Sunday, November 8, 2009
The Poisons in Our Foods
I recently completed a toxicology profile on myself. Keep in mind that I have been eating 6 plus cups of kale / collards/ onion family vegetables every day for nearly two years. Along with that I have been eating bright colors to maximize my antioxidant intake too. In short I have been following a reasonable detoxification diet.
however I did expect that I'd have some evidence of heavy metals, just because I have come to recognize that heavy metals in the body are often drivers of autoimmune diseases, including multiple sclerosis. I've been taking additional iodine for three months, again to help support my iodine intake.
I took the test through the FFP laboratory (J. D. Flechas, MD) because I wanted to get a status on my iodine and heavy metals. I just go my results and I was surprised.
Here they are
Flouride: normal range
Iodine: provocation 78% when the goal is 90% so iodine stores are low - I probably need another 3 to 6 months of replacement iodine to get my iodine levels in the fully replaced range)
Bromide spot low - but provocation was 38 (3X normal) - which means I have bromide in my body. Bromide competes with iodine, driving up the amount of iodine I need. Bromine will be excreted via urine. But I need a lot of iodine to do so.
Other heavy metals that were toxic
aluminum 2X normal
Barium 20X normal
cadmium slight elevation
cesium 2 X normla
Gadolinium 100 X normal
rubidium slight elevation
thalium 10X normal
tungsten slight elevation
Uraniaum 2 X normal
mercury slight elevation
The big questions --
Where did I get these compounds? \
Am I still taking more into my body?
How do I increase my ability to get rid of them?
Notably, I probably had much higher levels two years ago.
Since cruciferous, onions and sulfur amino acids induce more enzymes that are used in detoxification -- I have been following a good detox protocol.
But now I want to do even more..
I went out looking for more information on detoxification and came across this site.
I found it useful.
Other sources of information include Dr. Mark Hyman who has several books. Going to his website would provide some information as well.
More information can be found about iodine at
Sources for my heavy metals were probably related to growing up on an Iowa farm, living in communities that used treated river water and living in a home with a shallow well.
Now I have a reverse osmosis water filter. I take a sauna most days, and a clay foot soak. And I take chlorella, spirulina and green tea each day in my morning smoothie.
For those of you with an autoimmune disease, consider the possibility that heavy metals in your fat and brain are adding to your disease.
Wednesday, September 9, 2009
E stim for incontinenc e
Here are the abstracts for two articles about estim and leaky
The bottom line is that a rectal probe or a vaginal probe to deliver
electrical stimulation to help strengthen pelvic floor muscles works.
It is like an electrified kegel exercise. It is uncomfortable, but
one controls how much electricity is delivered. I have used it, and
am using it now each day and have found it to be quite helpful.
A second method uses electrical stimulation to skin over the posterior
tibiliais nerve (by the ankle). That has been quite helpful as well,
but I have not personallly tried that version. I've pasted copies of
the abstracts from two articles talking about estim and incontinence.
You could take the abstracts to your physician and discuss possible
treatments with estim for your leaky bladdder if that is an issue for
Although it is not yet approved for strengthening muscles to walk,
electrical stimulation of muscles is approved for strengthening
muscles to control one’s bladder. Treating a leaky bladder with
electrical stimulation works using a vaginal or rectal probe to
increase the strength of pelvic muscle works. Multiple studies have
shown this to be effective. The FDA has approved the use of such
devices. Minnova, manufactured by EMPI is one such device. If you
want to learn more – go to the EMPI web page.
Below is an abstract which one could take their physician or physical
therapist for more information to support the request to try e-stim
Treatment of urinary stress incontinence by intravaginal electrical
stimulation and pelvic floor physiotherapy
.Treatment of urinary stress incontinence (USI) by intravaginal
electrical stimulation (IES) and pelvic floor physiotherapy represents
an alternative to other therapies. The purpose of this work was to
evaluate the effectiveness of this treatment inpatients with urinary
incontinence. From January 1998 to May 2000, 30 women (mean age 54
years) were studied. All patients had USI and 70% urge incontinence;
average follow-up was 7 months. Selection criteria were based on
clinical history, objective evaluation of perineal musculature by
perineometry, and urodynamics. The treatment protocol consisted of
three sessions of IES per week for 14 weeks using INNOVA equipment.
Physiotherapy was initiated in the fifth week of IES. A significant
decrease in the number of micturitions and urgency was observed after
treatment ( P<0.01). The pad test showed a reduction in urinary
leakage from 13.9 to 5.9 g after treatment ( P<0.01). Objective
evaluation of perineal muscle strength showed a significant
improvement in all patients after treatment ( P<0.01). A positive
correlation was observed between maximum flow rate (Qmax) and all
three variables: urethral pressure profile at rest and on straining
(stop test), and abdominal leak-point pressure (ALPP). A positive
correlation was also observed between ALPP and the stop test. Over 100
different surgical and conservative treatments have been tried to
manage USI. The majority of these procedures reveal that despite
progress already made in this area, there is no ideal treatment.
Satisfactory results can be achieved with this method, especially with
patients who are reluctant to undergo surgery because of personal or
Urodynamic effect of acute transcutaneous posterior tibial nerve
stimulation in overactive bladder
J.Urol. Amarenco,G 2003
PURPOSE: Of the various treatments proposed for urge incontinence,
frequency and urgency electrostimulation has been widely tested.
Different techniques have been used with the necessity of surgical
implantation (S3 neuromodulation or sacral root stimulation) or
without requiring surgery (perineal transcutaneous
electrostimulation). Recently peripheral electrical stimulation of the
posterior tibial nerve was proposed for irritative symptoms in first
intention or for intractable incontinence. Clinical studies have
demonstrated good results and urodynamic parameters were improved
after chronic treatment. However, to our knowledge no data concerning
acute stimulation and immediate cystometry modifications have been
reported. We verified urodynamic changes during acute posterior tibial
nerve stimulation. MATERIALS AND METHODS: A total of 44 consecutive
patients with urge incontinence, frequency and urgency secondary to
overactive bladder were studied. There were 29 women and 15 men with a
mean age +/-SD of 53.3 +/- 18.2 years. Of the patients 37 had detrusor
hyperreflexia due to multiple sclerosis (13), spinal cord injury (15)
or Parkinson's disease (9), and 7 had idiopathic detrusor instability.
Routine cystometry at 50 ml. per minute was done to select the
patients with involuntary detrusor contractions appearing before 400
ml. maximum filling volume. Repeat cystometry was performed
immediately after the first study during left posterior tibial nerve
stimulation using a surface self-adhesive electrode on the ankle skin
behind the internal malleolus with shocks in continuous mode at 10 Hz.
frequency and 200 milliseconds wide. Volume comparison was done at the
first involuntary detrusor contraction and at maximum cystometric
capacity. The test was considered positive if volume at the first
involuntary detrusor contraction and/or at maximum cystometric
capacity increased 100 ml. or 50% during stimulation in compared with
standard cystometry volumes. RESULTS: Mean first involuntary detrusor
contraction volume on standard cystometry was 162.9 +/- 96.4 ml. and
it was 232.1 +/- 115.3 ml. during posterior tibial nerve stimulation.
Mean maximum cystometric capacity on standard cystometry was 221 +/-
129.5 ml. and it was 277.4 +/- 117.9 ml. during stimulation. Posterior
tibial nerve stimulation was associated with significant improvement
in first involuntary detrusor contraction volume (p <0.0001) and
significant improvement in maximum cystometric capacity (p
<0.0001). The test was considered positive in 22 of the 44
patients. CONCLUSIONS: These results suggest an objective acute effect
of posterior tibial nerve stimulation on urodynamic parameters.
Improved bladder overactivity is an encouraging argument to propose
posterior tibial nerve stimulation as a noninvasive treatment modality
in clinical practice
I thought you would want to hear about Acrylamide.
Acrylamide - kills brain cells
Acrylamide is a potent neurotoxin. It is used experimentally to induce damage to brain and spinal cord in animal models of brain disorders. It is also present in our food. See the links to the National Cancer Institute.
It is used primarily in industrial process – especially making plastics. Most important to recognize is that it is also in our food, especially foods that are cooked at high temperature – such as fried foods. French fries, potato chips and other fried foods are at particular risk. This adds to the growing list of toxins in our food which are capable of damaging brain tissues.
Eating organic, and NOT frying one’s food is a good thing to do for your brain. Eating for your mitochondria will make it easier to for your body to excrete the toxins which show up in your food.
I knew you would want to know about this exciting news.
Venous blockages and MS
This is long - but it is a copy of the press release from a scientific meeting convened to discuss venous blockages in the setting of MS.
