Always intrigued by mainstream media articles that promise "cures" for chronic disease, when I saw the link on MSN last week for an article detailing a "cure" for Type II diabetes, of course I had to read it.
The ever-hopeful part of me thought perhaps this time they got it right. That the article would be about the importance of diet & exercise in managing this insidious disease. Maybe it would even detail a new way of helping diabetics make better food choices. Or ,*gasp* detail strategies for identifying these patients earlier, when diet & exercise are more effective treatment protocols.
However, what I read nearly made me fall out of my chair.
The supposed, new "cure" for Type II diabetes is bariatric surgery.
Uh, does this sound barbaric to anyone else? "You have Type II diabetes, so we're going to open you up, staple your stomach so that you can barely eat, severely disrupt your body's digestive process so you become protein & vitamin deficient causing your body to waste away and everything will be all better!" That's not even taking into account the common and often horrendous side effects and complications of the surgery.
A further consideration is the cost. No wonder health care is so expensive in this country when we are recommending procedures that cost into the tens of thousands of dollars. Sure, the cost would be justified if that were the only solution, but its not.
The simple, but not so elegant truth, is that food is the cause of Type II diabetes and so must the remedy be.
Type II diabetes is not a disease that happens overnight or comes out of the middle of no where. Currently, the standard for diagnosing diabetes is two consecutive blood glucose readings of 120 or higher. The normal range for blood glucose is 85-100. However, measures of blood glucose alone can't reliably tell us if diabetes is developing because glucose levels can be effected by many things including what you ate recently and what your stress level may have been when your blood was drawn.
Blood sugar goes hand-in-hand with blood fats, namely measures of your cholesterol, triglycerides, HDL and LDL. This is because high levels of glucose in the blood can damage the linings of the blood vessels. Normally, the body tries to prevent clotting in the blood vessels because clots and plaques imped blood flow. But once the lining is damaged, the body goes into full-on repair mode. Cholesterol is actually the spackle used to patch the holes created in the lining of the blood vessels. Some triglycerides get incorporated too. You may have heard of LDL being called the so called "bad" cholesterol. Part of its bad reputation is because it brings cholesterol from the liver to the site of the damage in the blood vessels. HDL, often called the "good" cholesterol, shuttles cholesterol from the blood back to the liver.
Now that you have a basic primer on the relationship between blood sugar & blood fats, you can understand that by looking at cholesterol, triglycerides, HDL & LDL, we can see if a blood glucose reading of 110 is the beginning of insulin resistance, aka 'pre-diabetes', or if its just because you got into a minor fender-bender on the way to the lab and stress hormones have mobilized blood sugar for a flight-or-flight response. If you fasted before the blood draw, your cholesterol should be under 200, your triglycerides should be about half of your cholesterol number and HDLs should be about half of your number of triglycerides. When I see patient with triglycerides & HDL numbers approaching their cholesterol number, I definitely suspect insulin resistance.
Insulin resistance develops when blood sugar has been slightly high for a prolonged period of time. Insulin is a hormone secreted by the pancreas that stimulates cells to take in sugar (glucose). Yes, we need glucose too make energy, but you can have too much of a good thing. Over time, the cells start refusing to take in so much sugar and insulin becomes less effective, hence 'insulin resistance.' If you keep eating carbohydrates, especially simple ones, glucose begins to accumulate in the blood where it can damage the lining of the vessel walls.
The good news is that with a few dietary changes aimed at leveling blood sugar levels and possibly the use a few herbs and/or supplements, the development of insulin resistance into Type II diabetes can be significantly slowed or even halted. Since this strategy has many benefits beyond just blood sugar regulation, I'll take that as a 'cure' over a barbaric surgery any day.
Friday, November 5, 2010
Monday, September 13, 2010
Heart disease is a gut-immune-hormone disease
This is another article from Dr. Kharrazian's Blog, which you can read more of here.
"An ancient surgical procedure, called trepanation, consisted of drilling a hole in the head and removing a piece of the skull. It is thought this practice was used to release evil spirits that caused mental illness, migraine headaches and other ills. Nowadays, however, if you went to your naturopath with complaints of headaches and she pulled out her drill, you would bolt from her office in horror.
Sadly, when it comes to heart disease, it seems we haven’t advanced all that much. When future humans look back to 2010 and the way we treat heart disease, they will shake their heads in disbelief. Much of heart care today, in both conventional and alternative medicine, ranges from harmful to hopelessly misguided.
Although cancer recently took the top spot, heart disease has long been the leading cause of death since the advent of processed foods almost 100 years ago, and it’s no wonder. The root of disease almost always begins in the gastrointestinal (GI) tract, with problems compounding in the immune and endocrine (hormone) systems, which in turn stress the heart. That gut health and immunity status affects the heart is lost on most conventional doctors, including many holistic ones.
These days we see two extreme viewpoints of cholesterol, both of which are incomplete. In conventional medicine, cholesterol is the defining marker for heart disease. While your local MD’s approach to treating high cholesterol has been seriously questioned and successfully challenged by reputable science, the standard of treatment — low-fat diets and Lipitor, for example — hasn’t budged. And when this model fails to prevent heart disease, as it often does, doctors simply blame the patient for not toiling long enough in the prison of low-fat diets.
In holistic medicine, on the other hand, cardiovascular health is often dismissed when symptoms are lacking, and high cholesterol is brushed away. Although the nutritional model is safer (for statin drugs can have devastating side effects), it too falls short when it doesn’t address the risk of high cholesterol levels.
Consider inflammation
As always, the answer lies in the middle of these two extremes. Conventional doctors miss the mark when they look at cholesterol levels in isolation, as do holistic doctors when they hardly consider it at all. The truth is, high cholesterol is a risk when inflammation is present.
When looking at what causes heart disease and how to treat it, atherosclerosis, the formation of plaque within the arteries, is the bottom line. But it’s shortsighted to simply blame atherosclerosis on high cholesterol. Rather, atherosclerosis comes from an immune response. The immune response creates inflammation, with this inflammation gradually worsening into lesions in the arterial walls. Since the body’s priority is to stay alive now, even if means self-sabotage in the long run, it speedily delivers cholesterol to the lesions to patch them up, hence causing atherosclerosis.
The key for the practitioner then is not simply to lower cholesterol, leaving the arterial walls more vulnerable to failure, but rather to ferret out what’s driving the inflammation. This is where the skill and ongoing education of the practitioner come in. For instance, newer research shows that some people develop atherosclerosis due to an autoimmune disease in which the body attacks it’s own arterial wall tissue. Is a prescription for either Lipitor or CoQ10 going to do much for these folks? Obviously not.
The sleuthing for inflammation starts by understanding that atherosclerosis starts where the gastrointestinal, hormonal, and immune systems meet (and yes, they do meet!). But for the sake of simplicity, lets look at each individually.
The gut connection to heart disease
Although many practitioners understand that poor digestion creates inflammation, a couple of problems specific to the GI tract can trigger atherosclerosis. For instance, bile secreted by the gallbladder escorts cholesterol out of the body. However, with dysbiosis — when there is more bad bacteria than good bacteria in the gut — this process falters or fails. The result is a rise in cholesterol (not to mention estrogen and various toxins). In this case, a simple gut detox and inoculation with beneficial bacteria lowers cholesterol.
Also critical is the link between helicobacter pylori infection and atherosclerosis. H.pylori, a bacterium unique in its ability to survive the highly acidic environment of the stomach, is best known for causing peptic ulcers, gastritis, and duodenitis. What’s less known, however, is that H.pylori also destroys vascular tissue; autopsies are turning up H.pylori in the lesions of stroke and heart attack victims.
