fuel supply is one of the very few things that we can do preventively to maintain health. As long as we drive a two ton machine to a supermarket and buy our food in cardboard boxes, we are like cars that have been provided with the wrong fuel. The resulting failure to synthesize sufficient cellular energy winds up by supplying our only natural enemies with plenty of opportunity. It was not doctors that stopped the common appearance of tuberculosis. It was better housing, hygiene and less starvation. It is not too surprising that this dread disease has recently made its reappearance and is Mother Nature’s comment on our modern diet. The only difference is that we have swung from too little food to too much of the wrong food, the Yin and Yang that rule the natural order of things.

BLEPHAROSPASM

Blepharospasm (from the Greek blepharo; eyelid and spasm meaning an uncontrolled muscle contraction) is any abnormal contraction or twitch of the eyelid. It is well described in Wikipedia as “a neurological movement disorder involving involuntary and sustained contractions of the muscles around the eyes” Wikipedia goes on to say that “the person’s eyelids feel like they are clamping shut and will not open without great effort”. It is fairly rare, affecting only one in 20,000 people. In some cases an affected person is able temporarily to open his/her eyes by a voluntary mental diversion. For example, he/she might want to go into a store to buy something but is functionally blind. By saying “e.g. Mary had a little lamb---etc.” the eyes open, but close again after the verbal diversion is completed. This, of course, suggests a “psychosomatic” background, but I have tried to deal with that issue in previous posts. Wikipedia indicates that its cause is unknown but obviously it is related to abnormal brain function in sending unwanted messages to the eyelid muscles. I am addressing this because of a most unusual case that I encountered many years ago. She did not fit at all into the descriptions provided by Wikipedia. It seemed to illustrate two things that I have tried to emphasize repeatedly in this blog. First, it is the brain/body combination and secondly the fundamental role of oxidation, the use of intracellular oxygen in energy synthesis, particularly as it affects the brain. The patient was a girl, 12 years of age. She had been referred because her eyelids had been in a permanent state of spasm for some time. As I examined her I tried to open one of her eyes manually. The spasm was so strong that I could only open it as a slit and as I did this a stream of tear fluid shot out several inches in the form of a spray, indicating that the tear glands were being stimulated at the same time. The other thing that I noticed was that her skin was covered with “goose bumps”. At one time in our evolutionary history we were covered with hair and each hair could be raised by the contraction of a tiny muscle attached to the follicle from which the hair grew. It is thought that the ape-like animal would look much fiercer when confronting an enemy with all his hair fluffed up. We no longer have the hairs but the follicles have remained and when the little muscle contracts, it makes a tiny cone-like bump that we call a “goose bump”. We still experience hair rising on the back of the neck when we encounter a form of sudden stress. Running my hand over the child’s skin, it felt rough because of the generalized pilo-erection (pilo: a hair). Most people associate this skin appearance with feeling cold, quite correctly. This is because the action is mediated by the sympathetic branch of the autonomic (automatic) nervous system (ANS). In previous posts I have discussed the ANS and the sympathetic branch is responsible for mobilizing action as in the fight-or-flight reflex that is initiated in a state of imminent danger. In other words this child was experiencing a danger reaction without there being any form of danger. After admission to the hospital it was found that she had a high blood sugar indicating that she had diabetes. Then a strange thing happened; after a single injection of insulin the pilo-erection disappeared. This, of course, indicated that her sympathetic system had become less activated. How to explain this gave me a great deal of thought. I came to the conclusion that the diabetes was due to the fact that the central part of her brain was not monitoring the concentration of circulating blood sugar and failed to send a signal to the pancreas to produce the necessary insulin. This made some sense considering the fact that the blepharospasm was caused by an outpouring of signals from the brain. I came to the conclusion that oxidative metabolism in the brain was the central underlying cause for everything and started to give her thiamine tetrahydrofurfuryl disulfide (TTFD) {Blog posts:3/16/11, A Remarkable Nutritional Supplement. 10/8/11: An Unusual Recovery}. To my surprise and satisfaction, the eyes opened and she became clinically well. She turned out to be an exceptionally intelligent and delightful personality who delighted in writing poetry. She lived in another State and after discharge I lost sight of her. Some years later I heard from another source that she had developed a calcified tumor in the center of the brain but I was not a party to how this was treated or what was the outcome. That supported my original contention that the problem was due to abnormal activity in the lower part of the brain. I need hardly add that there was no evidence of a tumor when she was under my care. There was therefore no possibility of knowing whether the tumor was related to cause or effect. I am describing this case because, as I have already said, it illustrates the dual action of the brain and body in both health and disease. Her blood sugar was raised because the pancreas had not received an appropriate signal from the part of the brain that monitors blood sugar, so her diabetes was a most unusual form. The sympathetic branch of the ANS had evidently been alerted from the lower brain control system. To think of this as connected in any way with psychology is absurd and I have long since regarded traditional ”psychosomatic” disease as a reflection of abnormal chemistry in the brain, commonly induced by poor diet. There was probably a genetic cause for the disease in this unfortunate girl. The response to TTFD did indeed suggest that oxygen was not being consumed efficiently in brain cells. As I have previously indicated, TTFD can be compared to a spark plug that ignites gasoline in a car engine. Also, even if there had been a genetic cause, it must have influenced the chemistry of cellular oxidation .