The bottom line is that maybe having procedures to evaluate for the presence of blockages in the blood vessels and repairing those blockages will someday soon replace taking immune modulating drugs like Tysabri. I still think nutrition will be very important. Although we may be born with the predisposition to develop blockages -- our diets, and our mother's diet coupled with the toxins in our environment may play a strong role in turning on the genes that cause blood vessels to be twisty and at risk of blockages. This is breaking news. Yet - genetics take hundreds of thousands of years to shift how our bodies are made. Shifts in diet and toxins can shift which genes are on and how our bodies are made in one generation. As dramatic as this news is, it does not change the critical role of feeding one's mitochondria and our brain cells with all the nutrients they need.
Bologna, Tuesday Sept. 8, 2009
Venous Function And Multiple Sclerosis
Four main points concerning the relationship between CCSVI and
MULTIPLE SCLEROSIS were covered by several experts at a Meeting in
Bologna. All the investigations that gave an answer to these 4
fundamental points were coordinated by Prof Paolo Zamboni who discovered CCSVI and its association with Multiple Sclerosis; in some other cases, research was carried out in cooperation between Prof Zamboni and major foreign Universities.
1) What is the origin of the extracranial cerebral vein stenoses which
2) Are there advanced diagnostic systems capable of identifying which
changes are caused by CCSVI in the central nervous system?
3) Can CCSVI be treated and how?
4) Can CCSVI therapy improve the clinical outcomes of MS and affect its
Venous Function And Multiple Sclerosis is an international coterie of
experts who met in Bologna on September 8 to discuss these issues from the
perspective of neurologists – who have developed the scientific body of
knowledge on MS – and the vascular and neurological surgeons who have
further investigated these topics following the discovery of CCSVI. All
investigations were coordinated by Professor Paolo Zamboni who discovered CCSVI and its association with multiple sclerosis.
This first study was conducted by an Italian research team composed of the
vascular surgeons’ group headed by Professor Paolo Zamboni from the
University of Ferrara and the neurologists’ group from the Department of
Neurosciences of the Bellaria Hospital in Bologna headed by Dr. Fabrizio
Fondazione Hilarescere is a foundation specially set up to provide adequate
means and resources for research into medical and scientific insights aimed at
fully understanding and curing diseases which are still partly unknown.
Fondazione HILARESCERE, chaired by Professor Fabio Roversi-Monaco, was
set up on an initiative of Fondazione Cassa di Risparmio in Bologna.
THE MOST IMPORTANT ANSWER OF ALL:
endovascular therapy has led to a decrease in the number of disease
relapses, a marked reduction in the number of active brain and spinal
lesions and also a clear-cut improvement in the patients’ quality of life.
Prof. Paolo Zamboni headed a study where, together with Dr. Fabrizio Salvi,
he was able to show that in patients with the clinical form of Relapsing-
Remitting MS – which is the most common – there is a drop in the number of
active lesions which persists up to 18 months after surgery. The percentage of
active lesions falls from 50% to 12%, thus showing that the additional
treatment of CCSVI reduces the aggressiveness of the disease. This finding is
further confirmed by the number of patients who showed no relapses after
endovascular surgery. In the 2 years before surgery, acute multiple sclerosis
attacks were found in 50% of the recruited patients, while in the 2 years
following surgery 73% of the patients had no more attacks, with a change in
the clinical course of the disease. In all these patients also cognitive and motor
activities – assessed by means of an outcome measure called MSFC - are
significantly and persistently improved while the same is not true for patients
with the progressive forms of the disease. In the latter, however, progression
was stopped and the patients’ quality of life improved.
The experts discussed, provided data and gave an answer to all 4
1) What is the origin of the extracranial cerebral vein stenoses which
3 scientists answered this question from different perspectives: Professor
Byung B. Lee, Georgetown University School of Medicine di Washington DC,
showed that the malformations found in CCSVI are congenital truncular
malformations which therefore certainly precede the development of Multiple
Sclerosis. For this reason they cannot be regarded as a consequence of
Multiple Sclerosis. Prof. Lee showed in which phases of the venous system
development the malformations observed in CCSVI may appear. Byung B. Lee
is the Chairman of the World Consensus Conference which gathers vascular
experts from 47 countries and recently approved a scientific update on venous
malformations in Montecarlo. (1)Professor Giulio Gabbiani, Centre Médical Universitaire di Ginevra,demonstrated that there are no auto-immune phenomena in diseased veins thus excluding that the malformations found in CCSVI result from Multiple Sclerosis. He showed the results of a study which provides a histologic
comparison between the walls of the veins affected by CCSVI-MS and those of
normal subjects. Furthermore, at molecular level, CCSVI veins are structurally
different from those of the control subjects, thus confirming the approach of the
Montecarlo Consensus Conference. Prof. Gabbiani is one of the most important
world experts in microscopic vessel wall morphology. (2)
The third presentation was about whether – genetically speaking – these
malformations have any correlation with the findings so far obtained from the
genetic study of MS. Prof. Alessandra Ferlini, Director of the Institute of
Genetics at the University of Ferrara, discussed this point by presenting the
promising results of a pilot study. (3)2) Are there advanced diagnostic systems capable of identifying which changes are caused by CCSVI in the central nervous system? This is the second question addressed at the Meeting. Professor Mark Haacke,
Director of the MRI Istitute for Biomedical Research in Detroit (4,5,6) and
Professor Bianca Weinstock-Guttman, Neurologist at the Jacobs Neurological
Institute (7) showed new magnetic resonance (MRI) parameters linked to CCSVI which might in the future bring about a true revolution in the way of diagnosing MS. These new parameters include: quantification of iron deposits and volume assessment of intracranial veins and CSF. 3) The third question that was answered at the Meeting was: Can CCSVI be treated and how? Innovative minimally-invasive endovascular repair
techniques were discussed on account of the findings obtained by Dr. Roberto
Galeotti (8), Head of the Interventional Radiology Section at the University
Hospital of Ferrara who was the first in the world to perform this type of surgery,
and Dr. Michael Dake, Chief of Cardiovascular and Interventional Radiology at
Stanford University School of Medicine (California), who was the first to treat
CCSVI outside Italy. The most important finding is safety. At 2-year follow-up no major complications were observed. All surgical procedures were performed on a day hospital basis. Statistically, this treatment decreases pressure in the cerebral veins in a highly significant way, thus showing its enormous anti-inflammatory potential.(8)The risk of re-stenosis is 16 times higher in the jugular veins than in the azygos vein, thus pointing to the need for more sophisticated and efficient tools
to approach the former. Research will make such tools available during 2010.
4) The fourth and fundamental point is whether CCSVI therapy can improve
the clinical conditions of MS and affect its prognosis.
Dr. Fabrizio Salvi from the Bellaria Hospital in Bologna was the first
Neurologist who studied the clinical correlations of CCSVI treatment in
MS patients together with Prof. Paolo Zamboni. The patients enrolled in this
study were 120 from all clinical classes, but only the results of the 65 subjects
who are over 18 months from surgery will be reported in order to describe the
outcome with the greatest possible accuracy. Generally speaking, patients
treated with endovascular therapy showed a decrease in the number of
disease relapses, a marked reduction in the number of active brain and
spinal lesions and also a clear-cut improvement in the patients’ quality of
life. The findings of this investigations will soon be published in detail on the
Journal of Vascular Surgery (8).
Finally, Dr. Robert Zivadinov, Jacobs Neurogical Institute di Buffalo, discussed
the results of a revolutionary pilot study performed last year where both
American and Italian patients were blindly assessed in the USA by means of
advanced MRI technology, then submitted to vascular surgery in Italy and
followed up during the following year (9). This study was defined by the patients
who volunteered to participate as the study of the 50,000 miles for treatment,
because of the many trips they had to take overseas. This study was sponsored
by Fondazione Hilarescere.
(1) World Consensus Conference on Venous Malformations, Montecarlo
September 4th 2009. This document was approved by experts from 47 different
countries and will be published on all most important vascular surgery journals.
(2) G. Gabbiani, M. Coen, F. Mascoli, P. Zamboni. Manuscript in
(3) A. Ferlini, M. Bovolenta, M. Neri, F. Gualandi, A.Yuryev, F. Salvi, A.
Liboni and P. Zamboni. Manuscript in preparation.
(4) Haacke EM, Makki M, Ge Y, Maheshwari M, Sehgal V, Hu J, Selvan M,
Wu Z, Latif Z, Xuan Y, Khan O, Garbern J, Grossman RI. Characterizing iron
deposition in multiple sclerosis lesions using susceptibility weighted imaging. J
Magn Reson Imaging. 2009;29:537-44.