Our gut is exposed to many pathogens, including H.pylori, daily. A healthy stomach sufficient in hydrochloric acid (HCl) destroys pathogens as soon as they enter. It’s estimated that 90 percent of Americans are deficient in HCl, and that H.pylori can be found in 50 percent of the world’s population, so it’s easy to see why this may be the most common infectious disease worldwide. Not to mention that most, if not all, chronic users of antacids harbor excess H.pylori.
So why hasn’t medicine launched a full-scale attack? Because an H.pylori infection is asymptomatic, quietly wreaking havoc before more telltale signs such as gastric ulcers enter the picture. And since most practitioners, both conventional and natural, practice based on symptoms, it can easily go unnoticed until it’s too late.
I do not like using the serum antibody test for H.pylori. A retest will not show whether we have successfully treated the infection, for the antibody levels stay elevated for up to a year after treatment. The breath test is more useful diagnostically. Because this bacteria is so contagious (by saliva), I have found treating an individual for H.pylori does not have lasting success unless the entire family is treated. I once had a patient whose H.pylori infection kept rebounding, despite treating his family. It was when he sheepishly brought in his mistress for treatment that we were finally able to kick the infection for good.
The immune system and the heart
We typically don’t think of a weak immune system as having much to do with heart health, but as with H.pylori, undetected viruses and other antigens can prey on the cardiovascular system. Although I am wary of making diagnoses based on symptoms, my patients who complain of chronic pain and fatigue are often suspects for chronic viruses. Most often they are the ones I screen for antibodies to antigens associated specifically with atherosclerosis: Cytomegalovirus, coxsackievirus, chlamydia pneumonia and porphyromonas gingivitis (for this last one, proper oral hygiene is key). I then track the treatment with follow-up tests that look at antibodies and the viral load, even if patients report they are feeling wonderful. Sometimes nutritional support helps relieve symptoms tremendously, but the virus persists and we either need to dig deeper or find a more effective treatment. Asking, “How do you feel?” to treat your patients is a standard for failure.
Natural medicine offers the most effective treatment against viruses, compared to the prescription drug Interferon, which has caused more suicides than all other drugs combined throughout history. The goal, along with correcting the patient’s diet and digestion, is to boost the natural killer cells to combat the virus. This can be done quite nicely with a synergistic combination of botanicals.
When considering heart disease and immunity, one also needs to consider liver function, especially when running tests for C-Reactive Protein (CRP) and homocysteine. CRP is made in the liver as a response to inflammation. If your patient’s CRP comes back normal while other markers for atherosclerosis are present, it could be due to fatty liver, the use of multiple drugs, or other issues that impair liver function. When the liver is impaired, it simply won’t crank out the CRP like it should, and lab levels for CRP will come back normal. Likewise, statin drugs lower CRP and produce a kosher lab panel, but this is rather like removing the engine light instead of fixing the engine.
Another heart culprit is the amino acid homocysteine, which destroys arterial walls and promotes atherosclerosis. Most people understand high homocysteine levels to be related to B vitamin deficiencies, but hypochlorhydria (too little stomach acid), and the use of estrogen creams and birth control pills can also raise homocysteine. A lesser-known culprit is poor liver function, when the liver’s methylation pathway is not functioning. Therefore this pathway should always be supported in conjunction with the usual homocysteine-lowering therapies. Methyl-B12 and Metacrin DX both support clearing the liver’s methylation pathway.
Hormones and the heart
When we think of hormones, we typically think of the sex hormones and how clumsily they function for many people. What most provokes atherosclerosis, however, is a less glamorous but exceptionally touchy hormone that we tend to abuse: Insulin. After years of a high-carb, sugar-laden diet that calls on the pancreas repeatedly to flood the system with insulin, the body’s cells become insulin resistant. This leaves excess amounts of insulin circulating through the bloodstream, leading to high blood pressure, thicker blood (which can gum up the cardiovascular system), and an increase of the enzyme activity that elevates cholesterol. In men, testosterone protects the cardiovascular system, just as estrogen does for women. In cases of insulin resistance, however, we see men becoming estrogen dominant (developing “breasts”) and women becoming testosterone dominant (growing “beards”), and we know cardiovascular destruction is well under way. These are the folks who fatigue after meals, whose fasting blood sugar is over 100 and who typically show high LDL and triglyceride levels. For these folks, regulating dysglycemia is imperative to heart health.
Thyroid health also plays an important role in cholesterol levels and heart health. When a person’s thyroid is under functioning, he or she makes fat more quickly than it is burned, which drives up triglycerides, cholesterol and LDL cholesterol. Hypothyroidism also makes the liver and gallbladder sluggish, which contributes to high cholesterol.
The autoimmune or neurological connection to the heart
There are times when I have exhausted all the possibilities, and still arterial inflammation and high cholesterol persist. It is then that I suspect autoimmune disease, when the body is attacking it’s own arterial walls, hormones or environmental compounds such as heavy metals, that in turn lead to high cholesterol and atherosclerosis. At that point we run an immune panel for direction in taming the autoimmune response. This information is vital in knowing specifically how to treat each autoimmune case, as the wrong approach can exacerbate the condition. Additionally, an understanding of functional neurology is important. When brain degeneration is accelerated due to autoimmune disease, insulin surges, nutrient deficiencies and other factors, autonomic function can begin to fail. Knowing how to assess and address neurological function can aid in heart health.
For ideas on how to modulate an autoimmune condition, see my book Why Do I Still Have Thyroid Symptoms? Although it addresses the thyroid, the autoimmune mechanics are the same for any tissue being affected.
To lower or not to lower cholesterol?
As long as we are addressing the source of inflammation, I still feel it is prudent to lower overly high cholesterol in order to put the brakes on artery-clogging atherosclerosis. I do this with compounds that contains red yeast rice extract, which studies show to be more effective than statin drugs, while absent of the dangerous side effects. (This compound proved so beneficial that the FDA banned it, citing it was “too effective to be a natural agent.” When the ban was lifted and it came back on the market, the pharmaceutical industry successfully bankrupted about half the manufacturers through expensive litigation.) If cholesterol levels refuse to lower with these compounds, I then look for gallbladder congestion. As mentioned earlier, bile escorts cholesterol from the body, so a sluggish and congested gallbladder will hamper this mechanism.
Doing the work
Like other practitioners, I also prescribe sufficient essential fatty acids, antioxidants and vitamin D on top of specific therapies. Healing cardiovascular damage naturally requires patience, dedication and thoroughness, not only from the practitioner, but especially from the patient. As all practitioners know, noncompliance can sabotage the best of care. When my patients present with inflammation markers and poor cardiovascular health, I always ask them, “How deep do you want to go? Here are 10 steps I’d like to take with you,” and I outline what I have presented in this article. In the end it’s up to them whether they want to do the work, but it’s only when I give them all their options that I can sleep at night. I need to know I have done more than the modern equivalent of drilling a hole in their head."
"An ancient surgical procedure, called trepanation, consisted of drilling a hole in the head and removing a piece of the skull. It is thought this practice was used to release evil spirits that caused mental illness, migraine headaches and other ills. Nowadays, however, if you went to your naturopath with complaints of headaches and she pulled out her drill, you would bolt from her office in horror.
Sadly, when it comes to heart disease, it seems we haven’t advanced all that much. When future humans look back to 2010 and the way we treat heart disease, they will shake their heads in disbelief. Much of heart care today, in both conventional and alternative medicine, ranges from harmful to hopelessly misguided.
Although cancer recently took the top spot, heart disease has long been the leading cause of death since the advent of processed foods almost 100 years ago, and it’s no wonder. The root of disease almost always begins in the gastrointestinal (GI) tract, with problems compounding in the immune and endocrine (hormone) systems, which in turn stress the heart. That gut health and immunity status affects the heart is lost on most conventional doctors, including many holistic ones.
