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.
Sunday, June 12, 2011
WHAT IS DYSAUTONOMIA?
Everyone is aware that we possess what is called a voluntary nervous system that enables us to carry out actions at will. The control mechanisms are, of course, in the most developed part of the brain. Many people are, however, ignorant of another part of our complex body communication system. This is known as the autonomic nervous system and its controls are in the lower or more primitive part of the brain, the limbic system and brainstem. The sophisticated thinking part of the brain still has many activities that are still unexplained. We do not understand the true nature of thinking or consciousness. Whether it is a computer or not is unknown. The limbic system and brainstem are clearly vital parts of an extremely complex computer. They control our ability to adapt to all the mental and physical sensory input that we experience throughout life. Most people are aware that we have a bunch of glands collectively known as the endocrine system. They release their respective hormones on cue from messages that are sent out automatically by the lower brain control mechanisms. They are really messengers of the brain and as they return to the brain in the blood, their concentration is carefully monitored and controlled by biofeedback. That is why it is virtually impossible to give people hormones that imitate this for we do not know the required concentration of any hormone at any one time in the twenty-four hour cycle
The autonomic system can be compared to two telephone lines, each of which goes to every organ in the body. They are called sympathetic and parasympathetic and they essentially provide messages to the body organs that oppose each other. The sympathetic “telephone line” is the “action system” and it is capable of initiating a number of reflexes that are important to our survival. The best known of these is the fight-or-flight reflex, aimed at “killing the enemy, for example a wild animal, or escaping from it”. It consumes a great deal of cellular energy and is designed for short term action. After the danger, whatever that may be, is over and survival has been accomplished, the sympathetic system is automatically withdrawn and the parasympathetic arm goes into action. Under its guidance, we can “roll a stone over the mouth of our cave” and we can sleep, eat, have sex and do all the things that we can do in a safe environment. Of course, our stress factors have changed dramatically from that encountered by our ancestors. We now have the modern equivalents associated with our civilization. Most modern stress is mental and does not require a physical response as an escape. It is a very different kind of attack and can unfortunately be prolonged, thus exhausting cellular energy. It must be emphasized here that the word “stress” must be used as the “causative physical or mental input”. It is the response that is the important issue. It may explain, for example, why a given child can come out of a parental divorce without harm whereas another child may not, depending on how the stress is handled.
The prefix “dys” means “abnormality of” and so that is how dysautonomia simply means that the system is not functioning as it should. There are genetic factors, as there always are, but the most important cause of this dysfunction (see the prefix again) is inefficient use of oxygen in providing cellular energy. The brain is the organ that is most dependent on a continuous supply of oxygen and its use in oxidation. This particularly apples to the limbic system and brainstem because they compute 24 hours a day and maintain our survival. For example, the brainstem contains vital centers that control automatic breathing. Thus, as we go to sleep, these centers maintain both the speed and strength of heart muscle contraction as well as taking over the control of breathing. An example of this failure is the awful disaster of sudden infant death where the automatic mechanisms in a rapidly developing brainstem have been compromised. The infant stops breathing or his (more common in boys) heart ceases to beat. Published medical literature points to deficiency of magnesium or thiamine as a common underlying cause, even though the positioning of the infant in the crib is now apparently accepted as the only cause. It is well known that SIDS occurs more commonly where there is poverty and where “junk” nutrition is more likely to be a factor.
A condition in adults known as sleep apnea is one way in which abnormal brainstem function is indicated. There is also a lethal condition called "Ondine's Curse" where the automatic life mechanisms fail. Ondine is a mythological "water nymph" who was jilted by her human lover. As a punishment she cursed him by abolishing these normal life controls and hence he died in his sleep. By far the easiest and most common way to produce changes in these vitally necessary mechanism is to take an excess of sugar since its metabolism is tied to a number of essential nutrients, the most important of which are vitamin B1 (thiamine) and magnesium. In a previous post I described the “choked engine syndrome” that used the analogy of a car engine where there is too much gasoline in the cylinder and either insufficient oxygen or a defective spark plug.