(5) A. V. Singh and P. Zamboni Anomalous venous blood flow and iron
deposition in multiple sclerosis. J Cereb Blood Flow Metab. 2009 Sep 2. [Epub
ahead of print]
(6) P. Zamboni, E. Menegatti, B. Weinstock-Guttman, C. Schirda, J. L. Cox,
A. M. Malagoni, D. Hojnacki, C. Kennedy, E. Carl, M. G. Dwyer, N. Bergsland,
R. Galeotti, Sara Hussein, I. Bartolomei, F. Salvi, R. Zivadinov. The severity of
altered venous haemodynamics is related to CSF dynamics in chronic
cerebrospinal venous insufficiency Submitted To Current Neurovascular
(7) P. Zamboni, E. Menegatti, B. Weinstock-Guttman, C. Schirda, J. L. Cox,
A. M Malagoni, D. Hojnacki, C. Kennedy, M. G. Dwyer, N. Bergsland, R.
Galeotti, I. Bartolomei, F. Salvi, M. Ramanathan, R. Zivadinov. Csf flow and
brain volume in multiple sclerosis are associated with altered cerebral venous
doppler haemodynamics. Study presented at the European Multiple Sclerosis
Congress ECTRIMS Düsseldorf, 9-12 September 2009
(8) P. Zamboni, R. Galeotti; E. Menegatti; A. M. Malagoni, S. Gianesini, I.
Bartolomei, F. Mascoli, F. Salvi Endovascular treatment of chronic
cerebrospinal venous insufficency. A prospective opern-label study. Journal of
Vascular Surgery, 2009, in press.
(9) P. Zamboni, R. Galeotti, B. Weinstock-Guttman, G. Cutter, E. Menegatti,
A. M. Malagoni, D. Hojnacki, J. L. Cox, C. Kennedy, I. Bartolomei, F. Salvi, R.
Zivadinov Endovascular Treatment for Chronic Cerebrospinal Venous
Insufficiency in Multiple Sclerosis . A longitudinal pilot study. Study presented at
the European Multiple Sclerosis Congress ECTRIMS Düsseldorf, 9-12
Bologna, 8 September 2009
Press Office: Laboratorio delle idee – Francesca Rossini –
Although this is dramatic news, there are also press releases that indicate foods from the cabbage family influence how our blood vessels are shaped. That tells me that our nutrients influence how likely we are to develop chronic blockages which may lead to more aggressive MS. Once again, I think it is very important to have 3 cups of greens, cabbage family and onion family vegetables each day. To learn more about nutrition for mitochondria and brain check out my web site.
While not directly related to MS -- the issue of how we feed our children has direct impact on their future risk of MS.
See the notes below.
Dear members, supporters and friends,
On Labor Day, more than 20,000 people came together in all 50 states to tell Congress it's time to give kids real food at school. If you went to an Eat-In, we'd like to say thank you. And if you're one of the Slow Food Chapter Leaders and Eat-In Organizers who put incredible time and energy into the 300 Eat-Ins that took place nationwide, we'd like to shout thank you -- you made the day possible.
Check out some of the incredible photos: http://www.flickr.com/photos/ tags/timeforlunch/.
The momentum helped us surpass our Labor Day petition goal - there are more than 20,000 signatures online, another 10,000 on paper, and many more still coming in. That's a huge show of support. When Congress starts debating the Child Nutrition Act this fall, we'll be able to take those signatures to legislators and make a strong case for reform.
In the meantime, please take a moment to share some of the photos and stories of the Eat-Ins with your friends, and invite them to get involved. This movement is growing stronger by the day, and there will be plenty to do in the next phase of the Time for Lunch campaign.
P.S. The Day of Action is over, but the "Give More If You Can, Less If You Can't"membership offer lasts through the month of September. Make sure to tell your friends why it's a good time to be joining our movement for change.
Josh, Brian, Jerusha, Gordon, Deena, Emily
The Time for Lunch Team
Monday, September 7, 2009
By Dr. Terry L. Wahls
Dr. Wahls is an academic general internal medicine physician who has secondary progressive multiple sclerosis. Her MS confined her to a life of dependence on a tilt-recline wheelchair for four years. Eighteen months after starting her intensive, focused nutrition and electrical therapy to strengthen her muscles, Dr. Wahls now commutes to work five miles each day on her bicycle.
Minding My Mitochondria is a clear and concise explanation of the biochemistry that drives our brains and how the food we eat is linked to the health we do or do not have. Dr. Wahls teaches us how our brain cells work, the building blocks our cells need to do the work of living, and how to eat to ensure you have enough of them.
If you have a neurological or a psychological problem improving the health of your mitochondria will help your brain. If you have a chronic medical problem, improving the health of your mitochondria will help your body.
This book reveals the interventions, and the science behind them, that Dr. Wahls has used to restore her own health and the physical and mental health of her patients. Over 40 brain health recipes are included!
I.S.B.N. 13: 978-0-9821750-9-5
I.S.B.N. 10: 0-9821750-9-4
Publisher: TZ Press
Chapter 1. The Beginning
Chapter 2. Mitochondria
Chapter 3. Cellular Function and Brain Health
Chapter 4. Micronutrients, Supplements, and Food sources
Chapter 5. Neuro-protection
Chapter 6. Food Matters and MS
Chapter 7. Recipes
Chapter 8. The Synergy between Neuromuscular Electrical Stimulation and Nutrition
Chapter 9. Frequently Asked Questions--and Answers
Chapter 10. Conclusion
Nutrient and Function Chart
Chapter 1. The Beginning
Rising costs of health care is crushing us. It’s not just old people getting diabetes, heart disease, arthritis, and cancers that are adding the cost of healthcare. Nearly a third of our children have serious medical problems like autism, depression, learning disabilities, obesity, or pre-diabetes. In addition to the exploding costs of health care, productivity of the American worker is falling because of declining worker health. Despite all the money spent on health care, we, and our children, are progressively less well.
Why is this happening to us? Have our genes gone bad? After all scientists are identifying more genes associated with chronic disease each day. Are mutations transforming our strong, lean bodies into obese, chronically diseased ones, or is there something else going on that is causing this change in the health our country?
I think the explanation for what has happening can be found in the corn fields of Iowa. When you buy seed corn, all the kernels have essentially the same DNA. The way farmers know what kind of crop to expect in the fall. Say the farmer plants half of the bag of seed corn in black Iowa soil and the other half in a trash heap filled with clay, plastic debris, and rock. Return in the fall to harvest the corn. The corn planted in the black dirt will be tall with three ears of corn on every plant. But the corn in the trash heap will look diseased. Instead of being dark green, the corn stalks will yellowed, stunted and barely three feet tall. Very few will have an ear of corn. If they do, only a few kernels will be present on tiny nubbins. It was the same DNA in both fields. But the black Iowa dirt was filled with the nutrients the corn’s DNA needed. The trash heap lacked nutrients, and you saw the results.
All moving things, including our bodies, break down with time. Fortunately, our bodies have tiny little maintenance workers who are busy repairing all the little wear-and-tear damage that occurs each day. Our DNA provides the blueprint for all the proteins and other stuff that needs to be replaced. If those little maintenance workers don’t have the all the building blocks, that is, the correct minerals, amino acids, and fatty acids, then trouble happens. They can’t make things according to the DNA blueprints. Those replacement molecules and structures get made not at all, or incorrectly, and we begin to deteriorate.
Tuesday, September 1, 2009
The abstact is posted below.
Detection of glutathione (GSH) is technically challenging at clinical field strengths of 1.5 or 3 T due to its low concentration in the human brain coupled with the fact that conventional single-echo acquisitions, typically used for magnetic resonance (MR) spectroscopy acquisitions, cannot be used to resolve GSH given its overlap with other resonances. In this study, an MR spectral editing scheme was used to generate an unobstructed detection of GSH at 7 T. This technique was used to obtain normative white (WM) and gray matter (GM) GSH concentrations over a two-dimensional region. Results indicated that GSH was significantly higher (P<.001) in GM relative to WM in normal subjects. This finding is consistent with previous radionuclide experiments and histochemical staining and validates this 7 T MR spectroscopy technique. To our knowledge, this is the first study to report normative differences in WM and GM glutathione concentrations in the human brain. Glutathione is a biomarker for oxidative status and this non-invasive in vivo measurement of GSH was used to explore its sensitivity to oxidative state in multiple sclerosis (MS) patients. There was a significant reduction (P<.001) of GSH between the GM in MS patients and normal controls. No statistically significant GSH differences were found between the WM in controls and MS patients. Reduced GSH was also observed in a MS WM lesion. This preliminary investigation demonstrates the potential of this marker to probe oxidative state in MS.
How does one reduce oxidative stress? Eat 9 cups of vegetables and fruit. Three cups of cruciferous vegetables (especially kale or collards), 1 to 2 cups of onion, garlic and or mushrooms and 3 cups of brightly colored vegetables and fruit.