These days we see two extreme viewpoints of cholesterol, both of which are incomplete. In conventional medicine, cholesterol is the defining marker for heart disease. While your local MD’s approach to treating high cholesterol has been seriously questioned and successfully challenged by reputable science, the standard of treatment — low-fat diets and Lipitor, for example — hasn’t budged. And when this model fails to prevent heart disease, as it often does, doctors simply blame the patient for not toiling long enough in the prison of low-fat diets.
In holistic medicine, on the other hand, cardiovascular health is often dismissed when symptoms are lacking, and high cholesterol is brushed away. Although the nutritional model is safer (for statin drugs can have devastating side effects), it too falls short when it doesn’t address the risk of high cholesterol levels.
Consider inflammation
As always, the answer lies in the middle of these two extremes. Conventional doctors miss the mark when they look at cholesterol levels in isolation, as do holistic doctors when they hardly consider it at all. The truth is, high cholesterol is a risk when inflammation is present.
When looking at what causes heart disease and how to treat it, atherosclerosis, the formation of plaque within the arteries, is the bottom line. But it’s shortsighted to simply blame atherosclerosis on high cholesterol. Rather, atherosclerosis comes from an immune response. The immune response creates inflammation, with this inflammation gradually worsening into lesions in the arterial walls. Since the body’s priority is to stay alive now, even if means self-sabotage in the long run, it speedily delivers cholesterol to the lesions to patch them up, hence causing atherosclerosis.
The key for the practitioner then is not simply to lower cholesterol, leaving the arterial walls more vulnerable to failure, but rather to ferret out what’s driving the inflammation. This is where the skill and ongoing education of the practitioner come in. For instance, newer research shows that some people develop atherosclerosis due to an autoimmune disease in which the body attacks it’s own arterial wall tissue. Is a prescription for either Lipitor or CoQ10 going to do much for these folks? Obviously not.
The sleuthing for inflammation starts by understanding that atherosclerosis starts where the gastrointestinal, hormonal, and immune systems meet (and yes, they do meet!). But for the sake of simplicity, lets look at each individually.
The gut connection to heart disease
Although many practitioners understand that poor digestion creates inflammation, a couple of problems specific to the GI tract can trigger atherosclerosis. For instance, bile secreted by the gallbladder escorts cholesterol out of the body. However, with dysbiosis — when there is more bad bacteria than good bacteria in the gut — this process falters or fails. The result is a rise in cholesterol (not to mention estrogen and various toxins). In this case, a simple gut detox and inoculation with beneficial bacteria lowers cholesterol.
Also critical is the link between helicobacter pylori infection and atherosclerosis. H.pylori, a bacterium unique in its ability to survive the highly acidic environment of the stomach, is best known for causing peptic ulcers, gastritis, and duodenitis. What’s less known, however, is that H.pylori also destroys vascular tissue; autopsies are turning up H.pylori in the lesions of stroke and heart attack victims.
Our gut is exposed to many pathogens, including H.pylori, daily. A healthy stomach sufficient in hydrochloric acid (HCl) destroys pathogens as soon as they enter. It’s estimated that 90 percent of Americans are deficient in HCl, and that H.pylori can be found in 50 percent of the world’s population, so it’s easy to see why this may be the most common infectious disease worldwide. Not to mention that most, if not all, chronic users of antacids harbor excess H.pylori.
So why hasn’t medicine launched a full-scale attack? Because an H.pylori infection is asymptomatic, quietly wreaking havoc before more telltale signs such as gastric ulcers enter the picture. And since most practitioners, both conventional and natural, practice based on symptoms, it can easily go unnoticed until it’s too late.
I do not like using the serum antibody test for H.pylori. A retest will not show whether we have successfully treated the infection, for the antibody levels stay elevated for up to a year after treatment. The breath test is more useful diagnostically. Because this bacteria is so contagious (by saliva), I have found treating an individual for H.pylori does not have lasting success unless the entire family is treated. I once had a patient whose H.pylori infection kept rebounding, despite treating his family. It was when he sheepishly brought in his mistress for treatment that we were finally able to kick the infection for good.
The immune system and the heart
We typically don’t think of a weak immune system as having much to do with heart health, but as with H.pylori, undetected viruses and other antigens can prey on the cardiovascular system. Although I am wary of making diagnoses based on symptoms, my patients who complain of chronic pain and fatigue are often suspects for chronic viruses. Most often they are the ones I screen for antibodies to antigens associated specifically with atherosclerosis: Cytomegalovirus, coxsackievirus, chlamydia pneumonia and porphyromonas gingivitis (for this last one, proper oral hygiene is key). I then track the treatment with follow-up tests that look at antibodies and the viral load, even if patients report they are feeling wonderful. Sometimes nutritional support helps relieve symptoms tremendously, but the virus persists and we either need to dig deeper or find a more effective treatment. Asking, “How do you feel?” to treat your patients is a standard for failure.
Natural medicine offers the most effective treatment against viruses, compared to the prescription drug Interferon, which has caused more suicides than all other drugs combined throughout history. The goal, along with correcting the patient’s diet and digestion, is to boost the natural killer cells to combat the virus. This can be done quite nicely with a synergistic combination of botanicals.
When considering heart disease and immunity, one also needs to consider liver function, especially when running tests for C-Reactive Protein (CRP) and homocysteine. CRP is made in the liver as a response to inflammation. If your patient’s CRP comes back normal while other markers for atherosclerosis are present, it could be due to fatty liver, the use of multiple drugs, or other issues that impair liver function. When the liver is impaired, it simply won’t crank out the CRP like it should, and lab levels for CRP will come back normal. Likewise, statin drugs lower CRP and produce a kosher lab panel, but this is rather like removing the engine light instead of fixing the engine.
Another heart culprit is the amino acid homocysteine, which destroys arterial walls and promotes atherosclerosis. Most people understand high homocysteine levels to be related to B vitamin deficiencies, but hypochlorhydria (too little stomach acid), and the use of estrogen creams and birth control pills can also raise homocysteine. A lesser-known culprit is poor liver function, when the liver’s methylation pathway is not functioning. Therefore this pathway should always be supported in conjunction with the usual homocysteine-lowering therapies. Methyl-B12 and Metacrin DX both support clearing the liver’s methylation pathway.
Hormones and the heart
When we think of hormones, we typically think of the sex hormones and how clumsily they function for many people. What most provokes atherosclerosis, however, is a less glamorous but exceptionally touchy hormone that we tend to abuse: Insulin. After years of a high-carb, sugar-laden diet that calls on the pancreas repeatedly to flood the system with insulin, the body’s cells become insulin resistant. This leaves excess amounts of insulin circulating through the bloodstream, leading to high blood pressure, thicker blood (which can gum up the cardiovascular system), and an increase of the enzyme activity that elevates cholesterol. In men, testosterone protects the cardiovascular system, just as estrogen does for women. In cases of insulin resistance, however, we see men becoming estrogen dominant (developing “breasts”) and women becoming testosterone dominant (growing “beards”), and we know cardiovascular destruction is well under way. These are the folks who fatigue after meals, whose fasting blood sugar is over 100 and who typically show high LDL and triglyceride levels. For these folks, regulating dysglycemia is imperative to heart health.
Thyroid health also plays an important role in cholesterol levels and heart health. When a person’s thyroid is under functioning, he or she makes fat more quickly than it is burned, which drives up triglycerides, cholesterol and LDL cholesterol. Hypothyroidism also makes the liver and gallbladder sluggish, which contributes to high cholesterol.