EOSINOPHILIC ESOPHAGITIS

Eosinophils (so called because they stain with eosin for microscopic observation) are one of the varieties of white cells that we possess in the blood. Eosinophilic esophagitis is an inflammatory reaction in the esophagus associated with an infiltration of these cells. It is only in recent years that the disease was discovered and is easily confused with the more common gastro-esohageal reflux (GERD) since the symptoms are similar. However, it does not respond to GERD treatments and the diagnosis can only be made by upper endoscopy performed by a specialist when biopsies are taken and the true nature of the problem is revealed. The literature on the subject indicates that the cause is unknown and treatment appears to be very unpredictable and unsatisfactory at the best. I had never heard of this disease until a parent called my office and asked whether I might be able to help her fourteen year old boy. Since my practice is based on the principles that I have outlined in this blog, I agreed to a consultation. I want to describe the case in some detail because I believe that it throws new light on this mystery. It is particularly important because this formidable disease is apparently becoming much more common and there are few clues indicated in the medical literature. The history in this case is astonishing because it almost certainly reveals that the underlying cause starts long before the diagnosis is made. Indeed, in this boy it was very much apparent that the seeds of the inflammatory reaction started in infancy. He had been exhaustively studied at a number of prestigious medical institutions and many treatments had been attempted without success. His sensitivity to pain was extreme and it was reported to me that in one hospital he had been “shredding his underwear because of the pain”. It was also stated that he had experienced anaphylaxis, although the details were not given. This is a dangerous reaction that can occur, for example, as a result of a bee sting. It is regarded as an extreme form of allergy. This is the medical history that I obtained from the parents. A pediatrician always starts asking questions beginning with the mother’s pregnancy and the patient’s early infancy. This boy had suffered a series of ear infections in infancy and PE tubes (the little plastic tubes inserted through the ear drum) were inserted at the age of 2 years. I was told that three procedures were performed because of technical difficulties. This is important because I learned from an experienced ear, nose and throat surgeon that PE tubes are placed, “not for drainage but to allow oxygen into the middle ear cavity”. This again implies that oxidative deficiency plays a vital part in the cause of these common ear infections in infants. He had experienced several episodes of cough and wheezing called asthmatic bronchitis. On specific questioning, I was told that he would cough in his sleep. We will see later why that was also of possible importance. On questioning about emotional reaction, I was told that he “wanted to be destructive” (post: Nov 8,2010). He would become very fatigued and fall asleep on the school bus. He was frequently irritable, had experienced “panic attacks”, frequent brief chest pains, severe abdominal pain, joint pains and stiffness, fits of depression and 3 to 5 headaches a week. He complained of difficulty in getting to sleep and would awaken frequently in the night. At the age of 8 years he had his first abdominal pain that was severe enough to consider appendicitis. It was initially diagnosed as Irritable Bowel Syndrome, but the diagnosis of Eosinophilic Esophagitis was finally made by endoscopy at the age of 11 years. Physical examination revealed that he had the heart signs strongly suggestive of mitral valve prolapse, a condition that is known to be associated with dysautonomia. This diagnosis was supported by abnormal knee reflexes. Heart rate was 54 beats per minute, unusually slow for a child, suggesting parasympathetic dominance(Post: June12,2011). His abdominal wall was extremely tense and even a slight touch made in the examination elicited extreme pain. To the uninformed observer this would suggest a neurotic over-reaction to stimulus, but oxidative dysfunction in the control mechanisms of the autonomic nervous system can cause exaggeration of the reaction to many different stimuli, including tactile input. Until the findings of the endoscopy, showing clearly that he had organic disease, this boy’s condition was considered to be psychosomatic, for all laboratory studies had been repeatedly normal. The finding in the endoscopy was considerted to exclude the brain as part of the disease. An unusual laboratory study (unusual because therapeutic use of nutrients is not an accepted general approach to any disease except the classic vitamin deficiencies considered to be of only historical interest) showed that there was something seriously wrong with vitamin B1 metabolism. He was treated exclusively with intravenous and oral nutrients that included thiamine disulfide (Post: March 16,2011, “A remarkable nutritional supplement”) and a complete removal of sugar in all its forms. His gradual improvement, for the first time since symptoms had begun, has been highly significant and has led to