More details on how to improve one's oxidative status and health of one's mitochondria can be found in my book, Minding My Mitochondria. I've have just gotten it back from the printers and so it is now available on my web site www.terrywahls.com. The book reviews how the mitochondria support brain health, remove toxins and the key nutrients needed for optimal mitochondrial health. It also has 40 plus recipes which are mitochondria and brain healthy.
Tuesday, August 18, 2009
This is a copy of an article published in the LA Times which is devoted to battling inflammation through food. Many of the concepts discussed in this article mirror what I've been discussing in my blog.
Battling inflammation through food
Though it's an emerging field, proponents of anti-inflammatory diets point to growing evidence that foods like vegetables and fish can ease an overactive immune system.
By Shara Yurkiewicz
August 17, 2009
If you want to live longer -- avoid heart disease, Alzheimer's disease and cancer -- then pick and choose your foods with care to quiet down parts of your immune system.
That's the principle promoted by the founders and followers of anti-inflammatory diets, designed to reduce chronic inflammation in the body.
Dozens of books filled with diets and recipes have flooded the market in the last few years, including popular ones by dermatologist Dr. Nicholas Perricone and Zone Diet creator Barry Sears.
Those who frequent message boards that discuss arthritis or acne trade tips on which pro- or anti-inflammatory foods may help or trigger their symptoms -- urging co-sufferers to try cherries for their rheumatoid arthritis or avoid gluten for their psoriasis.
But proponents claim the benefits go far beyond that, fighting not just pain from inflamed joints or skin flare-ups but also life-threatening diseases.
"If your future currently looks bleak because of high levels of silent inflammation, don't worry, because you can change it within thirty days," Barry Sears promises in his book, "The Anti-Inflammation Zone."
There's still a lot of science to be done. And should you try such a diet, you probably shouldn't expect any 30-day miracles. But there may be something to eating in an anti-inflammatory way.
"[Chronic inflammation] is an emerging field," says Dr. David Heber, a UCLA professor of medicine and director of the university's Center for Human Nutrition. "It's a new concept for medicine."
The point of an anti-inflammation diet is not to lose weight, although it is not uncommon for its followers to shed pounds. The goal: to combat what proponents call "chronic silent inflammation" in the body, the result of an immune system that doesn't know when to shut off.
The theory goes that long after the invading bacteria or viruses from some infection are gone, the body's defenses remain active. The activated immune cells and hormones then turn on the body itself, damaging tissues. The process continues indefinitely, occurring at low enough levels that a person doesn't feel pain or realize anything is wrong. Years later, proponents say, the damage contributes to illnesses such as heart disease, neurological disorders like Alzheimer's disease or cancer.
In general terms, following an anti-inflammatory diet means increasing intake of foods that have anti-inflammatory and antioxidant properties. (Antioxidants reduce the activity of tissue-damaging free radicals at sites of inflammation.) The diet includes vegetables, whole grains, nuts, oily fish, protein sources, spices such as ginger and turmeric and brightly colored fruits such as blueberries, cherries and pomegranates.
Foods that promote inflammation -- saturated fats, trans fats, corn and soybean oil, refined carbohydrates, sugars, red meat and dairy -- are reduced or eliminated.
It would seem logical that a diet that could dampen an overactive immune system could help prevent or slow diseases that are caused or exacerbated by inflammation. And evidence is certainly mounting that such diseases include heart disease, cancer and Alzheimer's. (See related story online.)
Studies with animals suggest that the diet's followers may be on to something.
"If you feed rodents different diets, you can very strongly modulate inflammation," says Dr. Andrew Greenberg, the director of the Obesity and Metabolism Laboratory at the Human Nutrition Research Center on Aging at Tufts University in Boston. "Fish oil, for example, ameliorates inflammation in rodents."
Resveratrol, found in grape skin and red wine, has been shown to improve blood vessel function and slow aging in rats.
Pomegranate juice decreases atherosclerosis development in mice with high cholesterol. Garlic improves blood vessel functioning in the hearts of rats with high blood pressure.
And curcumin (an antioxidant chemical found in turmeric) improves ulcerative colitis, rheumatoid arthritis and pancreatitis in mice and has anti-cancer effects in the animals too.
Curcumin has also been shown to ease the symptoms of rheumatoid arthritis in people, reducing joint swelling, morning stiffness and walking time. In India, turmeric is used to promote wound healing and reduce inflammation. But though curcumin's effects are being tested in several clinical trials addressing various diseases, rigorous human results are lacking -- as is the case for most anti-inflammatory foods.
Large, careful human clinical trials are expensive and few have been designed to test dietary interventions. Small trials on individual supplements have been done, though. And scientists have learned a lot from studying populations -- chronicling the natural habits of people and seeing what diseases they get and which they don't.
The drug factor
It makes sense that anti-inflammatory methods might help the heart, says Dr. Robert H. Eckel, a past president of the American Heart Assn. and professor of physiology and biophysics at University of Colorado Denver's Health Sciences Center.
Statin drugs, for example, are known to cut heart disease risk by reducing cholesterol levels -- among other things, these meds fight inflammation.
"We don't know how much of statins' effect are due to their anti-inflammatory effects," Eckel says. But, he adds, a growing number of researchers suspect that this property is important.
Fish oil, rich in anti-inflammatory omega-3 fatty acids and derived from oily fish such as tuna, salmon and mackerel -- is already recommended by the American Heart Assn. to help prevent cardiovascular disease. It has been shown to reduce blood triglyceride levels and slightly lower blood pressure, lowering the risk for heart attacks and strokes.
There is also reason to believe that anti-inflammatory substances would help to ward off cancers. Non-steroidal anti-inflammatory drugs have been shown to prevent tumors with people with inherited colorectal cancer, for example.
And population studies have shown that people who had been taking non-steroidal anti-inflammatory meds for other conditions were less likely to develop Alzheimer's disease.
In trials, such drugs have failed to treat already-developed Alzheimer's, but the studies suggest that it might be possible to prevent the disease by reducing inflammation, says Greg Cole, a professor of medicine and neurology at UCLA and associate director of the UCLA Alzheimer's Disease Research Center.
But it is not safe to take non-steroidal anti-inflammatory drugs for years because of harmful side effects, such as gastrointestinal bleeding. What about anti-inflammatory foods? Several clinical trials, in the U.S. and abroad, have shown that people with mild memory complaints related to aging (not necessarily Alzheimer's disease) showed significant improvement when given the omega-3 fatty acid docosahexaenoic acid, Cole says.
And in an 18-month study released in June sponsored by the National Institutes of Health, treating Alzheimer's disease with docosahexaenoic acid slowed its progression in a subgroup of the study population.
There are other trials with positive results for fish oil in early Alzheimer's cases, but they are not large enough to be definitive, Cole says.
But, he adds, "the real utility is not to slow the progression of someone who's already demented, but it's to treat before dementia happens. We'd like to turn off or keep down [the inflammation] with something that doesn't cause gastrointestinal bleeding or other side effects."
Cole's laboratory is looking at the potential for Alzheimer's prevention by controlling inflammation with omega-3 fatty acids and curcumin. Other food substances -- such as resveratrol in red wine and flavonoids in fruits -- may have anti-inflammatory effects by acting along the same pathway that curcumin does, he says.
Cole suspects that people are more likely to take a supplement or two than to radically change their diets. "Nutritionists, they'll tell you to eat right. It is good, sound advice, but you can't always get people to do it," he says. "The question is, can you find an easier supplement approach that doesn't require a restricted diet?"
Supplements do have their drawbacks. "Many Alzheimer's researchers were prescribing vitamin E [an antioxidant] to all their patients," says Debra Cherry, a clinical psychologist and the executive vice president of the Alzheimer's Assn. of the California Southland. "But some data came out that people had high bleeds and suffered from cardiovascular problems."
Perhaps a complete diet overhaul -- difficult though that may be -- would be a better strategy. The Mediterranean diet, named for the region in which it originated, has many anti-inflammatory features.
It includes fruits, vegetables, nuts, fish, whole grains, alcohol, and healthful fats like olive and canola oil. It has been shown to lower LDL cholesterol and triglyceride levels and reduce the risk of blood clots. Studies have shown that diets high in fish, olive oil and cooked vegetables reduce the symptoms of rheumatoid arthritis. A Mediterranean diet or elements of it seems linked to reduced risk for a number of chronic conditions, including cardiovascular disease, cancer, diabetes and Alzheimer's. (See related story online.)
"If people noticed they're slightly overweight, or if blood pressure is starting to creep up, or if blood sugar [increases], and they went on a Mediterranean-type diet, they might be able to decrease inflammation and stop the progression of disease," says Dr. Wadie Najm, a clinical professor of family medicine and geriatrics at UC Irvine who directs an integrated medicine clinic at UCI that focuses on complementary and alternative medicine.