The autoimmune or neurological connection to the heart
There are times when I have exhausted all the possibilities, and still arterial inflammation and high cholesterol persist. It is then that I suspect autoimmune disease, when the body is attacking it’s own arterial walls, hormones or environmental compounds such as heavy metals, that in turn lead to high cholesterol and atherosclerosis. At that point we run an immune panel for direction in taming the autoimmune response. This information is vital in knowing specifically how to treat each autoimmune case, as the wrong approach can exacerbate the condition. Additionally, an understanding of functional neurology is important. When brain degeneration is accelerated due to autoimmune disease, insulin surges, nutrient deficiencies and other factors, autonomic function can begin to fail. Knowing how to assess and address neurological function can aid in heart health.
For ideas on how to modulate an autoimmune condition, see my book Why Do I Still Have Thyroid Symptoms? Although it addresses the thyroid, the autoimmune mechanics are the same for any tissue being affected.
To lower or not to lower cholesterol?
As long as we are addressing the source of inflammation, I still feel it is prudent to lower overly high cholesterol in order to put the brakes on artery-clogging atherosclerosis. I do this with compounds that contains red yeast rice extract, which studies show to be more effective than statin drugs, while absent of the dangerous side effects. (This compound proved so beneficial that the FDA banned it, citing it was “too effective to be a natural agent.” When the ban was lifted and it came back on the market, the pharmaceutical industry successfully bankrupted about half the manufacturers through expensive litigation.) If cholesterol levels refuse to lower with these compounds, I then look for gallbladder congestion. As mentioned earlier, bile escorts cholesterol from the body, so a sluggish and congested gallbladder will hamper this mechanism.
Doing the work
Like other practitioners, I also prescribe sufficient essential fatty acids, antioxidants and vitamin D on top of specific therapies. Healing cardiovascular damage naturally requires patience, dedication and thoroughness, not only from the practitioner, but especially from the patient. As all practitioners know, noncompliance can sabotage the best of care. When my patients present with inflammation markers and poor cardiovascular health, I always ask them, “How deep do you want to go? Here are 10 steps I’d like to take with you,” and I outline what I have presented in this article. In the end it’s up to them whether they want to do the work, but it’s only when I give them all their options that I can sleep at night. I need to know I have done more than the modern equivalent of drilling a hole in their head."
Wednesday, September 8, 2010
Red Light, Green Light
"Red light!" "Green light!" "Red light!"
We all remember playing that game as children. It was a fun way to pass the time. Personally, I always wanted to know what happened to the yellow light.
Oddly enough, as a doctor, I find myself asking the same question- where's the yellow light???
The yellow light, of course, is a caution, a warning light- 'slow down! the light is changing to red soon!' While listening to a lecture about blood chemistry the other day, it occurred to me- there's no yellow light in medicine.
When your doctor sends you for blood work and then reviews the results, your lab values are compared to a laboratory reference range. The limits of this range are viewed much like a cliff: you are either safely on top of the cliff or at the bottom. You're either sick or you're not. You need a prescription or you're 'perfectly healthy.' Green light or Red light. What happened to the yellow light?
You don't need to go to medical school to know that things are going wrong in the body before a full-blown disease develops. No one is perfectly healthy one day and suddenly wakes up with diabetes or heart disease the next. These diseases develop over time, after many months or even years of physiologic processes gone amuck. Its one of the reasons why we refer to them as chronic diseases. So again, where's the yellow light to say 'caution! if you don't change some things, you're going to develop diabetes or heart disease or fill-in-the-blank?'
This is the reason to use functional ranges instead of laboratory ranges. The functional ranges are based more on what the body needs to functional optimally, opposed to 'not be sick.'
At this point, you may be asking yourself right now, 'If functional ranges are based on what the body needs to functional optimally, then what the heck are those laboratory ranges based on?'
Good question.
In general, laboratory ranges are based on the average value for all the people who have had a given test done in whatever particular time frame. Lab ranges vary from lab to lab and can even vary by region for the same lab. For instance, one common test is TSH, thyroid stimulating hormone. The laboratory range for this test is approximately .45 to 5.0. (To give you an idea, according to the American Endocrine Society, the functional range for TSH is 1.8- 3.0). Why is the lab range so much bigger? Well think about who is having their thyroid function tested- people with thyroid problems! So when your doctor says 'your tests are normal' what that really means is 'your tests aren't nearly as bad the other people who have had this test.'
Not exactly a good way to go about creating health! This is also why so many people don't feel well, but aren't getting answers as to why they feel so bad either.
So back to our yellow light. If we look at the blood tests a different way, with a functional range within a laboratory range, we can see our green, yellow and red lights. The green light is within the functional range; the yellow light is between the functional range and the laboratory range and the red light is of course, outside of the laboratory range.
Now with the yellow light we can begin to see areas of physiology that aren't working quite right, but aren't bad enough to be full-blown disease either. Even better then seeing them of course, is that we can begin to do something about them before they become full-blown disease. After all, isn't that the point of healthcare?
We all remember playing that game as children. It was a fun way to pass the time. Personally, I always wanted to know what happened to the yellow light.
Oddly enough, as a doctor, I find myself asking the same question- where's the yellow light???
The yellow light, of course, is a caution, a warning light- 'slow down! the light is changing to red soon!' While listening to a lecture about blood chemistry the other day, it occurred to me- there's no yellow light in medicine.
When your doctor sends you for blood work and then reviews the results, your lab values are compared to a laboratory reference range. The limits of this range are viewed much like a cliff: you are either safely on top of the cliff or at the bottom. You're either sick or you're not. You need a prescription or you're 'perfectly healthy.' Green light or Red light. What happened to the yellow light?
You don't need to go to medical school to know that things are going wrong in the body before a full-blown disease develops. No one is perfectly healthy one day and suddenly wakes up with diabetes or heart disease the next. These diseases develop over time, after many months or even years of physiologic processes gone amuck. Its one of the reasons why we refer to them as chronic diseases. So again, where's the yellow light to say 'caution! if you don't change some things, you're going to develop diabetes or heart disease or fill-in-the-blank?'
This is the reason to use functional ranges instead of laboratory ranges. The functional ranges are based more on what the body needs to functional optimally, opposed to 'not be sick.'
At this point, you may be asking yourself right now, 'If functional ranges are based on what the body needs to functional optimally, then what the heck are those laboratory ranges based on?'
Good question.
In general, laboratory ranges are based on the average value for all the people who have had a given test done in whatever particular time frame. Lab ranges vary from lab to lab and can even vary by region for the same lab. For instance, one common test is TSH, thyroid stimulating hormone. The laboratory range for this test is approximately .45 to 5.0. (To give you an idea, according to the American Endocrine Society, the functional range for TSH is 1.8- 3.0). Why is the lab range so much bigger? Well think about who is having their thyroid function tested- people with thyroid problems! So when your doctor says 'your tests are normal' what that really means is 'your tests aren't nearly as bad the other people who have had this test.'
Not exactly a good way to go about creating health! This is also why so many people don't feel well, but aren't getting answers as to why they feel so bad either.
So back to our yellow light. If we look at the blood tests a different way, with a functional range within a laboratory range, we can see our green, yellow and red lights. The green light is within the functional range; the yellow light is between the functional range and the laboratory range and the red light is of course, outside of the laboratory range.
Now with the yellow light we can begin to see areas of physiology that aren't working quite right, but aren't bad enough to be full-blown disease either. Even better then seeing them of course, is that we can begin to do something about them before they become full-blown disease. After all, isn't that the point of healthcare?
Wednesday, August 25, 2010
What is Functional Medicine anyway?
Maybe you have heard the term 'functional medicine' and then again, maybe you haven't.
Even if you haven't, you probably have a good idea what it means- medicine focused on proper function of the human body, not just treating diseases.
