Tuesday, February 21, 2012

Notes on Chronic Illness and Inflammation

I recently attended a series of seminars on chronic illness and inflammation. These are some notes from this event about hyper-sensitivity to mold toxins, the importance of genetics and inflammation for mercury toxicity, an online test for neuro-toxin exposure, alpha lipoic acid as a mercury chelator, phytonutrients as epigenetic triggers, and herbal anti-inflammatories in cancer-therapy. /CW

Note #1: There is a gene (or rather a cluster of genes) that makes some people extremely sensitive to mold toxins. Sensitive to the point where a minute exposure can create a cascade of inflammation resulting in terrible symptoms which are often misdiagnosed as fibromyalgia, asthma, emphysema, fatigue syndrome, etc. (If you have "inexplicable" health issues, this may be something to look into.)

Note #2: What makes some people able to live relatively unaffected with a mouthful of mercury while others cannot? 1) GENETICS: The presence of ApoE 3/3, 3/4, 4/4 makes you more vulnerable - check your genes with 23andme. 2) INFLAMMATION: Inflammation shuts down mercury detox pathways. (Chronic inflammation is in turn caused by poor food- and lifestyle choices.)

Note #3: Chronic conditions (especially those with a neurological component, such as fibromyalgia and dementia) often has an important component of neurotoxicity from fungi, bacteria, spirochetes (e.g., lyme), etc. One can determine if such a factor is likely to be present through an online test that measures the person's ability to detect visual patterns: "VCS Test" - Visual Contrast Sensitivity Test.

Note #4: Don't use the popular (and hyped) anti-oxidant Alpha Lipoic Acid if you have amalgam fillings. It chelates mercury and may put it into your brain. (When fillings have been removed, ALA can then be used in very specific dosing protocols to get mercury out properly.)

Note #5: ‎"Phytonutrients" such as curcumin (turmeric) & resveratrol (red grapes) work by flipping genetic switches that activate detox- & antioxidant systems. By taking such nutrients in effective amounts you are telling the body: "I know better than you do that you need to increase detox/anti-ox." Is such "central planning" a good idea? In today's toxic environment, I tend to think YES, but it should be done intelligently.

Note #6: Gliablastoma (a nasty type of brain cancer) may be put into remission by high dose curcumin, gingerol, and boswellic acid (these plant compounds turn on anti-inflammation genes). I think that the broad lesson is that a cornerstone of an anti-cancer lifestyle is to avoid foods and toxins that cause inflammation and oxidative stress. As the ancients said: "the cure points to the cause".


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Note: This is all for educational purposes only. Consult with a qualified healthcare practitioner to determine the applicability of this information.

Wednesday, February 8, 2012

Food Elimination Q/A Part Two (Effectiveness)

I'm doing a lot of work on helping people identify and fix food sensitivities, so I often receive questions related to this. If you have a question, please put it in the comments section, and I will try to answer it in a follow up post. Thanks! /Christian

Please read part one of this Q/A first, if you haven't done so.

Q: Do you have any thoughts on the reliability of MRT (“Mediator Release Testing”) vs. other food sensitivity tests?

That's a good question, but it opens up a can of worms!

There are a couple of considerations with regard to “reliability” that we need to discuss, so let's dig in.

I like Mediator Release Testing (MRT) because it saves people a lot of time when trying to pinpoint certain types of food sensitivities that are otherwise quite difficult to detect (for instance, these sensitivities can have delayed symptoms,).

Now, as with all tests, MRT has its inherent limits (for instance, there are many types of food sensitivities that it just cannot discover), and, as with all tests, it can also certainly be abused in many ways when designing therapies based on its results.

The MRT measures a common type of food sensitivities, which are so called “cell-mediated reactions” to food proteins and chemicals.

These reactions (sometimes called “Type IV” sensitivities), which could be thought of as a type of “contact allergy” (think nickel allergy) do not need the involvement of antibodies. This is different from, for example, classic allergies (Type I - e.g., a person dying from exposure to peanuts) or so called IgG delayed sensitivities (Type III), which both involve antibodies that laboratory tests can look for.

So instead of looking for antibodies, MRT measures inflammatory “squirts” of “mediators” that cells produce when exposed to food proteins and chemicals. More squirting equals a higher degree of sensitivity.