Of particular interest, it has long been known that the autonomic nervous system controls the body organs asymmetrically. For example, the message received by the heart from the right side of the sympathetic nerve system is different from that received by the left side. One of the curious things that happens in the early stages of dysautonomia (the prototype for dysautonomia is beriberi, the disease discussed in some detail in an earlier post) is that the reflex control mechanisms in the limbic system and brainstem become much more reactive to perfectly normal mental or physical sensory input. Blood pressures in the two arms become widely different when measured at the same time. Since our emotions are generated in the limbic system automatically by the kind of input it receives, (for example, an insult initiates anger) affected individuals become much more emotional. Anger becomes exaggerated and may explode in violence that would not be perpetrated if the emotional reflex was normal and influenced by the thinking part of the brain. That is why I have suggested that the school shootings and otherwise inexplicable human reactions in this modern era are related to high calorie malnutrition. I have never seen anyone interested in the diet for a "school shooter". It simply does not exist as a question. A recent medical paper from Japan reported 17 adolescents with beriberi, caused by the ingestion of sodas in their social relationships. Dietary mayhem may be an extremely important factor that is largely ignored in this modern era that we refer to as civilization. The more that we forget our biologic orgins and how our diet affects our energy metabolism, the greater the danger of abnormal behavior and loss of control under the influence of stress.
The autonomic system can be compared to two telephone lines, each of which goes to every organ in the body. They are called sympathetic and parasympathetic and they essentially provide messages to the body organs that oppose each other. The sympathetic “telephone line” is the “action system” and it is capable of initiating a number of reflexes that are important to our survival. The best known of these is the fight-or-flight reflex, aimed at “killing the enemy, for example a wild animal, or escaping from it”. It consumes a great deal of cellular energy and is designed for short term action. After the danger, whatever that may be, is over and survival has been accomplished, the sympathetic system is automatically withdrawn and the parasympathetic arm goes into action. Under its guidance, we can “roll a stone over the mouth of our cave” and we can sleep, eat, have sex and do all the things that we can do in a safe environment. Of course, our stress factors have changed dramatically from that encountered by our ancestors. We now have the modern equivalents associated with our civilization. Most modern stress is mental and does not require a physical response as an escape. It is a very different kind of attack and can unfortunately be prolonged, thus exhausting cellular energy. It must be emphasized here that the word “stress” must be used as the “causative physical or mental input”. It is the response that is the important issue. It may explain, for example, why a given child can come out of a parental divorce without harm whereas another child may not, depending on how the stress is handled.
The prefix “dys” means “abnormality of” and so that is how dysautonomia simply means that the system is not functioning as it should. There are genetic factors, as there always are, but the most important cause of this dysfunction (see the prefix again) is inefficient use of oxygen in providing cellular energy. The brain is the organ that is most dependent on a continuous supply of oxygen and its use in oxidation. This particularly apples to the limbic system and brainstem because they compute 24 hours a day and maintain our survival. For example, the brainstem contains vital centers that control automatic breathing. Thus, as we go to sleep, these centers maintain both the speed and strength of heart muscle contraction as well as taking over the control of breathing. An example of this failure is the awful disaster of sudden infant death where the automatic mechanisms in a rapidly developing brainstem have been compromised. The infant stops breathing or his (more common in boys) heart ceases to beat. Published medical literature points to deficiency of magnesium or thiamine as a common underlying cause, even though the positioning of the infant in the crib is now apparently accepted as the only cause. It is well known that SIDS occurs more commonly where there is poverty and where “junk” nutrition is more likely to be a factor.
A condition in adults known as sleep apnea is one way in which abnormal brainstem function is indicated. There is also a lethal condition called "Ondine's Curse" where the automatic life mechanisms fail. Ondine is a mythological "water nymph" who was jilted by her human lover. As a punishment she cursed him by abolishing these normal life controls and hence he died in his sleep. By far the easiest and most common way to produce changes in these vitally necessary mechanism is to take an excess of sugar since its metabolism is tied to a number of essential nutrients, the most important of which are vitamin B1 (thiamine) and magnesium. In a previous post I described the “choked engine syndrome” that used the analogy of a car engine where there is too much gasoline in the cylinder and either insufficient oxygen or a defective spark plug.