The fact that we have such a term is strong evidence that we have gotten away from true healthcare. What many of us take for granted in our drug- & disease-oriented culture is that the human body actually has many complex mechanisms for regulating and healing itself. You know this intuitively- when you get a cut on your finger, it heals on its own. Well guess what? Your body also has mechanisms for regulating it's pH, blood sugar, blood pressure, energy production- even searching out & destroying cancer cells before they become invasive tumors.
What this means to you is that once you have developed a disease like diabetes, heart disease, or even cancer, your body's physiology has been out of whack for so long that it can no longer regulate itself. This can take years to develop, but once it does, it is very difficult for the body to effectively regulate itself again. This is when pharmaceuticals become necessary to manage the fall-out from these non-existent control mechanisms.
But what if there was a kind of doctor who could 'catch' these things before they developed in to full-blown, chronic disease? What would this doctor use to see this future cascade? Tea leaves? A crystal ball?
Or how about a basic blood test?
Yes, the very same thing your doctor is already using to tell you about your current state of health can also be used to 'predict' your future state of health. The difference is a matter of perspective.
There is essentially two different lenses with which to view this information. One lens, the one most commonly employed is what I call the 'disease lens' while the other is what I call the 'functional lens.' Here's an example of these two lenses at work: You have annual blood work done and your TSH (thyroid stimulating hormone) is 3.8. The 'normal' range is usually .45 to 4.0, so 3.8 looks good right? You are judged to be free of the disease of hypothyroidism.
But just because you are proclaimed disease-free doesn't mean you are healthy. What if you feel tired, sluggish and are cold all the time? You certainly don't feel healthy. This is one of the reasons why I use a functional lens to look at these measures. The functional range for TSH, a range that supports health, not just the absence of disease, is 1.8-3.0. Through this lens, a TSH of 3.8 would indicate the early stages of hypothyroidism. And if you were having the symptoms described above, this would be further evidence of hypothyroidism. If the cause of the hypothyroidism is determined earlier enough, the need for synthetic replacement hormones may be avoided. Imagine- preventing the need for life long medications!
Functional medicine and its practitioners are dedicated to finding and reversing problems before they become disease. If that wasn't exciting enough, the even better news is that when problems are found early enough, they can generally be corrected with diet, exercise, and herbs. So in the future, you may want to look for a functional medicine practitioner to add to your healthcare team.
Even if you haven't, you probably have a good idea what it means- medicine focused on proper function of the human body, not just treating diseases.
The fact that we have such a term is strong evidence that we have gotten away from true healthcare. What many of us take for granted in our drug- & disease-oriented culture is that the human body actually has many complex mechanisms for regulating and healing itself. You know this intuitively- when you get a cut on your finger, it heals on its own. Well guess what? Your body also has mechanisms for regulating it's pH, blood sugar, blood pressure, energy production- even searching out & destroying cancer cells before they become invasive tumors.
What this means to you is that once you have developed a disease like diabetes, heart disease, or even cancer, your body's physiology has been out of whack for so long that it can no longer regulate itself. This can take years to develop, but once it does, it is very difficult for the body to effectively regulate itself again. This is when pharmaceuticals become necessary to manage the fall-out from these non-existent control mechanisms.
But what if there was a kind of doctor who could 'catch' these things before they developed in to full-blown, chronic disease? What would this doctor use to see this future cascade? Tea leaves? A crystal ball?
Or how about a basic blood test?
Yes, the very same thing your doctor is already using to tell you about your current state of health can also be used to 'predict' your future state of health. The difference is a matter of perspective.
There is essentially two different lenses with which to view this information. One lens, the one most commonly employed is what I call the 'disease lens' while the other is what I call the 'functional lens.' Here's an example of these two lenses at work: You have annual blood work done and your TSH (thyroid stimulating hormone) is 3.8. The 'normal' range is usually .45 to 4.0, so 3.8 looks good right? You are judged to be free of the disease of hypothyroidism.
But just because you are proclaimed disease-free doesn't mean you are healthy. What if you feel tired, sluggish and are cold all the time? You certainly don't feel healthy. This is one of the reasons why I use a functional lens to look at these measures. The functional range for TSH, a range that supports health, not just the absence of disease, is 1.8-3.0. Through this lens, a TSH of 3.8 would indicate the early stages of hypothyroidism. And if you were having the symptoms described above, this would be further evidence of hypothyroidism. If the cause of the hypothyroidism is determined earlier enough, the need for synthetic replacement hormones may be avoided. Imagine- preventing the need for life long medications!
Functional medicine and its practitioners are dedicated to finding and reversing problems before they become disease. If that wasn't exciting enough, the even better news is that when problems are found early enough, they can generally be corrected with diet, exercise, and herbs. So in the future, you may want to look for a functional medicine practitioner to add to your healthcare team.
Wednesday, August 18, 2010
The Effects of Hashimoto's and hypothyroidism on brain health
This is article written by a colleague, Dr. Datis Kharrazian, who has been doing brilliant research into the widespread effects of mistreated hypothyroidism.
February 17th, 2010 | Author: Dr. Datis Kharrazian
Do you need to take the Leaky Brain Challenge? Read on to find out.
The most disturbing thing I see in regards to Hashimoto’s is that although people’s TSH may be managed with thyroid hormones, their immune dysregulation goes unchecked. This leaves other areas of the body vulnerable to attack, the most profound being the brain.
There are three ways Hashimoto’s can affect the brain. First, many people with Hashimoto’s also have an autoimmune attack against their nervous system. On a blood test this can be identified by positive antibodies to neurological tissue. Second, unrelated to an autoimmune attack against the nervous system, the inflammatory response generated by Hashimoto’s can activate the brain’s immune system, hence promoting inflammation in the brain. Third, Hashimoto’s can lead to low thyroid hormones, which are necessary to dampen the brain inflammation caused by the previous two factors.
Depression, fatigue, and brain fog
It’s important to know that we all experience brain degeneration on an ongoing basis. A more common term for accelerated brain degeneration is simply known as aging. The trick is to prevent the brain from degenerating any faster than it has to.
Unfortunately, it is very common to see advanced brain degeneration in long-term, unresolved Hashimoto’s cases, with the most common symptoms being depression (from decreased firing of the frontal cortex), fatigue (from brain fatigue due to neurodegeneration), and brain fog (from brain inflammation).
True, these are also symptoms of hypothyroidism, but in some cases, particularly when the condition is long standing or still persistent despite successful management of thyroid levels, the impact of an unresolved thyroid condition on the brain should be investigated.
How Hashimoto’s affects the brain’s immune system
The brain is made up of two types of cells: neurons and microglia cells. Neurons are responsible for communication within the brain and everything we associate with brain activity, such as our intelligence, emotions, and the ability to automatically breathe, digest or maintain a heartbeat.
The microglia cells are the brain’s immune cells. It’s their job to react to foreign invaders, clean up debris and plaque, and dissolve dead neurons. The microgia are necessary for optimal neuronal communication and healthy brain function.
Although microglial cells function as the brain’s immune system, they are unlike the immune system in the rest of the body. When a virus or bacteria invades your body, the body’s immune system orchestrates a comlex and multi-faceted response, as described briefly in Chapter Three of my book. For instance, once an antigen (a foreign invader) is successfully dispatched, the immune system’s T-suppressor cells call off the attack and send the troops home.
Not so with the brain’s immune system. If an antigen makes its way into the brain, there is no complex orchestration, but rather an all-out assault by the brain’s microglial cells on the invader and, as a consequence, inflammation and degeneration of surrounding brain tissue. What’s worse is that there are no T-suppressor cells to call off the attack, and the glial cells, in their unrestrained assault, create brain inflammation and chew up brain tissue in a degenerative cascade.