Bottom line: What MRT measures is very different from other allergy and food sensitivity tests, and, well, these other tests don’t measure what MRT measures.

To concretize a bit more, MRT cannot discover celiac type gluten sensitivity (or cross reactivity with gluten, e.g, coffee looking like gluten to the body), or issues with lectins. Nor can the MRT discover problems with certain sugars and fibers or “FODMAPS”. (A burp/fart challenge test may be best for these, but I digress!)

However, concerning to the types of sensitivities that MRT does measure (and the other tests don't!), it does so with a high degree of accuracy. (90% according to a clinical study.)

So each type of food sensitivity testing (MRT, IgG, IgE, and many others) or, any other test for that matter, should be considered on its own merits (and limitations) in the context of the person that has the health complaint. (A fantastic idea, isn't it! Forget this under ObamaCare, by the way.)

If your health issues are really tricky, such as if you have autoimmune disease, you could benefit from a whole battery of food sensitivity tests that target different types of sensitivities. The limits mostly being price and the ability of your practitioner to interpret the tests correctly - sometimes more of an art than a science.

Personally, I love the MRT for basically one important and common task, which is that it assists with identifying foods that may cause inflammation of the gut lining (“the intestinal mucosal barrier”) .

This is big, because when the gut lining is perpetually assaulted by foods that cause inflammatory reactions, the stage is set for poor gut flora and intestinal permeability which in turn exacerbates “systemic” (whole body) inflammatory problems (acne, arthritis, migraines, etc), as well as problems with gluten and other types of sensitivities.

Constant inflammatory irritation of the gut lining is also a direct cause of cortisol issues and associated problems such as hormonal imbalances and dangerous visceral fat accumulation. (If you have a cortisol response from eating, you may experience it as a raised pulse rate during or after a meal.)

Now let’s look at two important factors that will determine how effective food elimination based on MRT or other testing technologies might be for you:

The first factor in effectiveness is how much dysfunction related to food sensitivity that you actually have and where exactly. In other words, for instance, the degree of “leaky gut", poor gut flora, or problems with immune function that you have. 

These and other "functional" factors determine the degree to which reactive foods may cause problems for you, but these factors cannot be estimated with confidence through food sensitivity tests alone.

For instance, the MRT uses live blood cells which the laboratory exposes directly to food extracts, and for this reason it cannot tell if food proteins actually tend to leak into the blood stream in the process of your normal digestion. (I'm assuming that you don't juice and then inject your foods.)

In practice this means that a person with a high degree of leaky gut who tests reactive to, say, beef may therefore see powerful improvements in overall symptoms when eliminating beef from the menu, whereas another person with little “leakiness” may experience much more subtle improvements even if beef tests highly reactive. (This said, I actually have yet to encounter anyone who hasn’t reported some noticeable improvement, such as a bit of fat loss, after taking out MRT reactive foods for a couple of months.)

The second factor in effectiveness is the total “therapeutic force" applied to repair damage while eliminating reactive foods.

This issue is most often overlooked by people who think that food-elimination is the end-all-be-all. (It can be, but often it is not.)



All healing, whether it is about healing an annoying paper-cut, or healing an entire digestive tract (or an entire body for that matter), depends on doing enough things right for a long enough time (this is what I call “therapeutic force”) so that a virtuous feedback loop can take hold in the body so that it may heal itself.

To put it differently: One cannot overcome the vicious cycle of a degenerative process without creating at least an equally powerful healing process.

Think of this as the need to use enough force when pushing a boulder up a hill so that it can reach the peak of the hill. Only then may the boulder roll down the slope on the other side.

If you, on the other hand, don’t apply enough (and sufficiently persistent) force to the boulder, you will be like Sisyphus - doomed to roll a boulder up a hill, only to see it roll back down again, and to repeat this for the rest of your life. Not very productive.

So to apply this idea to food sensitivities, it is quite common that people go through Sisyphean torture in the quest for the ultimate elimination diet. For example, people wind up eating extremely restricted diets, such as meat-only diets, or they find themselves stuck in the midst of an ever changing and confusing landscape of food sensitivities and associated symptoms coming and going.

In many cases these types of struggles come from focusing too narrowly on food elimination as the only therapy and therefore from not achieving sufficient “therapeutic force”.