Of particular interest, it has long been known that the autonomic nervous system controls the body organs asymmetrically. For example, the message received by the heart from the right side of the sympathetic nerve system is different from that received by the left side. One of the curious things that happens in the early stages of dysautonomia (the prototype for dysautonomia is beriberi, the disease discussed in some detail in an earlier post) is that the reflex control mechanisms in the limbic system and brainstem become much more reactive to perfectly normal mental or physical sensory input. Blood pressures in the two arms become widely different when measured at the same time. Since our emotions are generated in the limbic system automatically by the kind of input it receives, (for example, an insult initiates anger) affected individuals become much more emotional. Anger becomes exaggerated and may explode in violence that would not be perpetrated if the emotional reflex was normal and influenced by the thinking part of the brain. That is why I have suggested that the school shootings and otherwise inexplicable human reactions in this modern era are related to high calorie malnutrition. I have never seen anyone interested in the diet for a "school shooter". It simply does not exist as a question. A recent medical paper from Japan reported 17 adolescents with beriberi, caused by the ingestion of sodas in their social relationships. Dietary mayhem may be an extremely important factor that is largely ignored in this modern era that we refer to as civilization. The more that we forget our biologic orgins and how our diet affects our energy metabolism, the greater the danger of abnormal behavior and loss of control under the influence of stress.
Wednesday, May 11, 2011
YIN AND YANG
What did the ancient Chinese philosophers and observers of humanity mean by Yin and Yang and why is it an important philosophical contribution in the modern world? Reading an English translation of Chinese literature, I found no clear definition, although it became obvious that the two words represented extremes on either side of a median, the equivalent of the "bell-shaped curve" which is so popular with statisticians today. Thus, the idea of a “point of balance”, expressed thousands of years ago, is as important today as it was then. It applies to lifestyle and nutrition. If something is good for us, more of it may be better, but an excess is bad. There must always be an optimum state.
It is worth noting the ancient origin of this very important philosophical concept. Genealogies of Chinese dynasties list the Yellow Emperor as the third of China's first five rulers and ascribe to him the period of 2697-2597 BCE. The Age of the Five Rulers is said to have lasted 647 years (2852-2205 BCE) and is called the "Legendary Period". The Yellow Emperor is considered to be the author of NEI CHING SU WEN, the classic treatise on internal medicine, and supposedly the oldest medical book extant. The development of Chinese medical philosophy even predates this and may have been in existence for centuries before the book was written. With our short lives, the wisdom of the ages locked up in books that are rarely read, we have accumulated a vast amount of knowledge that is largely ignored. This is so ingrained that a reference older than about 10 years, provided for a medical article is considered to be “out of date”. We should be building our perpetual gain of knowledge standing on the shoulders of history. But how we access it is extremely difficult, particularly when it is often thought to be the primitive concepts of an age gone by.
The idea of “balance” in the human body is best illustrated by considering the intake of oxygen. We cannot live without it and its excess is lethal, as every diver knows. Another illustration is from the history of selenium, now known to be an essential nutrient. Until 1957, selenium was classified as a poison. Then someone, initially thought to be “crazy”, found that it was essential to life as a nutrient. It is the “dose window” that counts, that amount between too little and too much. We require selenium in a vanishingly small daily dose that is measured in micrograms, one thousandth of a milligram. All the essential nutrients, even water, have their own “dose window”. For example, both oxygen and vitamin C have very large dose windows as do most of the vitamins. Minerals are different and their limited dose windows make it much easier to reach a toxic level. They should always be ingested under the care of a professional who understands the developing art and science of nutritional supplementation.
It is obvious that pharmaceutical drugs all have dose windows and toxicity from their use is disastrous since every person has his/her own tolerance and there are at least one hundred thousand deaths a year in the U.S. in people using such drugs as prescribed according to the published dose “safety” in Physicians Desk Reference (PDR). Nutrient supplements are used therapeutically in doses that exceed the expected daily intake. They are therefore being used as drugs since they influence our physiology. There has never been a report of death from their use in the emerging paradigm of Complementary Alternative Medicine.
I was surprised one day when I found a book that described an animal experiment. The investigators put together a diet that was completely free of lead and they described the difficulty of its preparation. When they fed it to young animals, they failed to grow. When the minute amount of lead was restored, they began to grow. Everyone today knows that lead is poisonous, but the idea of a minute dose being essential, like selenium, is extremely surprising and known by only a few. It may well be that the entire periodic table represents our nutritional requirement. This would make sense of the formula used in the burial service “dust to dust and earth to earth”. Boron has been used clinically to strengthen bones and calcium is known by all as an element of bone. Both are potentially toxic when used improperly. Could it be that even mercury in vanishingly minute doses is essential, like lead? Nobody, to my knowledge, has attempted to find out.