the introduction of another patient of a similar age. Although this second boy showed evidence of a vitamin deficiency other than thiamine, he has also shown great improvement with vitamin therapy. Since all vitamins contribute to oxidative metabolism, their absence represents a biochemical riddle that must be solved for each case. My conception of this disastrous disease is that the infiltration of the esophagus by these cells is a bizarre form of inflammation initiated by the brain [1]. The changes in brain would occur because thiamine plays a vital role in oxidative metabolism, particularly in the lower brain that I have described as a computer (Posts: June 14, 2010; Oct 14, 2010; July 28, 2011.) Coughing in sleep is an example of an exaggerated reflex,similar to panic attacks [2] that are really just fragmented fight-or-flight reflexes fired because of brain sensitivity and without an observed physical danger. So this must give us thought about whether our present concept of separate, named and well defined diseases is an accurate representation of health decline. It would seem that the brain always plays a part in physical disease of the body and that no organic disease occurs without brain involvement. 1.Rosas-Ballina M, Tracey K J. The neurology of the nervous system: neural reflexes regulate immunity. Neuron 2009;64(1):28-32. 2.Blechert J, Wilhelm F H, Meuret A E, et al. Respiratory, autonomic, and experiential responses to repeated inhalations of 20% CO(2) enriched air in panic disorder, social phobia, and healthy controls. Biol Psychol 2010;84(1):104-111.

SUDDEN INFANT DEATH SYNDROME

Sudden infant death syndrome (SIDS) is defined as the sudden, unexplained, usually nocturnal, death of an infant between the ages of about 2 months to roughly the end of the first year. The peak incidence is three to four months, unusual after six months and rare after one year. It is more common in male infants. Gross examination at autopsy is invariably negative, but there is plenty of evidence in the medical literature that there are microscopic changes in the brainstem. These changes have been explained as “agonal”, meaning that it is damage produced at the time of death rather than related to the cause. There is every reason to believe that these microscopic changes provide important clues that will be discussed later in this discussion. SIDS has been under investigation for many years and nobody has come up with a definite explanation for the tragedy. The latest information that has proved to be greatly beneficial is that the prone position in the crib is more dangerous than the supine. It has been suggested that the prone position is more likely to lead to suffocation or possibly that the infant might inhale chemicals in the mattress that are placed there commercially as a fire retardant. Anyway, this has led to a statistically significant reduction in this terrible event that has marred the lives of so many parents. There is still an incidence of SIDS that is unexplained and it seems to be more in the lower socioeconomic segment of the population where diet may be more inappropriate for good health. Many years ago I became deeply interested in the vitally important metabolic activity of vitamin B1 (thiamine). This came about because I was confronted with a 6-year old boy who had a neurological disease that occurred intermittently. It was invariably initiated by some form of stress such as a vaccination, a mild head injury, a sudden change in ambient temperature, or an infection. It took several years to solve the problem and required the help of a researcher at the National Institutes of Health. It proved to be thiamine dependency. This produces the same effects as thiamine dietary deficiency but there was a genetically determined defect in a crucially important thiamine requiring enzyme that enables glucose to be used as fuel for all body cells and particularly the brain. I have written repeatedly that the brain requires huge amounts of energy so it was not surprising that this boy’s illness affected the normal function of his brain. What was even more important was that this effect centered more on the lower, more primitive, part of the brain. This part of the brain contains all the vital mechanisms that enable us to compute an adaptive response to the constant changes that we meet daily in our environment. The intermittent nature of the disease indicated that the energy supply could cope with a smooth daily lifestyle but was inadequate to meet an adaptive response to some form of physical or mental stress. This boy could be protected from his brain illnesses by taking huge doses of thiamine daily. If he had a simple infection such as a cold, he would have to double this dose. It taught me how a stress event such as a relatively mild to moderate head injury, or even a simple infection such as a cold, can be converted to serious brain illness in a person with marginal energy metabolism. (Lonsdale D, Faulkner W R, Price J W, and Smeby R R. Intermittent cerebellar ataxia associated with hyperpyruvic acidemia, hyperalaninemia, and hyperalaninuria. Pediatrics 1969;43:1025-34). Because of this, I began an exhaustive library search for everything that I could find about thiamine metabolism. Not surprisingly, it led me to the complex symptoms