The sticking points may be different from one person to another, but common ones are failure to correct cortisol issues (sleep and stress management are very important); failure to rebalance gut flora (probiotics therapy can accelerate the process); failure to get rid of any pathogens/parasites (very common if intestinal health has been poor for a long time); and the failure to supply enough restorative nutrients (a so called “gut repair protocol” can help tremendously).

Actually, in many cases, after a successful repair process (which can take a year or more) it is often revealed that reactive foods found on food sensitivity tests, particularly if they are “paleo foods” such as meat and veggies, are not actually true root causes of a person’s health problems, but that the foods were merely problematic in the context of dysfunction such as "leaky gut" or a gut flora that was out of balance.

Food Elimination Q/A Part One (Is food elimination for life?)

I'm doing a lot of work on helping people identify and fix food sensitivites, so I often receive questions related to this. If you have a question, please put it in the comments section, and I will try to answer it in a follow up post. Thanks! /Christian

Q: Let’s say that I have discovered a few foods that I react badly too. Will I have to stop eating them for life?

To answer this in an as illuminating way as possible, I’m going to define food sensitivity very broadly:

Let’s consider “food sensitivity” as something that could include everything from abnormal blood sugar levels when eating carbs, to tummy discomfort when eating lactose, to autoimmune flareups from gluten or nightshades, to anaphylactic shock from eating peanuts.

If the food sensitivity is part of your “hard wiring” either because of genetics or because a part of your body has become irreparably damaged, then YES, you need to stay away from that particular food for the rest of your life.

An example of hardwired genetic food sensitivity is genetically based lactose intolerance. In this case, your body just doesn’t have the genetic information that it needs to make the needed digestive enzyme (lactase), and hence you will never be able to digest lactose on your own without ingesting some lactase at the same time. (Strictly speaking this may depend on your gut flora and if you drink raw milk, but let's not complicate things!)

(Note: To put this in the context of "Paleo": Paleo theory essentially holds that we are all genetically hardwired to be more or less sensitive to grains, legumes, dairy and certain other foods.)

The second category of "hardwired" food sensitivity is caused by irreparable damage.

One example of this is problems metabolizing carbohydrate due to the inability of the pancreas to produce insulin (diabetes). Another example is the poor ability to digest fat in people who have had the gall bladder removed.

In addition to these examples of irreparable damage, I would like to add that in a person with auto-immune disease there is the possibility that the immune system has become permanently unable to distinguish between “self” and and “non-self” in such a way that some foods will always be problem triggers. (An example is a person with Celiac disease who will have to stop eating gluten for life.)

Let’s now look at food sensitivity that is not hardwired, but that could be called functional (or “circumstantial”) food sensitivity:

In this case the sensitivity is a result of a degenerative process that has caused a degree of malfunction in some organ or system in the body such as the intestinal mucosa, gut flora, blood sugar regulation, or immune system (all of which can cause the body to react adversely to various foods).

This type of food sensitivity is most often present when people discover problems with typical paleo foods such as meats or seafood or inconspicuous fruits and vegetables.

If this is your situation, your prospects for being able to eat the food again without problems hinges on if you can successfully halt the responsible degenerative processes and restore proper function.

Part of the healing process is to stay away from the reactive foods for a significant time (say, three months), and then do an experiment with re-introduction.

Now, I deliberately said “part of the healing process”, because removing trigger foods may not be enough to to stop and reverse the underlying degenerative process that caused the food sensitivity.

In many cases one needs to do additional repair work in conjunction with eliminating reactive foods to regain full health and the ability to eat the excluded foods again.

Conversely, not doing the repair work can result in a merry-go-round of food sensitivities. The person may develop new sensitivities to whatever foods they are eating for a prolonged period of time. (This is a classic sign of “leaky gut”.)

Details of the repair process are far beyond the scope of this post, but, as a summary, one may have to use restorative nutrients to repair the digestive tract, as well as address other surrounding issues such as hormonal imbalance, gut pathogens, and toxicity issues that can all contribute to poor gut function.

PS. What I have found is that when a person doesn't have optimal health overall (could be anything from acne to obesity to auto-immunity), poor gut health is always part of various viscous cycles in that person's body, and that in order to heal the body, one must heal the gut… But to heal the gut one must also heal the rest of the body! (One of the big "paradoxes" of the enterprise of health!)

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