An experiment in mice was published two years ago. Normal mice were overfed and, as expected, they became obese. It was found that a gene for a mechanism in the hypothalamus, the epicenter of the lower brain computer, was silent if nutrition was appropriate. With overfeeding this gene became active and caused obesity and/or inflammation or both. Since the mouse genome is surprisingly close to human, perhaps we can extrapolate from mouse to man. If that is true for us, can we suggest a reason for this apparent anomaly? In times of plenty, it would have been an advantage for our ancestors to become fat so that they could survive on it in a period of food deficiency. It would be a solution that only Mother Nature could invent. Perhaps we have our own solution to the epidemic of gross obesity in America for we know that obese people are more at risk for chronic disease that involves inflammation. Inflammation is a perfectly normal process when it is induced in the body as a defensive mechanism. If we cut ourselves, inflammation brings in the right amount of blood containing the white cells to fight infection and the nutrients and oxygen to provide the energy for healing. But if it gets out of hand and is applied to tissues that do not require it, it becomes a cause of inflammatory disease, the Yin and the Yang of extremism once again. It is an interesting comment on the gross malnutrition that is being experienced in this crazy world. It does no good to say that we should use “this” or “that” diet. I tell all my patients the same thing: eat “God made” food and leave the man made junk alone. The further we go from our biologic origins, the greater the peril. If the food had not been on the Earth when man arrived on it, we could not have survived as a species. It was all natural and all we had to do was to hunt and gather.
Our stewardship of planet Earth has been and continues to be destructive and our source of food containing all the nutrients that we require to remain healthy is compromised. Many people are becoming sick, not so much from 3 meals a day (although that is bad enough) but what they consume between meals in social activities. Sugar is indeed dangerous and the universal accompaniment of high sugar snacks with watching TV is a potent source of trouble for those that are sensitive to its ingestion. The trouble is they have no idea at all that their multiple symptoms are related and keep going to their doctors for medicines that they do not need if they were made acquainted with the real cause. I tell people to stay away from the “hair of the dog that is biting them” and eat only “God made food”. It is well to remember that even some of that is compromised. Cow’s milk was “invented” for calves and is not intended for humans, some of whom get sick from its consumption, a surprise for many when its commercial touting is so common. Unfortunately, proper food has become so expensive that many people are unable to afford it, particularly when they have to trim the budget for a family. I am aware that there will be some that read this that will automatically reject it as nonsense. They will say “If this is so important to our health, why have doctors in general not adopted these simple principles”? Well, even though the inherent dangers of tobacco are now well accepted by all, there are still thousands that still smoke. It would be difficult for them not to know the risks, so why do they continue to commit slow suicide? It is incredibly difficult to pass on wisdom, as illustrated by ignoring the advice capability of elderly people in our modern era. At one time age was respected. Now it is trashed and the young are totally ignorant of what they are missing in their planning for life.
It is worth noting the ancient origin of this very important philosophical concept. Genealogies of Chinese dynasties list the Yellow Emperor as the third of China's first five rulers and ascribe to him the period of 2697-2597 BCE. The Age of the Five Rulers is said to have lasted 647 years (2852-2205 BCE) and is called the "Legendary Period". The Yellow Emperor is considered to be the author of NEI CHING SU WEN, the classic treatise on internal medicine, and supposedly the oldest medical book extant. The development of Chinese medical philosophy even predates this and may have been in existence for centuries before the book was written. With our short lives, the wisdom of the ages locked up in books that are rarely read, we have accumulated a vast amount of knowledge that is largely ignored. This is so ingrained that a reference older than about 10 years, provided for a medical article is considered to be “out of date”. We should be building our perpetual gain of knowledge standing on the shoulders of history. But how we access it is extremely difficult, particularly when it is often thought to be the primitive concepts of an age gone by.
The idea of “balance” in the human body is best illustrated by considering the intake of oxygen. We cannot live without it and its excess is lethal, as every diver knows. Another illustration is from the history of selenium, now known to be an essential nutrient. Until 1957, selenium was classified as a poison. Then someone, initially thought to be “crazy”, found that it was essential to life as a nutrient. It is the “dose window” that counts, that amount between too little and too much. We require selenium in a vanishingly small daily dose that is measured in micrograms, one thousandth of a milligram. All the essential nutrients, even water, have their own “dose window”. For example, both oxygen and vitamin C have very large dose windows as do most of the vitamins. Minerals are different and their limited dose windows make it much easier to reach a toxic level. They should always be ingested under the care of a professional who understands the developing art and science of nutritional supplementation.