Hashimoto’s is a double whammy for the brain
Unfortunately, Hashimoto’s activates microglia cells in two ways. First, thyroid hormones are integral to brain health, and Hashimoto’s can lead to low thyroid hormone status. Thyroid hormones dampen overactivity of the microglial cells, thus preventing or slowing down this cascade that causes inflammation and degeneration in the brain.(1-8)
Second, the inflammatory response caused by Hashimoto’s increases the activity of the brain’s microglia cells, hence promoting brain inflammation.(9)
So failing to address the autoimmune attacks of Hashimoto’s is a double whammy on the brain — the inflammation caused by Hashimoto’s increases microglial activity, while low thyroid hormone status fails to adequately dampen the microglial cells.
The effect of Hashimoto’s on the blood-brain barrier
The microglia cells not only make up more than half of the total mass of the brain, but they also make up the blood-brain barrier, a thin barrier that lines the brain and allows necessary, nano-sized substances to pass through. The blood-brain barrier is important for keeping antigens (foreign invaders, such as viruses or bacteria) and environmental toxins out of the brain.
Unfortunately, the blood-brain barrier can develop “leaks” for a variety of reasons, including poor blood-sugar stability (particularly insulin resistance),(10) chronic stress,(11) chronic inflammation,(12) poor gut health, poor diet with unhealthy fats,(13) and unchecked autoimmune activity, such as Hashimoto’s disease (alcohol and high homocysteine are other recognized factors(14-16)). If you are familiar with leaky gut, as discussed in the book, then you’ll understand leaky brain, as both the gut and the brain are immune barriers vulnerable to the same problems.
When the blood-brain barrier develops leaks, bad guys get in, the microglial cells go nuts, and a whole lot of brain tissue gets chewed up. This creates inflammation, which in felt in some as “brain fog,” and leads to accelerated brain degeneration.
The Leaky Brain Challenge
How do you know if your blood-brain barrier is leaky? A simple and easy way to find out is to do Blood-Brain Barrier Challenge. To do this, simply take 1000 mg of straight GABA (not GABA precursors such as theanine).
GABA is a neurotransmitter synthesized in the brain and is responsible for calming or inhibiting over activity. Although some companies sell GABA supplements, the reality is the GABA molecule is too large to pass through an intact blood-brain barrier. The fact that this supplement sells so well is a testament to the integrity of the average American’s blood-brain barrier.
So, if several hours after taking 1000 mg of GABA, you feel calm, relaxed or sleepy, you know that GABA, a molecule too large to pass through the blood-brain barrier, has nevertheless made it into your brain and is performing its calming duties. This means your blood-brain barrier has become compromised and your brain is highly susceptible to the immune rampages I discussed above.
Some people, instead of feeling relaxed, will find GABA makes them feel more anxious or jittery. There are other reasons for this that will be discussed in my next book, however any reaction at all indicates a leaky brain barrier.
If you felt no change after taking GABA, that is a good sign that your blood-brain barrier is intact and functioning well. (For accurate results, be sure to take this test during the day and not at bedtime.)
What to do about a leaky brain barrier
Addressing the areas that helped cause a permeable blood-brain barrier is the best place to start if you want to restore integrity. First make sure your diet is strictly void of gluten. Then do an Elimination/Provocation diet, as explained in my book, to determine whether other foods, such as dairy or eggs, are also provoking the immune system.
Continue on with the other strategies explained in the book: Balancing blood sugar, addressing gut health and gut infections, and supporting adrenal health so your adrenal hormones are neither too high or too low. All of these will help quench inflammation, a notorious saboteur of brain health. Also, ask your practitioner about the supplements I have created specifically for blood-brain barrier integrity, brain inflammation and increased blood flow to the brain (which will be discussed in my next book). Other strategies include enhancing the liver’s methylation pathway (Chapter Eight of the thyroid book) and supplementing with alpha-lipoic acid.
Modulating your autoimmune disease is a vital step to protecting the integrity of your blood-brain barrier and the health of your brain. The longer Hashimoto’s or any autoimmune disease goes on unchecked, the more vulnerable your brain is to autoimmune disease, degeneration, and inflammation.
References
1 Pumirat J. Prog Neurobiol. 1992;39:281-294.
2 Limr FRS, et al. J Endocrinol. 1997;154:161-175.
3 Gomes FCA, et al. Adv Exp Med Biol. 1997;429:99-108.
4 Mallet M, et al. Adv Exp Med Biol. 1997;429:99-108.
5 Dobbertin A, et al. J Neuroscie. 1997;17:5305-5315.
6 Bernal J, et al. Thyroid hormones and brain development. Eur J Endocrinol;133:390-398.
7 Calza L, et al. Thyroid hormone-induced plasticity in the adult rat brain. Brain Res Bull. 1997;44(4):549-57.
8 Flavin RSL, et al. Regulation of microglial development: A novel role for thyroid hormones. The Journal of Neuroscience. 2001;21(6):2028-2038.
9 Flavin RSL, et al. Regulation of microglial development: A novel role for thyroid hormones. The Journal of Neuroscience. 2001;21(6):2028-2038
10 Kamada H et al. Influence of hyperglycemia on oxidative stress and matrix metalloproteinase-9 activation after focal cerebral ischemia/reperfusion in rats. Stroke. 2007;38:1022-1049.
11 Espositie, P, et al. Acute stress increases permeability of the blood-brain barrier through activation of brain mast cells. Brain Research. 2001;888(1):117-127.
12 Haroh J, et al. Oxidative stress activates protein tyrosine kinase and matrix metalloproteinases leading to blood-brain barrier dysfunction. J neurochem. 2007;22(1).
13 Jali C, et al. Cyclooxygenase inhibition limits blood-brain barrier diruption following intracerebral injection of tumor necrosis factor-alpha in the rat. JPET. 2007;323(2):488-498.
14 Haorah J, et al. Alcohol0induced oxidative stress in brain endothelial cells causes blood-brain barrier dysfunction. Journal of Leukocyte Biology. 2005;78:1223-1232.
15 Atul F, et al. Elevated levels of homocysteine compromise blood-brain barrier integrity in mice. Blood. 2005.
16 Homocysteine attenuates blood-brain barrier function by inducing oxidative stress and the junctional proteins. FASEB. 2008;22:734-7.
February 17th, 2010 | Author: Dr. Datis Kharrazian
Do you need to take the Leaky Brain Challenge? Read on to find out.
The most disturbing thing I see in regards to Hashimoto’s is that although people’s TSH may be managed with thyroid hormones, their immune dysregulation goes unchecked. This leaves other areas of the body vulnerable to attack, the most profound being the brain.
There are three ways Hashimoto’s can affect the brain. First, many people with Hashimoto’s also have an autoimmune attack against their nervous system. On a blood test this can be identified by positive antibodies to neurological tissue. Second, unrelated to an autoimmune attack against the nervous system, the inflammatory response generated by Hashimoto’s can activate the brain’s immune system, hence promoting inflammation in the brain. Third, Hashimoto’s can lead to low thyroid hormones, which are necessary to dampen the brain inflammation caused by the previous two factors.
Depression, fatigue, and brain fog
It’s important to know that we all experience brain degeneration on an ongoing basis. A more common term for accelerated brain degeneration is simply known as aging. The trick is to prevent the brain from degenerating any faster than it has to.
Unfortunately, it is very common to see advanced brain degeneration in long-term, unresolved Hashimoto’s cases, with the most common symptoms being depression (from decreased firing of the frontal cortex), fatigue (from brain fatigue due to neurodegeneration), and brain fog (from brain inflammation).
True, these are also symptoms of hypothyroidism, but in some cases, particularly when the condition is long standing or still persistent despite successful management of thyroid levels, the impact of an unresolved thyroid condition on the brain should be investigated.
How Hashimoto’s affects the brain’s immune system
The brain is made up of two types of cells: neurons and microglia cells. Neurons are responsible for communication within the brain and everything we associate with brain activity, such as our intelligence, emotions, and the ability to automatically breathe, digest or maintain a heartbeat.