caused by the ancient scourge known as beriberi, now known by all physicians to be due to a combination of thiamine deficiency and empty calories, most often in the form of white rice. It is clearly a disease that is related to the rate of metabolism, so infantile beriberi is more lethal than in childhood and the adult form is more chronic, representing the rate of metabolism as we become older. I found that infantile beriberi causes sudden death and in the early days of research of this disease one of the investigators had made an important statement. He said that “anywhere that public health statistics report sudden infant death, the unequivocal diagnosis is beriberi. There is no other disease known that affects infants like this”. I discovered a paper written in 1944 by a British medical officer of health. She had been sent from Britain to Hong Kong, then a British protectorate, to study a form of sudden infancy death in Chinese women who were breast feeding these infants. (Fehily L . Human milk intoxication due to B1 avitaminosis. Brit Med J 1944;2:590-2). She had discovered that the cause of this death was infantile beriberi caused by thiamine deficiency in the mothers’ breast milk. Some readers may remember that the Japanese invaded China before World War II and the Chinese women were kept on a starvation diet of rice. There was severe malnutrition in both mothers and infants but, curiously enough, the sudden infancy deaths disappeared. When the Japanese invaders were driven out of Hong Kong, these mothers had restoration of ad lib rice in their diet. Just as curiously, the sudden infant deaths began to reappear. This may have been the first inkling in humans that the ratio of carbohydrate calories to thiamine was the important issue. We now know that the intake of “empty carbohydrate calories” overloads the capacity of thiamine to process it. Sir Rudolph Peters, in Cambridge, England, had clearly shown this to be true in his experiments with thiamine deficient pigeon brain cells in 1936. The production of carbon dioxide from thiamine deficient cells was no different than that exhibited by thiamine sufficient cells UNTIL GLUCOSE WAS ADDED. The thiamine sufficient cells immediately began respiration (CO2 production) while the thiamine deficient cells remained inert. Peters called this the "catatorulin effect". Fehily had noted in her paper that this infantile beriberi had the exact epidemiology as “cot deaths”, the term used for SIDS in Britain, and that it might be worth some research. It was initially thought that there was no way of predicting a SIDS incident but it was found that certain symptoms were potentially predictable, the most important one being short episodes of sleep apnea (cessation of breathing) occurring in sleep. My colleagues and I turned our attention to this and found that a study known as Brainstem Auditory Evoked Potential (BAEP) could actually predict SIDS potential risk in infants with any of the symptoms brought to our attention by parents. (Lonsdale D, Nodar R H, and Orlowski J P. The effects of thiamine on abnormal brainstem auditory evoked potentials. Cleve Clin Quart 1979;46:83-8). We also found that we could successfully treat affected infants with large doses of thiamine, given by injection. Another investigator, Joan Cardell, had found evidence that magnesium deficiency could be blamed and it is now well known that magnesium and thiamine are intimately related in their metabolic functions. I visited a researcher in Australia who had found that some abnormality in thiamine metabolism was indeed related to SIDS. Curiously, he had found that the level of thiamne in blood from SIDS victims was abnormally high. A pediatric colleague in New Zealand had found an unusual incidence of SIDS in his locality and sent me the results of blood thiamine values from 20 anonymous patients that had died. Among them were four SIDS. I was asked to let him know if I could spot the SIDS by the higher value of the blood thiamine. Three were obvious and the fourth was marginally higher and it was easy to spot the four. We concluded that it was a form of thiamine dependency similar to that in the child described above and with perhaps a different mechanism that still has not been explored. Thiamine deficiency (or dependency) in that part of the brain is equivalent to deprivation of oxygen, hence the so-called “agonal” defects in the brainstem of SIDS infants is evidence of cause rather than effect. All of this has largely been ignored by pediatricians and those investigators researching the problem of SIDS. The brilliant work of Peters is probably known by few, for medical journals consider that a scientific reference older than about 10 years is “out of date”. This is in spite of the fact that all scientific knowledge is built on the shoulders of those who have gone before and have often made fundamentally important observations that are major clues. I decided that I would place this information for public view, since it surely must have general interest, particularly to the would-be mothers who have read about SIDS and often nurse a secret dread of the possibility if and when they become pregnant. It should remind them that diet during that pregnancy is of fundamental importance in the healthy future of the baby.