It is obvious that pharmaceutical drugs all have dose windows and toxicity from their use is disastrous since every person has his/her own tolerance and there are at least one hundred thousand deaths a year in the U.S. in people using such drugs as prescribed according to the published dose “safety” in Physicians Desk Reference (PDR). Nutrient supplements are used therapeutically in doses that exceed the expected daily intake. They are therefore being used as drugs since they influence our physiology. There has never been a report of death from their use in the emerging paradigm of Complementary Alternative Medicine.
I was surprised one day when I found a book that described an animal experiment. The investigators put together a diet that was completely free of lead and they described the difficulty of its preparation. When they fed it to young animals, they failed to grow. When the minute amount of lead was restored, they began to grow. Everyone today knows that lead is poisonous, but the idea of a minute dose being essential, like selenium, is extremely surprising and known by only a few. It may well be that the entire periodic table represents our nutritional requirement. This would make sense of the formula used in the burial service “dust to dust and earth to earth”. Boron has been used clinically to strengthen bones and calcium is known by all as an element of bone. Both are potentially toxic when used improperly. Could it be that even mercury in vanishingly minute doses is essential, like lead? Nobody, to my knowledge, has attempted to find out.
An experiment in mice was published two years ago. Normal mice were overfed and, as expected, they became obese. It was found that a gene for a mechanism in the hypothalamus, the epicenter of the lower brain computer, was silent if nutrition was appropriate. With overfeeding this gene became active and caused obesity and/or inflammation or both. Since the mouse genome is surprisingly close to human, perhaps we can extrapolate from mouse to man. If that is true for us, can we suggest a reason for this apparent anomaly? In times of plenty, it would have been an advantage for our ancestors to become fat so that they could survive on it in a period of food deficiency. It would be a solution that only Mother Nature could invent. Perhaps we have our own solution to the epidemic of gross obesity in America for we know that obese people are more at risk for chronic disease that involves inflammation. Inflammation is a perfectly normal process when it is induced in the body as a defensive mechanism. If we cut ourselves, inflammation brings in the right amount of blood containing the white cells to fight infection and the nutrients and oxygen to provide the energy for healing. But if it gets out of hand and is applied to tissues that do not require it, it becomes a cause of inflammatory disease, the Yin and the Yang of extremism once again. It is an interesting comment on the gross malnutrition that is being experienced in this crazy world. It does no good to say that we should use “this” or “that” diet. I tell all my patients the same thing: eat “God made” food and leave the man made junk alone. The further we go from our biologic origins, the greater the peril. If the food had not been on the Earth when man arrived on it, we could not have survived as a species. It was all natural and all we had to do was to hunt and gather.
Our stewardship of planet Earth has been and continues to be destructive and our source of food containing all the nutrients that we require to remain healthy is compromised. Many people are becoming sick, not so much from 3 meals a day (although that is bad enough) but what they consume between meals in social activities. Sugar is indeed dangerous and the universal accompaniment of high sugar snacks with watching TV is a potent source of trouble for those that are sensitive to its ingestion. The trouble is they have no idea at all that their multiple symptoms are related and keep going to their doctors for medicines that they do not need if they were made acquainted with the real cause. I tell people to stay away from the “hair of the dog that is biting them” and eat only “God made food”. It is well to remember that even some of that is compromised. Cow’s milk was “invented” for calves and is not intended for humans, some of whom get sick from its consumption, a surprise for many when its commercial touting is so common. Unfortunately, proper food has become so expensive that many people are unable to afford it, particularly when they have to trim the budget for a family. I am aware that there will be some that read this that will automatically reject it as nonsense. They will say “If this is so important to our health, why have doctors in general not adopted these simple principles”? Well, even though the inherent dangers of tobacco are now well accepted by all, there are still thousands that still smoke. It would be difficult for them not to know the risks, so why do they continue to commit slow suicide? It is incredibly difficult to pass on wisdom, as illustrated by ignoring the advice capability of elderly people in our modern era. At one time age was respected. Now it is trashed and the young are totally ignorant of what they are missing in their planning for life.