The microglia cells are the brain’s immune cells. It’s their job to react to foreign invaders, clean up debris and plaque, and dissolve dead neurons. The microgia are necessary for optimal neuronal communication and healthy brain function.
Although microglial cells function as the brain’s immune system, they are unlike the immune system in the rest of the body. When a virus or bacteria invades your body, the body’s immune system orchestrates a comlex and multi-faceted response, as described briefly in Chapter Three of my book. For instance, once an antigen (a foreign invader) is successfully dispatched, the immune system’s T-suppressor cells call off the attack and send the troops home.
Not so with the brain’s immune system. If an antigen makes its way into the brain, there is no complex orchestration, but rather an all-out assault by the brain’s microglial cells on the invader and, as a consequence, inflammation and degeneration of surrounding brain tissue. What’s worse is that there are no T-suppressor cells to call off the attack, and the glial cells, in their unrestrained assault, create brain inflammation and chew up brain tissue in a degenerative cascade.
Hashimoto’s is a double whammy for the brain
Unfortunately, Hashimoto’s activates microglia cells in two ways. First, thyroid hormones are integral to brain health, and Hashimoto’s can lead to low thyroid hormone status. Thyroid hormones dampen overactivity of the microglial cells, thus preventing or slowing down this cascade that causes inflammation and degeneration in the brain.(1-8)
Second, the inflammatory response caused by Hashimoto’s increases the activity of the brain’s microglia cells, hence promoting brain inflammation.(9)
So failing to address the autoimmune attacks of Hashimoto’s is a double whammy on the brain — the inflammation caused by Hashimoto’s increases microglial activity, while low thyroid hormone status fails to adequately dampen the microglial cells.
The effect of Hashimoto’s on the blood-brain barrier
The microglia cells not only make up more than half of the total mass of the brain, but they also make up the blood-brain barrier, a thin barrier that lines the brain and allows necessary, nano-sized substances to pass through. The blood-brain barrier is important for keeping antigens (foreign invaders, such as viruses or bacteria) and environmental toxins out of the brain.
Unfortunately, the blood-brain barrier can develop “leaks” for a variety of reasons, including poor blood-sugar stability (particularly insulin resistance),(10) chronic stress,(11) chronic inflammation,(12) poor gut health, poor diet with unhealthy fats,(13) and unchecked autoimmune activity, such as Hashimoto’s disease (alcohol and high homocysteine are other recognized factors(14-16)). If you are familiar with leaky gut, as discussed in the book, then you’ll understand leaky brain, as both the gut and the brain are immune barriers vulnerable to the same problems.
When the blood-brain barrier develops leaks, bad guys get in, the microglial cells go nuts, and a whole lot of brain tissue gets chewed up. This creates inflammation, which in felt in some as “brain fog,” and leads to accelerated brain degeneration.
The Leaky Brain Challenge
How do you know if your blood-brain barrier is leaky? A simple and easy way to find out is to do Blood-Brain Barrier Challenge. To do this, simply take 1000 mg of straight GABA (not GABA precursors such as theanine).
GABA is a neurotransmitter synthesized in the brain and is responsible for calming or inhibiting over activity. Although some companies sell GABA supplements, the reality is the GABA molecule is too large to pass through an intact blood-brain barrier. The fact that this supplement sells so well is a testament to the integrity of the average American’s blood-brain barrier.
So, if several hours after taking 1000 mg of GABA, you feel calm, relaxed or sleepy, you know that GABA, a molecule too large to pass through the blood-brain barrier, has nevertheless made it into your brain and is performing its calming duties. This means your blood-brain barrier has become compromised and your brain is highly susceptible to the immune rampages I discussed above.
Some people, instead of feeling relaxed, will find GABA makes them feel more anxious or jittery. There are other reasons for this that will be discussed in my next book, however any reaction at all indicates a leaky brain barrier.
If you felt no change after taking GABA, that is a good sign that your blood-brain barrier is intact and functioning well. (For accurate results, be sure to take this test during the day and not at bedtime.)
What to do about a leaky brain barrier
Addressing the areas that helped cause a permeable blood-brain barrier is the best place to start if you want to restore integrity. First make sure your diet is strictly void of gluten. Then do an Elimination/Provocation diet, as explained in my book, to determine whether other foods, such as dairy or eggs, are also provoking the immune system.
Continue on with the other strategies explained in the book: Balancing blood sugar, addressing gut health and gut infections, and supporting adrenal health so your adrenal hormones are neither too high or too low. All of these will help quench inflammation, a notorious saboteur of brain health. Also, ask your practitioner about the supplements I have created specifically for blood-brain barrier integrity, brain inflammation and increased blood flow to the brain (which will be discussed in my next book). Other strategies include enhancing the liver’s methylation pathway (Chapter Eight of the thyroid book) and supplementing with alpha-lipoic acid.
Modulating your autoimmune disease is a vital step to protecting the integrity of your blood-brain barrier and the health of your brain. The longer Hashimoto’s or any autoimmune disease goes on unchecked, the more vulnerable your brain is to autoimmune disease, degeneration, and inflammation.
References
1 Pumirat J. Prog Neurobiol. 1992;39:281-294.
2 Limr FRS, et al. J Endocrinol. 1997;154:161-175.
3 Gomes FCA, et al. Adv Exp Med Biol. 1997;429:99-108.
4 Mallet M, et al. Adv Exp Med Biol. 1997;429:99-108.
5 Dobbertin A, et al. J Neuroscie. 1997;17:5305-5315.
6 Bernal J, et al. Thyroid hormones and brain development. Eur J Endocrinol;133:390-398.
7 Calza L, et al. Thyroid hormone-induced plasticity in the adult rat brain. Brain Res Bull. 1997;44(4):549-57.
8 Flavin RSL, et al. Regulation of microglial development: A novel role for thyroid hormones. The Journal of Neuroscience. 2001;21(6):2028-2038.
9 Flavin RSL, et al. Regulation of microglial development: A novel role for thyroid hormones. The Journal of Neuroscience. 2001;21(6):2028-2038
10 Kamada H et al. Influence of hyperglycemia on oxidative stress and matrix metalloproteinase-9 activation after focal cerebral ischemia/reperfusion in rats. Stroke. 2007;38:1022-1049.
11 Espositie, P, et al. Acute stress increases permeability of the blood-brain barrier through activation of brain mast cells. Brain Research. 2001;888(1):117-127.
12 Haroh J, et al. Oxidative stress activates protein tyrosine kinase and matrix metalloproteinases leading to blood-brain barrier dysfunction. J neurochem. 2007;22(1).
13 Jali C, et al. Cyclooxygenase inhibition limits blood-brain barrier diruption following intracerebral injection of tumor necrosis factor-alpha in the rat. JPET. 2007;323(2):488-498.
14 Haorah J, et al. Alcohol0induced oxidative stress in brain endothelial cells causes blood-brain barrier dysfunction. Journal of Leukocyte Biology. 2005;78:1223-1232.
15 Atul F, et al. Elevated levels of homocysteine compromise blood-brain barrier integrity in mice. Blood. 2005.
16 Homocysteine attenuates blood-brain barrier function by inducing oxidative stress and the junctional proteins. FASEB. 2008;22:734-7.
Tuesday, August 17, 2010
Do you take Synthroid? Armour? Cytomel?
Synthroid is the 4th most prescribed medication in the United States, so there are probably many of you who said yes.
How do you feel???
Did you initially feel really great and then many of the symptoms- the tiredness, weight gain and irritability, crept back in?
Have you been bouncing back and forth between different medications and dosages trying to find the one that will relieve your symptoms and give you your life back? Have you found it yet?