Many patients visiting his clinic have chronic inflammatory conditions, including autoimmune diseases such as arthritis and gastrointestinal problems such as Crohn's disease. Patients begin a specialized diet and exercise, and make other lifestyle changes to decrease inflammation.
"In three weeks, if [patients] follow the protocol, we see great results in improvement in symptomology and reduction in flare-ups," says Bianca Garilli, a naturopathic doctor at the clinic.
Of course, these dietary and other lifestyle changes might help treat pain conditions through the placebo effect -- a belief in a treatment rather than the treatment itself, says Dr. Roger Chao, an associate professor of medicine at Oregon Health and Science University and director of clinical guidelines development for the American Pain Society.
"You're giving something for people to focus on and do something good for themselves," Chao says.
At the end of the day, there is evidence to suggest that your best bet at curbing inflammation is to eat a healthful diet -- and keep your weight in check -- without specifically thinking about anti-inflammatory foods.
"There is no doubt that if you lose weight, inflammation is dramatically improved," Greenberg says. When a person is overweight or obese, body fat breaks down into fatty acids, which circulate in the blood. These fatty acids promote an immune response in the same way that infection does, increasing inflammation.
It will take time to tease apart the effects of anti-inflammatory diets and supplements. But Cole thinks the effort is well worth it. "The alternative to these kinds of things aimed at prevention is to pay for treatments," he says. "And we can't always afford them."
Copyright © 2009, The Los Angeles Times
Monday, August 3, 2009
Funding health care reform in the US.
I received this note from the center for science in the public interest which is a non-profit group that publishes an excellent newsletter. It also provides important update on issues that relate to science nad politics. Because I am convinced that much of athe epidemic of neurological/ psychological diseases are linked to eating diets so devoid of nutrition courtesy all the junk food I vigorously support their call for taxing junk food to help pay for the damage / chronic disease which results from eating the junk food. Please take a few minutes to contact your political leaders in which ever country you reside. These same issues affect you whether or not you are in the US.
Dear Terry Wahls,
Although moving more slowly than the President hoped, legislation to enact comprehensive health insurance reform has inched forward this week and is very likely to be considered by the full House of Representatives and the Senate when Congress reconvenes after the August recess. Among the many issues still to be fully resolved is how to fund the large expansion of health care coverage, and the degree to which the legislation will prioritize prevention-oriented measures to reduce health care costs and improve the health of Americans.
Members of Congress need to hear from you about prevention-oriented revenue raisers like alcohol and sugar-sweetened beverage taxes that can provide more than $250 billion over the next ten years in new money for health care reform, as they work to reduce the staggering health and social costs associated with obesity and excessive use of alcohol.
Please write your Senators and U.S. Representative NOW to encourage their consideration of health taxes on alcohol and sugar-sweetened beverages to help make real health care reform a reality.
Send a letter to the following decision maker(s):
Below is the sample letter:
Subject: Looking for Revenue for Health Care Reform?
Dear [decision maker name automatically inserted here],
As a consumer of health care and a taxpayer, I am writing to urge you to include higher taxes on alcoholic beverages and new taxes on sugar-sweetened beverages in health care reform legislation that will be considered in Congress during the fall. Such action can raise substantial new revenue to support expanded access to and delivery of health care services and will help this country reduce the significant harms and costs of alcohol problems and obesity, which impose unsustainable burdens on our health care system and our economic productivity.
Even modest taxes (a nickel a drink extra on alcohol and 3 cents per can on soft drinks) would raise more than $100 billion over ten years; larger taxes could raise as much as $250 billion over that period. Alcohol taxes haven't been raised since 1991, and inflation has eaten up some 40% of their value. That erosion in tax has meant that alcoholic beverages have become cheaper relative to other consumer products, and much more available to underage persons.
Low prices for alcohol fuel excessive consumption, as they have for sugar-sweetened beverages, which are the only food or beverage with a direct link to obesity. Since the 1990s, consumption of soft drinks has exceeded consumption of milk, and that has contributed to widespread obesity in this country. More than two-thirds of Americans are overweight or obese. Medical expenditures related to obesity total more than $147 billion per year, of which half is paid with Medicare and Medicaid dollars. One way or another, we all pay a lot of those unnecessary bills.
The economic costs of alcohol are also astronomical, more than $200 billion per year, on top of 85,000 deaths from accidents, homicides, diseases, and suicides. Current federal taxes on alcohol, which bring in $9.3 billion per year, are woefully inadequate to compensate society for all that harm.
Imposing meaningful taxes on unhealthy sugar-sweetened be verages and on intoxicating and potentially addictive alcoholic drinks will have the added benefit of reducing their use and some of the associated harms. That's a perfect fit for health care reform- helping us become a healthier nation and helping to reduce health care, public safety, and social costs.
I urge you to include these health taxes in pending legislation to reform our health care system. Please let me know your views on this subject. Thank you for your consideration.
Sunday, July 26, 2009
In the interim we are getting close to having the original case report accepted for publication. Because we chose to put it into a journal that has open access when it is published I will be able to put a link to the article on this web site so that it can be accessed more readily. Although the pilot study is not approved, the research survey studies about the nutrition and the use of electrical therapy are ongoing. We have 42 responses in the nutritional study and 22 responses in the electrical stimulation study. While I can't talk about the data from those studies in any kind of detail I will comment on what people have reported about the presence of adverse event or complications from nutrition / e stim.
No significant adverse problems associated with the nutrition were reported. For the estim a couple of individuals have reported skin burns and discomfort as problems. One person reported their MS worsened and they discontinued the estim. Although this is not enough to prove safety or efficacy, I consider this good news.
The other thing that is happening is that my physical therapist is writing up a case series reporting on his first 9 patients that he's treated with electrical stimulation. Unfortunately doing a scientific article usually takes several months to a year to go from start to being in print. Science is like that, painfully, arduously slow. I find it maddening too, but that is the nature of the beast.
Like everyone else in the world the recession is affecting the academic world too. We are also being asked to do more for less. That means that we are all picking up more clinic time and have less time to work on unfunded research. The consequence to that is that my partners who are doing this research are also being asked to do more. We have less time to devote to trying find the answers to the questions raised by the pharmacists. So we work at it. That means I choose between putting some time on the blog, or time on getting the pilot going. I've been prioritizing getting the pilot study approved. Of the two, I think that is the more important task. Getting a pilot study so we have preliminary data and can submit a grant for a larger study -- which could then be recognized by the medical community has the greatest impact for everyone.
For those of you who are dismayed that I'm not blogging more frequently I apologize. I also apologize for creating the hope that I'd have a pilot study open in the near future. I do not know when or if it will ever be approved.
That is not in my control, although I do tell myself it can't be harder than getting out of the wheelchair (some days I wonder however!). In the interim I'm working, seeing patients, teaching a couple times each month, working with my team on trying to get a pilot protocol through the review process so it can be approved.
I apologize to those of you who were wondering what happened to me.
Over 70 percent of Americans do not take in a sufficient amount of iodine in their diet to meet the daily recommended dietary allowance for Iodine. This is because the North American soils are Iodine depleted and we physicians have advised our patients to not use table salt. Since most of us were getting our daily Iodine through the use of Iodized table salt instead of consuming sea weed, the majority of Americans now consume less than 1/3 of the recommended daily intake for Iodine.
That is important for those who suffer from MS because Iodine is an important nutrient for making myelin. It is also an important nutrient for removing toxins.
The best food sources for iodine include sea weed (especially kelp), iodized sea salt, sea salt and iodized salt. Also because kale and other cruciferous (cabbage family) vegetables compete with iodine receptors - those of us who eat a lot of cabbage family vegetables need to eat more iodine than those who do not. I can't find a specific dietary recommendation on how much much iodine we need however. My personal approach has been to add a teaspoon of powdered kelp to my kale salads.
Ideally to determine whether or not one has iodine deficiency would be to work with a physician who is expert in Iodine. More information about iodine can be found at http://iodine4health.com/
Wednesday, May 27, 2009
we are getting closer- one last committee has to give its approval - the VA research and development committee. If all goes well we will be able to begin recruitment this summer.
This is a from a physician colleague with MS who has noted the similarity between MS and other types of neuro-degenerative types of brain disorders. With his permission I've copied his correspondence below.
Re DIET and MS/ Other Neuro-degenerative Brain Diseases
Dear Dr. Wahls:
I was diagnosed with MS 14 years ago after having about 4 relapses over a 32 month period. These involved loss of sensation in my legs, forearms, hands, and the left side of my face. I also had patellar hyperreflexia, altered proprioception in my legs, and bladder spasticity. I was diagnosed by Dr. Doug Williams in Bristol, TN, after an MRI showed a lesion at T10 and an LP showed elevated monoclonal bands.