Wednesday, March 16, 2011
A REMARKABLE NUTRITIONAL SUPPLEMENT
I want to tell you something about one of Mother Nature’s gifts. I am sure that some people taking the trouble to read this blog have tried to get information on garlic. It has been used, of course, in food preparation for centuries. In about the middle of the last century a group of medical researchers in Japan were studying it and they found something that alerted their curiosity. When the inside of a garlic bulb is exposed to air by cutting or crushing it, vitamin B1, also known as thiamine, is worked on by an enzyme that exists in the bulb. It converts thiamine to a disulfide derivative that they called allithiamine. This name was given because they found it in other plants within the allium species that includes garlic. Garlic also contains about twenty sulfur containing compounds called thiols that are important in the normal use of cellular oxygen. Originally the investigators thought that this newly discovered substance had lost the biochemical properties that are known to be initiated by thiamine in animal cells, including humans. Further study in animals showed that it had biologic properties that actually exceeded those exhibited by the original thiamine. In order to understand why this was an important discovery I have to remind you about the action of thiamine in the body.
The human adult body is made up of between 70 and 100 trillion cells. Each has to use oxygen to create the energy that enables it to function, as has been discussed in previous posts. Thiamine is the “spark plug” that “ignites” glucose, the fuel of all our cells and it is particularly important in the brain, heart and nervous system. Its absorption from the foods that contain it, its journey in the blood to the cells that require it and its delivery to those cells, involves complex biochemistry. It has long been thought that the RDA of thiamine is sufficient and that any form of megadose would be of no physiological value. This is because the enzymes that require it cannot be accelerated in their function by introducing an excess of the vitamin. Remember from an earlier post that most vitamins are cofactors to enzymnes. This is essentially correct in healthy people whose diet has remained excellent over the years of life. We know from history that it required months of huge doses of thiamine to cure advanced beriberi and sometimes it was too late since there was permanent damage. The enzymes that require thiamine to function to full capacity begin to deteriorate when there is an overload of glucose and an insufficiency of the vitamin, as discussed in the “Choked Engine Syndrome” in an earlier post. In order to recuperate this efficiency, the enzyme needs to be “hit” with much larger doses of thiamine. The normal physiological mechanisms for absorbing dietary thiamine are inadequate for large doses and that is where allithiamine comes into the picture. Further research showed that this disulfide form of the vitamin did not need the complex biochemistry to absorb it into body cells.
A Vitamin B Research Committee was formed in Japan because of their vested interest in beriberi that was still seen quite commonly in 1965 when they published their work in Tokyo in a book entitled “Thiamine and Beriberi”. I was lucky to receive an English translation from one of the members of the Japanese committee. It has within its pages a cornucopia of information that is of vast importance in our modern era. The discovery of allithiamine sparked a long period of research that led to synthesis of a huge number of thiamine derivatives that can now be separated into a group of disulfides and non disulfides. The most efficient derivative is thiamine tetrahydrofurfuryl disulfide (TTFD). It is sold as a prescription item in Japan as Alinamin and also known elsewhere as Fursultiamine. The best known of the non disulfides is Benfotiamine. Alinamin is capable of entering the brain whereas it has been shown by a researcher in Belgium that Benfotiamine does not cross the blood brain barrier. This barrier is a normal physiological mechanism.
I want now to concentrate on TTFD since I have been studying its benefits for 38 years and have written many papers in the medical literature. It is not approved by the FDA in the United States in spite of its enormous therapeutic value because it is considered to be a drug. For an American drug company to import it, it would involve the millions of dollars for testing. The present model of disease demands that the drug must be virtually unique in the cure of a specific disease to warrant the expenditure and its recuperation in profits. The trouble with that is that the model itself is outmoded as indicated in an earlier post and the therapeutic properties of TTFD have biochemical implications that do not fit the model. The reason is that it addresses energy metabolism that is the underlying root of many (if not all) diseases and particularly those involving the brain.
We know that depletion of thiamine is the equivalent of oxygen deficiency since they are both essential ingredients of cellular energy production. Published material has shown that thiamine is involved in many brain diseases and that its administration as TTFD has shown some benefit in autism and even in Alzheimer disease. Japanese investigators have shown that it improves muscle function (I have treated Duchenne muscular dystrophy with partial success) and that it shortens the recovery time from post surgical paralysis of bowel function known as “post operative paralytic ileus”. Animal studies have shown that it removes lead and mercury from body tissues and also has anti-inflammatory properties. Amazingly,pretreatment of mice with TTFD partially protects the animal from cyanide death and liver damage from carbon tetrachloride administrations. Beriberi is the prototype of dysautonomia in its early stages and this category of disease is very common in America because of the huge ingestion of sugar as already discussed. It is my view that TTFD could easily be introduced to the United States under GRAS rules (generally regarded as safe) but our bureaucracy is stiffer that the proverbial poker. If there is a substance available in this cruel world that helps so-called untreatable disease, should we not welcome it? Even a 10 percent improvement, achieved cheaply and without toxic risk, is better than the status quo and we should be trying hard to find its full value in medicine. If it has indeed rendered the medical model outmoded, there is nothing more constant than change!