If you haven't, here's something to consider: 90% of patients with hypothyroidism have a subset of hypothyroidism called Hashimoto's Autoimmune Thyroid.
What's that????
Hashimoto's is a condition where the body makes antibodies to its own thyroid tissue. Your body for some reason thinks your thyroid is a foreign invader and needs to be destroyed.
Since Hashimoto's in an immune problem and not a thyroid problem, thyroid-hormone replacement medications like Synthroid are a stop-gap measure, making up for the deficient thyroid hormone, but not addressing the immune system dysfunction that is causing the thyroid hormone to be low in the first place. This is why many people on these drugs bounce back & forth between different formulations & dosages, but don't seem to get any lasting relief.
How do you know if you have Hashimoto's? If you feel worse on bio-identical hormone formulations, like Armour, you may be making antibodies to your thyroid. Symptom-wise, a strong clue that you may have Hashimoto's is if you have hyper AND hypothyroid symptoms. Do you sometimes have heart palpitations, insomnia, night sweats, nervousness or inward trembling and other times feel tired, sluggish, have cold hands & feet, gain weight easily, are constipated and feel depressed with lack of motivation?
A diagnosis of Hashimoto's can also be confirmed with a blood test. If antibodies to the thyroid are found, this confirms a diagnosis of Hashimoto's. However, because it is an immune disorder, the presence of antibodies depends on how well the immune system is functioning at the time of the blood test. It can sometimes take 2-3 tests over the course of a couple months to confirm the diagnosis of Hashimoto's one way or the other.
Once Hashimoto's is diagnosed, what can you do to feel better? Well the good news is that this condition can be managed well completely naturally. Stay tuned for my next article where I will talk about this in more detail.
How do you feel???
Did you initially feel really great and then many of the symptoms- the tiredness, weight gain and irritability, crept back in?
Have you been bouncing back and forth between different medications and dosages trying to find the one that will relieve your symptoms and give you your life back? Have you found it yet?
If you haven't, here's something to consider: 90% of patients with hypothyroidism have a subset of hypothyroidism called Hashimoto's Autoimmune Thyroid.
What's that????
Hashimoto's is a condition where the body makes antibodies to its own thyroid tissue. Your body for some reason thinks your thyroid is a foreign invader and needs to be destroyed.
Since Hashimoto's in an immune problem and not a thyroid problem, thyroid-hormone replacement medications like Synthroid are a stop-gap measure, making up for the deficient thyroid hormone, but not addressing the immune system dysfunction that is causing the thyroid hormone to be low in the first place. This is why many people on these drugs bounce back & forth between different formulations & dosages, but don't seem to get any lasting relief.
How do you know if you have Hashimoto's? If you feel worse on bio-identical hormone formulations, like Armour, you may be making antibodies to your thyroid. Symptom-wise, a strong clue that you may have Hashimoto's is if you have hyper AND hypothyroid symptoms. Do you sometimes have heart palpitations, insomnia, night sweats, nervousness or inward trembling and other times feel tired, sluggish, have cold hands & feet, gain weight easily, are constipated and feel depressed with lack of motivation?
A diagnosis of Hashimoto's can also be confirmed with a blood test. If antibodies to the thyroid are found, this confirms a diagnosis of Hashimoto's. However, because it is an immune disorder, the presence of antibodies depends on how well the immune system is functioning at the time of the blood test. It can sometimes take 2-3 tests over the course of a couple months to confirm the diagnosis of Hashimoto's one way or the other.
Once Hashimoto's is diagnosed, what can you do to feel better? Well the good news is that this condition can be managed well completely naturally. Stay tuned for my next article where I will talk about this in more detail.
Monday, June 14, 2010
Spare tire? Change it now!
Spare tire. Pudge. Beer belly. Muffin tops. No matter what you call it, we're talking about the same thing- abdominal fat.
Perhaps you've heard lately that this type of fat is more dangerous then the fat we tend to put on in our hips, butt or thighs. We know that the more abdominal fat a person has, the greater their cardiovascular risk. But that's not the whole story of belly fat.
We also know that increased belly fat indicates insulin resistance, an indicator of pre-diabetes. Don't forget that insulin is a hormone and the pancreas, the organ that makes and secretes insulin, is an endocrine gland. The endocrine (hormone) system is complex and we are still learning about the myriad of interactions between hormones and the tissues they affect. One thing is for sure, if one hormone is out of balance, others usually are too.
With this in mind, its no surprise that insulin resistance comes with increased levels of DHEA & testosterone. At first, that might not seem like a big deal, but consider that this trifecta of insulin resistance, high DHEA & high testosterone causes Polycystic Ovary Syndrome in women. The facial hair growth typical of PCOS is caused by the higher-then-normal levels of testosterone.
These hormone imbalances can also lead to adrenal fatigue, as the overworked adrenals struggle to keep up with the increased demand for cortisol, DHEA and sex hormones (estrogen & testosterone). How do you know if you have adrenal fatigue? I tell my patients if you're sick & tired of being sick & tired, if you need caffeine and sugar to get through your day, or if you are absolutely flat-line after lunch, you have adrenal fatigue.
Insulin resistance, metabolic syndrome, PCOS, and adrenal fatigue can all therefore, be traced back to a common source- hormone imbalance.
So, how does one fix this hormone imbalance?
It's starts with testing. But it has to be the right test. Blood tests for hormone levels are inaccurate because most of the hormones in the blood travel around bound to proteins. Since we can't measure them accurately when they are bound this way, blood tests are inaccurate. Salivary testing has been shown to be a more accurate test for cortisol, estrogen, progesterone, testosterone and DHEA levels. And its a simple as spitting in to a test tube.
If you're ready to get rid of that spare tire, see a health care practitioner who can properly evaluate you for the hormone imbalance that may be causing the abdominal fat in the first place.
Perhaps you've heard lately that this type of fat is more dangerous then the fat we tend to put on in our hips, butt or thighs. We know that the more abdominal fat a person has, the greater their cardiovascular risk. But that's not the whole story of belly fat.
We also know that increased belly fat indicates insulin resistance, an indicator of pre-diabetes. Don't forget that insulin is a hormone and the pancreas, the organ that makes and secretes insulin, is an endocrine gland. The endocrine (hormone) system is complex and we are still learning about the myriad of interactions between hormones and the tissues they affect. One thing is for sure, if one hormone is out of balance, others usually are too.
With this in mind, its no surprise that insulin resistance comes with increased levels of DHEA & testosterone. At first, that might not seem like a big deal, but consider that this trifecta of insulin resistance, high DHEA & high testosterone causes Polycystic Ovary Syndrome in women. The facial hair growth typical of PCOS is caused by the higher-then-normal levels of testosterone.
These hormone imbalances can also lead to adrenal fatigue, as the overworked adrenals struggle to keep up with the increased demand for cortisol, DHEA and sex hormones (estrogen & testosterone). How do you know if you have adrenal fatigue? I tell my patients if you're sick & tired of being sick & tired, if you need caffeine and sugar to get through your day, or if you are absolutely flat-line after lunch, you have adrenal fatigue.
Insulin resistance, metabolic syndrome, PCOS, and adrenal fatigue can all therefore, be traced back to a common source- hormone imbalance.
So, how does one fix this hormone imbalance?
It's starts with testing. But it has to be the right test. Blood tests for hormone levels are inaccurate because most of the hormones in the blood travel around bound to proteins. Since we can't measure them accurately when they are bound this way, blood tests are inaccurate. Salivary testing has been shown to be a more accurate test for cortisol, estrogen, progesterone, testosterone and DHEA levels. And its a simple as spitting in to a test tube.
If you're ready to get rid of that spare tire, see a health care practitioner who can properly evaluate you for the hormone imbalance that may be causing the abdominal fat in the first place.
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