Doug told me about a friend’s father who had practiced OB/GYN until 65 years of age while having MS. Doug quoted him as saying “Stay away from doctors; they will kill you.” Doug said that he was very upset when his son became a neurologist. Doug told me that he was not very impressed with Beta-Seron and did not prescribe it for me. He said to stay away from steroids, since they seemed to worsen the long-term rate of relapses. He said to avoid getting overheated. Most important, he said to limit my total fat intake to 20 grams a day – he said that this treatment was recommended in England and France even though it was not recognized in the USA.
I have complied with his recommendation for a low-fat diet for the past 14 years. Initially I could find nothing in the adult neurology texts or the NMSS web site to support its use. I felt that this must be cutting edge research that had not had time to make it into the textbooks. I initially felt that it was unlikely that the diet would have much effect of the MS, but that at least it would be good for my heart, as shown by Dean Ornish, MD. After about 2 years without further relapses or progression I started searching for more information about dietary treatment of MS. I found a mention of using a low-fat diet in Menkes’ Textbook of Child Neurology, 2nd edition. It gave a reference for an article published in 1970 by Dr. Roy Swank “20 years on the low fat diet.”
This article reported on a group of patients who had been told to limit their saturated fat intake to less than 20 grams a day, starting in 1950. An initial attempt at having a control group failed because the patients would talk with each other about their results while in the waiting room waiting for appointments, and after less than a year all the patients had gone on the low-fat diet. Swank had to use historical controls – how the patients had been doing before starting the diet and how other MS patient typically progressed. He found that the relapse rate dropped from 1 a year to less than 0.1 yearly (a 90% reduction), and that the rate of progression slowed.
Swank continued his study until about 1984. Not all of his patients remained in compliance with the diet. Among those who had minimal disability at the start of the study, there was a 5% death rate from MS among those who remained compliant with the diet, while there was an 80% death rate among those who were noncompliant.
Studies that show a benefit from a low-fat diet include:
1. Swank, RL. Multiple Sclerosis: Fat-Oil Relationship. Nutrition 1991; 7:368-376
2. Nordvik, I, et al. Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients. Acta Neurol Scand 2000; 102:143-149
3. Weinstock-Guttman, B, et al. Low fat dietary intervention with w-3 fatty acid supplementation in multiple sclerosis patients. J.plefa 2005; 73:397-404
Your results with diet and exercise are like those reported by Joan Seliger Sidney in J Clin Epidemiol 1994 47:953-954. She went from using a rolling walker to being able to cross country ski 15 km after strictly following the Kousmine Diet (virgin oils, organic wholegrains, fruit, vegetables, nuts).
Your diet is very similar to the one that I have been on for 14 years. Others who use a similar diet include Ann Romney and Montel Williams.
Other discussion of the diet for MS is given in The China Study by Colin Campbell, Diet for a New America by John Robbins, The McDougall Program by John McDougall MD, Taking Control of Multiple Sclerosis by George Jelinek MD, and The Multiple Sclerosis Diet Book by Roy Swank MD.
Web sites that include information about dietary therapy for MS include www.swankmsdiet.org, www.drmcdougall.com, and www.hacres.com.
Since starting a low fat diet for MS in 1995 I have had no further relapses or progression. I have not missed any work due to MS since I started the diet. I am a pediatrician in solo practice in Bristol, TN.
Good luck in getting your results publicized. The benefits of a low-fat diet have been hidden for way too long.
John Hovious, MD
John Hovious, MD
You are welcome to use this note on your blog.
Follow up message
I have included 3 articles from Swank; the 1991 article is the most complete report of his study, and the 2003 article gives a 50 year follow-up on several of his patients. The 2003 Weinstock-Guttman article is an early abstract of the article that came out in 2005; I think that it is easier to follow than the abstract in the 2005 article. The neuropsychology and the breakdown of the BBB articles both state that BBB breakdown occurs before demyelination, which goes against the autoimmune hypothesis. The adrenoleukodystrophy and the nervonic acid articles show some similarity between ALD and MS.
Saturday, May 9, 2009
If you are considering adopting any of the nutritional and or electrical therapy which I used so successfully I encourage you to visit my research opportunity page and participate in the on-line survey. Visit my webpage www.terrywahls.com and visit the research opportunity page. There you will find more information about the survey and a link to the survey itself.
Also my eBook and Food as Medicine lecture are one step closer to being available.
Watch my website fore details.
Terry L. Wahls
As an internal medicine physician, I see it every day. Americans have serious chronic diseases and younger and younger ages. In our schools, we have ever higher rates of autism, severe behavior problems, obesity and pre-diabetes. The productivity of the American worker is falling because of declining worker health. Despite all the money spent on health care, we, and our children, are progressively less well. How did we get this way?
I think the explanation can be found in the corn fields of Iowa.
When you buy seed corn, all the kernels have essentially the same DNA -- this is the way farmers know what kind of crop to expect in the fall. Plant half of the bag of seed corn in black Iowa soil and the other half in a trash heap of clay, plastic debris and rock. Return in the fall. The black dirt corn will have a bumper crop. But the trash heap corn will be yellowed and sickly with no ears of corn at all. The same DNA was in both fields, but the black Iowa dirt was filled with the nutrients the corn's DNA needed. The trash heap lacked nutrients, and you can see the results.
All moving things, including our bodies, break down with time. Fortunately, our bodies have tiny little maintenance workers who are busy repairing all the little wear-and-tear damage that occurs each day. Our DNA provides the blueprint for all the proteins and other stuff that needs to be replaced. But if those little maintenance workers don't have all the building blocks, that is, the correct minerals, amino acids and omega 3 fatty acids, trouble happens. They can't make things according to the DNA blueprints. Those replacement molecules and structures get made not at all, or incorrectly, and we begin to deteriorate, developing chronic diseases like diabetes, high blood pressure, heart disease, arthritis, mood disorders and many others.
Thousands of years ago, our ancestors ate what they could find or catch -- mostly green leaves, fruit and some fish or meat. It was packed with the vitamins, minerals and omega 3 fatty acids that cells need to follow the DNA blueprint instructions. Each day, they easily ate nine cups of vegetables and fruit.
The standard American diet is very poor by comparison. Our children drink sugared beverages throughout the day. Rarely do they eat even one cup of vegetables or fruit with a meal. The adults do no better. Most Americans do not have the necessary building blocks to make the structures outlined by their DNA. Molecules don't get made, or they get made incorrectly. As a result our society gradually becomes stunted and sickly, filled with chronic diseases, just like the corn planted in the trash heap.
It will not matter how many trillions of dollars we spend on health care. The solution to our crushing health care costs is not free medicines or universal health care. It is better health and greater vitality. Unless we teach our nation, especially our children, the critical importance of vegetables and fruit to health and vitality, we as a nation are doomed to become more and more sickly and diseased.
Having America's athletic heroes, pop stars and politicians all proclaiming that eating six to nine cups of non-starchy vegetables and fruit each day is necessary to be cool, sexy, healthy and fully alive would be a powerful beginning to restoring America's health. If we don't collectively begin eating our spinach and kale, no matter how many trillions we spend, we as a nation will continue to be ever more sickly and diseased.
I am working with my sound engineer to create a DVD which captures the audio and handouts for the food as medicine course which I've been teaching this winter and spring. Hopefully I'll be able to get that finished and available by the end of May. I am also working with my editor to have an electronic copy of my book which talks in more detail about my interventions, and the theories I have about why they have been so successful for me. The target is to have the ebook with the DVD available yet this spring, but of course things never go quite as smoothly we expect.
by Dr. Nancy Lonsdorf
Forgetting names lately? Battling brain fog? Lost your "edge?" Don't write it off to just "getting older." It could be something as simple—and curable—as vitamin B12 deficiency.
Once thought to occur only in vegetarians or the elderly, suboptimal B12 levels are found in nearly 40 percent of Americans of all ages, according to the recent Framingham Offspring Study. That puts virtually everyone at risk.
What Does B12 Do?
Known as the "energy vitamin," vitamin B12 is essential for many critical functions in the body, including energy production, DNA synthesis, and blood formation. However, B12 is most critically needed to form myelin, the protective "insulation" that surrounds nerve endings and helps nerves "talk" to each other efficiently.
Without adequate B12, myelin can break down and cause symptoms that mimic multiple sclerosis, depression, or dementia. Other common symptoms include poor memory and mental fogginess, loss of motivation, apathy, mood swings, low energy, fatigue, muscle weakness, soreness or redness of the tongue, tingling, numbness or crawling sensations in the arms, legs, or feet, lack of coordination, and hair loss.