The human adult body is made up of between 70 and 100 trillion cells. Each has to use oxygen to create the energy that enables it to function, as has been discussed in previous posts. Thiamine is the “spark plug” that “ignites” glucose, the fuel of all our cells and it is particularly important in the brain, heart and nervous system. Its absorption from the foods that contain it, its journey in the blood to the cells that require it and its delivery to those cells, involves complex biochemistry. It has long been thought that the RDA of thiamine is sufficient and that any form of megadose would be of no physiological value. This is because the enzymes that require it cannot be accelerated in their function by introducing an excess of the vitamin. Remember from an earlier post that most vitamins are cofactors to enzymnes. This is essentially correct in healthy people whose diet has remained excellent over the years of life. We know from history that it required months of huge doses of thiamine to cure advanced beriberi and sometimes it was too late since there was permanent damage. The enzymes that require thiamine to function to full capacity begin to deteriorate when there is an overload of glucose and an insufficiency of the vitamin, as discussed in the “Choked Engine Syndrome” in an earlier post. In order to recuperate this efficiency, the enzyme needs to be “hit” with much larger doses of thiamine. The normal physiological mechanisms for absorbing dietary thiamine are inadequate for large doses and that is where allithiamine comes into the picture. Further research showed that this disulfide form of the vitamin did not need the complex biochemistry to absorb it into body cells.
A Vitamin B Research Committee was formed in Japan because of their vested interest in beriberi that was still seen quite commonly in 1965 when they published their work in Tokyo in a book entitled “Thiamine and Beriberi”. I was lucky to receive an English translation from one of the members of the Japanese committee. It has within its pages a cornucopia of information that is of vast importance in our modern era. The discovery of allithiamine sparked a long period of research that led to synthesis of a huge number of thiamine derivatives that can now be separated into a group of disulfides and non disulfides. The most efficient derivative is thiamine tetrahydrofurfuryl disulfide (TTFD). It is sold as a prescription item in Japan as Alinamin and also known elsewhere as Fursultiamine. The best known of the non disulfides is Benfotiamine. Alinamin is capable of entering the brain whereas it has been shown by a researcher in Belgium that Benfotiamine does not cross the blood brain barrier. This barrier is a normal physiological mechanism.
I want now to concentrate on TTFD since I have been studying its benefits for 38 years and have written many papers in the medical literature. It is not approved by the FDA in the United States in spite of its enormous therapeutic value because it is considered to be a drug. For an American drug company to import it, it would involve the millions of dollars for testing. The present model of disease demands that the drug must be virtually unique in the cure of a specific disease to warrant the expenditure and its recuperation in profits. The trouble with that is that the model itself is outmoded as indicated in an earlier post and the therapeutic properties of TTFD have biochemical implications that do not fit the model. The reason is that it addresses energy metabolism that is the underlying root of many (if not all) diseases and particularly those involving the brain.
We know that depletion of thiamine is the equivalent of oxygen deficiency since they are both essential ingredients of cellular energy production. Published material has shown that thiamine is involved in many brain diseases and that its administration as TTFD has shown some benefit in autism and even in Alzheimer disease. Japanese investigators have shown that it improves muscle function (I have treated Duchenne muscular dystrophy with partial success) and that it shortens the recovery time from post surgical paralysis of bowel function known as “post operative paralytic ileus”. Animal studies have shown that it removes lead and mercury from body tissues and also has anti-inflammatory properties. Amazingly,pretreatment of mice with TTFD partially protects the animal from cyanide death and liver damage from carbon tetrachloride administrations. Beriberi is the prototype of dysautonomia in its early stages and this category of disease is very common in America because of the huge ingestion of sugar as already discussed. It is my view that TTFD could easily be introduced to the United States under GRAS rules (generally regarded as safe) but our bureaucracy is stiffer that the proverbial poker. If there is a substance available in this cruel world that helps so-called untreatable disease, should we not welcome it? Even a 10 percent improvement, achieved cheaply and without toxic risk, is better than the status quo and we should be trying hard to find its full value in medicine. If it has indeed rendered the medical model outmoded, there is nothing more constant than change!
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