Here are several real-life cases of B12 deficiency—out of several dozen—that I have treated in the past few years:
• Suzanne is a 57-year-old teacher who came to me worried that she was developing multiple sclerosis like her brother. She was experiencing "cramps" in her legs, along with numbness in her hands and feet while walking. Fortunately, low B12 was the cause and her symptoms disappeared within three months of starting B12 supplements.
• Bruce, a 52-year-old broker, had tried "everything" for his recalcitrant depression. His B12 tested low, and within days of beginning B12 supplements, his mood improved dramatically.
• Rob, a usually tireless globe-trotting reporter, felt unusually fatigued after completing a big project. He also felt uncharacteristically lacking in motivation. A B12 test showed a level of nearly zero. Within a few weeks of supplementation, his usual drive and energy returned.
Are You B12 Deficient?
Anyone can have B12 deficiency. The Framingham study found that taking supplements, eating fortified cereal, or drinking milk helps protect against deficiency, but interestingly, meat consumption does not. In my clinical practice, I find that many vegetarians who get plenty of milk and dairy still have low B12, so lacto-vegetarians should not feel they are protected.
If you are over 50, mainly vegetarian, have digestive problems, do not take vitamin supplements or eat fortified cereal containing B12 regularly, or you take 500 mg or more of vitamin C with your food daily (which blocks B12 absorption), you are at increased risk of B12 deficiency.
The best way to find out is to ask your doctor for a B12 blood test. Experts give various opinions on the "gold standard" test, but a simple B12 blood level will do.
Do keep in mind (and challenge your doctor if needed) that the low "normal" limit of about 200 pg/ml is not enough. Levels below 300 double your risk of Alzheimer's disease and increase your risk of hearing loss with age. Children and teenagers with low B12 are at risk for reduced learning ability and intelligence. Your B12 level should be above 350 or 400 to be safe.
If you can't afford a test, and do not have symptoms, you may simply take a supplement of 100 to 500 mcg per day, but do it regularly for effective prevention.
How to Replenish Your B12
Vitamin B12 is found naturally only in animal products, including dairy, and in certain seaweeds, tempeh, and nutritional yeasts. However, B12 in non-animal products may not be active in the human body and may even block the effects of active vitamin B12, so it's safest not to rely on non-animal sources. Keep in mind that if you are deficient, it is not possible to correct it with food alone.
Fortunately, oral supplements are as effective for most people as getting shots. Methylcobalamin, the form naturally in your body, is preferable to the more prevalent cyanocobalamin tablets (which contain toxic cyanide, albeit in trace amounts). Over-the-counter B12 patches, sublingual tablets, and nasal sprays are available and may enhance absorption.
B12 deficiency is common today in all age groups, whether you are vegetarian or not. If you are at increased risk, take supplements regularly to prevent future health problems. If you have symptoms now, see your doctor for a check-up and blood test. B12 deficiency is preventable and treatable, and correcting a deficiency may be just what you need to perk up your memory, mood, and overall well-being.
Nancy Lonsdorf, M.D., practices Maharishi Ayurveda and integrative medicine for women in Maharishi Vedic City, IA. Call (641) 469-3174.
April 6, 2009
Research survey about nutrition and electrical stimulation
The survey is being modified based on your feedback. It is being split into two brief (10 to 15 minute) surveys. Once it is approved the new shorter survey will be available online. Typically such approvals may take a month to happen.
200 grams of Broccoli spouts markedly improve mitochondrial function and reduce oxidative stress
I am often asked about what supplements provide the most protection against oxidative stress. It is my impression that food is much more important than the supplements. When I first started traveling again I noticed a big difference in my energy that was associated with what I was eating. I took my supplements ands my electrical stimulator with me, but I did not take all of my kale with me. What I noticed was an erosion of my energy and clarity of my thinking which quickly resolved when I returned home and ate 6 to 9 cups of kale each day.
A study conducted by David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and the Environmental Protection Agency (EPA) may explain why. They studied how sulforaphane (SFN) — a compound that is found in cruciferous vegetables and is especially high in broccoli sprouts affected the mitochondria and the cells lining the airways in the lung. This placebo-controlled clinical study demonstrated the positive effects of oral SFN administration on up-regulation of a variety of antioxidant enzymes. Inflammation caused during oxidative stress is seen in patients with multiple sclerosis.
Our Phase II enzymes are made in the mitochondria and are known to reduce oxidative stress. Animal studies had shown that SFN is a potent inducer of Phase II enzymes. “This study provides support for the concept that we can enhance the body's own natural antioxidant and cytoprotective mechanisms,” Because oxidative stress is a critical pathway in multiple sclerosis this may explain why I experience noticeably better energy and clarity in my thinking when I eat a lot of kale which is a cruciferous vegetable rich in SFN.
What is notable is that the researchers used a homogenate (food run through a blender) of broccoli sprouts to deliver the SFN. The doses that they used ranged from 25, 50, 75, 100, 125, 150, 175 and 200 grams once daily for three days. The control subjects received a placebo, alfalfa sprout homogenate, which is similar in taste and appearance but does not have high levels of SFN. There was no apparent toxicity in administering the broccoli sprouts orally, and it was well tolerated by the subjects. For comparison I weighed one cup of my finely shredded kale: 200 grams.
At doses of 100g daily, the broccoli sprouts induced expression of several important Phase II enzyme genes (glutathione s-transferase M1 (GSTM1), glutathione S-transferase P1 (GSTP1), heme-oxygenase-1 (HO-1) and NADPH quinone oxidoreductase 1 (NQO1) — in the cells. There was also a dose-dependent increase in the expression of the enzymes. The maximum BSH dosage of 200 grams generated a doubling of helpful 101 percent increase in GSTP1 and a 199 percent increase in NQO1. Expression of GSTM1 and HO-1 also increased by more than 100 percent at the maximum dosage. To get a comparison of how much kale this would be I weighed one cup of finely shredded kale that I eat. It weighed 180 grams. If you don’t mince the kale - and the cup is more loosely filled it is only 70 grams. Since I eat two platefuls of kale most days (6 cups), the amount that I’m eating is approximately over 1000 grams. If you compare the kale I eat each day then to taking 2 grams of N acetylcysteine (which is a sulfur containing amino acid that also increases the same enzymes) each day you can see why eating six cups of kale delivers more benefits to the function of our mitochondria than taking supplements.
Science needs to do our experiments compound by compound to improve our understanding of cellular physiology. The studies therefore typically talk about specific micronutrients. However when comparing eating a plateful of greens to taking the equivalent of 200 one gram capsules of a specific amino acid like N acetylcysteine you can see why eating the food is so much better. That is why I stress the importance of food: 9 cups of vegetables and fruits (3 cups of shredded kale, collards or other dark green leaves each day, 3 cups of bright colors and 3 more of your choice) each day.
If you don’t eat the food, taking anti-inflammatory and anti-oxidant supplements will have a relatively small effect on your health. Greatly reducing the carbohydrates, and maximizing the vegetables and fruits provides your cellular machinery the building blocks they need to make the necessary molecules, enzymes and neurotransmitters that your brains need.
Citation: Riedl MA, Saxon A, Diaz-Sanchez D. 2009. Oral sulforaphane increases Phase II antioxidant enzymes in the human upper airway. Clin. Immunol. 130(3):244-251.
(Shweta Trivedi, Ph.D., is a postdoctoral fellow in the Laboratory of Respiratory Biology Environmental Genetics Group.)
published in Clinical Immunolog.
From my last post I have had several people contact me wondering if I am saying that electrical stimulation is not helpful and am actively discouraging its use. This is intended to clarify my thoughts.
Electrical stimulation has been shown to increase muscle mass in paralyzed individuals. Thus it is likely to be able to increase mass in people with MS. But I predict that stim alone will not be enough to restore walking. It is a long slow process to restore strength. The stim should help produce more muscle mass -- but without the exercise program the gait is less likely to return -
Application of both is likely to be the most beneficial -having a base of slowly growing the muscles should allow the gradual increase of volitional exercise. Having a PT can help identify which exercises to add to get the most benefit for the effort expended.
I don't know what happens with stim alone - there would be some rationale to think the biochemistry in the brain would be improved even without exercise -- but restoring more normal walking, sitting or other muscle functions probably requires exercise and re-education of the brain - muscle pathways.
Re the food/ micronutrient/ supplement questions
I can only report my observations on my own experience. Food - will have more micronutrient content than supplements alone -- But there may be benefits from targeted augmentation with supplements in addition to food - particularly if tailored to the individual based on medical family history etc.
Your observations about the dilemma for most who are struggling to get by is unfortunately too common - and I am sure makes it frustrating for anyone who is trying to regain their health.
Food alone -- won't solve MS - because it is multifactorial - with toxic exposures, micronutrient deficiencies, food allergies, genetic differences and infection exposures and current infections all adding up to each person's unique experience with the disease. That makes providing and finding a generalizable solution so elusive. Finding out what are you own contributions to the disease state -- requires finding someone who can unpeel the onion of all these factors.
From my own experience -- very few physicians understand this -- and I am unraveling the onion slowly myself. An organization -- institute for functional medicine has international membership of physicians and other health professionals who view chronic disease including MS through this lens. Going to there web site - you can find the pages for providers and look under the international provider listings to find someone who does.
Unfortunately I don't have many answers - only questions and my personal observations/ experiences which may or may not be generalizable to others -- I wish that I did -- and I wish that we'd get the study approved so that we could begin accumulating experience with others.
March 22, 2009
Powdered Greens, Wheat Grass and Gluten Sensitivity
For two months I believed that I was experiencing a decline in my back strength and stamina despite continued exercise, NMES and intensive nutrition. I had been using KYOGREEN to provide additional green intake during the day for the prior six months.
I had presumed that wheat grass would not have significant levels of gliadin or gluten, particularly since acutely I believed the Kyogreen improved my energy while traveling.
I have since discontinued the KYOGREEN, and have made no other changes in my routines. Now after three weeks without the KYOGREEN my stamina, and strength are back on the rebound.
I’ve decided to use my Vitamix to create my own green beverages to have at work instead of using the instant greens. I’ve been rotation between blending cilantro, parsley or kale with water and ice. It’s worked well for me. I have more energy immediately following the glass of greens. And my energy levels are better off the wheat grass.
My conclusion is that the cereal grasses likely contain the same antigens as the grain. If you have food sensitivity to gluten, likely you’ll have sensitivity to the wheat and other cereal grasses as well.
I think greens are still incredibly good for us. But it is likely preferable make your own green beverage using a blender and greens leafs that you know you can tolerate. Its a great energy boost to one's day.
March 20, 2009
Home exercise program is superior to electrical stimulation.
An article on the use of functional electrical stimulation in the setting of secondary progressive multiple sclerosis was recently published in Multiple Sclerosis.
A recent study demonstrates that a physiotherapy home exercise program provides statistically more improvement to walking ability than the use of functional electrical stimulation or FES in patients with secondary progressive MS.
A randomized trial comparing the use of functional electrical stimulation (FES) to home exercise therapy for individuals with secondary progressive MS and foot drop was recently published in Multiple Sclerosis. Twenty individuals received FES to flex ankle during the swing phase of walking. Twenty four received a home exercise program. At the end of 18 weeks the home exercise group had a statistically significantly greater level of gait improvement as compared to the group using FES.
The way I interpret these findings is that exercise is a very important component of the rehabilitation of gait. FES maybe beneficial as an intervention that is equivalent to an ankle foot orthosis (AFO), but greater levels of gait rehabilitation can be achieved by using a home exercise program. NMES is the stimulation of muscles directly and is to be coupled with volitional contraction during the electrical contraction. It is also intended to be coupled with an exercise program to re-educate the muscle firing patterns to improve functional use of the muscles. While the hypertrophy of muscles may be achieved without an exercise program, re-education of the muscles important to the rehabilitation of gait
http://msj.sagepub.com/cgi/content/abstract/1352458508101320v1March 7, 2009
First published on March 12, 20090
A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis
CL Barrett, GE Mann, PN Taylor*, and P Strike
The National Clinical FES Centre, Department of Clinical Sciences and Biomedical Engineering, Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ, UK
A randomized trial comparing the use of functional electrical stimulation to
http://msj.sagepub.com/cgi/content/abstract/1352458508101320v1March 7, 2009
First published on March 12, 2009
Multiple Sclerosis March 2009
* To whom correspondence should be addressed.
Functional electrical stimulation (FES), is a means of producing a contraction in a paralyzed or weak muscle to enable function through electrical excitation of the innervating nerve.
This two-group randomized trial assessed the effects of single channel common peroneal nerve stimulation on objective aspects of gait relative to exercise therapy for people with secondary progressive multiple sclerosis (SPMS).
Forty-four people with a diagnosis of SPMS and unilateral dropped foot completed the trial. Twenty patients were randomly allocated to a group receiving FES and the remaining 24 to a group receiving a physiotherapy home exercise program for a period of 18 weeks.
The exercise group showed a statistically significant increase in 10 m walking speed and distance walked in 3 min, relative to the FES group who showed no significant change in walking performance without stimulation. At each stage of the trial, the FES group performed to a significantly higher level with FES than without for the same outcome measures.
Exercise may provide a greater training effect on walking speed and endurance than FES for people with SPMS. FES may provide an orthotic benefit when outcome is measured using the same parameters. More research is required to investigate the combined therapeutic effects of FES and exercise for this patient group.
Another article has been published which indicates a need to revise our recommended daily allowance for vitamin D needs to be increased.
Maintaining adequate levels of vitamin D during winter months requires a daily dose that is four times the current recommended dose, says a new study.
Source: Journal of Nutrition
2009, Volume 139, Pages 540-546, doi:10.3945/jn.108.096180
"Supplements of 20 ug/d Cholecalciferol Optimized Serum 25-Hydroxyvitamin D Concentrations in 80% of Premenopausal Women in Winter”
Authors: M.L. Nelson, J.M. Blum, B.W. Hollis, C. Rosen, S.S. Sullivan
The study, led by Susan Sullivan from the University of Maine, has important implications for ongoing consultations on vitamin D recommendations, with the current level of five milligrams (200 International Units) seen by many as insufficient.
Current recommended daily intakes (RDIs) of vitamin D are 200 IU for people up to 50 years of age, 400 IU for people between 51 and 70, and 600 IU for over the 70s years.
Sullivan and her co-workers recruited 112 women with an average age of 22.2 were assigned to receive a placebo from March 2005 until September 2005, and then randomly assigned to receive either placebo or a daily vitamin D3 supplement (20 micrograms) until February 2006.
“Daily supplementation with 20 micrograms (about 2000 IU)of D3 during winter achieved optimal 25(OH)D concentrations (at least 75 nmol/L) in 80 per cent of participants, indicating that this dose is adequate to optimize vitamin D status in most young women in Maine,” concluded the researchers.
Bottom line - if you have an autoimmune disease get your vitamin D levels checked and take enough vitamin D or sunshine to get your vitamin D level in the upper range of normal.
Neurostim - is it safe for me to try on my own?
I am often asked that question.
My answer is - No, it's not safe.
A physical therapist can analyze which muscles are weak, how your gait is abnormal and design a program specific to you. As you get stronger the therapist can advance your exercises and advance which muscles you give neurostim. It is impossible to know on your own how to restore a more normal walking pattern without someone to analyze your muscles.
My rehabilitation of walking took many months of work, with ongoing adjustments of both my exercise program, and which muscles to stimulate. I doubt that anyone can successfully get their walking rehabilitated without some level of PT support. Also, even I have managed to give myself electrical burns because I did not recognize the hazards of the electrical therapy appropriately. The initial experience my therapist has had treating others with MS indicates that about a quarter of those who try neurostim cannot continue because for them the experience appears to activate a neuropathic type of pain response.
Again, I must remind people that one positive experience is not proof that neurostim will be helpful for others with MS. Nor does one positive experience tell us what the risks are either.
TENS vs NMES
Electrical therapy is delivered at various frequencies (cycles per second), wave shapes, and intensity of current. T ENS is t ypically at a lower frequency than NMES. The waves are shaped differently and the current is typically lower in T ENS which is why NMES is much more painful than TENS.
NMES alone isn't likely to be of much long term benefit
Finally, if the reasons for the smoldering activity in the MS are not addressed - it is likely that the neurostim will have limited benefit for the individual. If you have not read the MS Recovery Diet - I suggest you look into that book. It would also be wise to look into the issues related to food sensitivies mentioned in the previous post.
In our study - we do plan to address the issues of smoldering MS activity associated with food sensitivities. I think that will be another important factor. in our study once we get it going.
MS is a complex disease - with many contributing factors. The more you an address each potential contributor, the more likely you are to cool off the fires of inflammation and begin the healing.
Sunday, February 22, 2009
This article was published December 2008
the link below should take you to the article --
J Neurol Sci. Author manuscript; available in PMC 2008 December 15.
Published in final edited form as:
J Neurol Sci. 2008 December 15; 275(1-2): 106–112.
Published online 2008 September 9. doi: 10.1016/j.jns.2008.07.032.
Copyright notice and Disclaimer
Cerebrospinal fluid evidence of increased extra-mitochondrial glucose metabolism implicates mitochondrial dysfunction in multiple sclerosis disease progression
William T. Regenold,1 Pornima Phatak,1 Michael J. Makley,2 Roger D. Stone,3 and Mitchel A. Kling4
1University of Maryland School of Medicine, Department of Psychiatry, Division of Geriatric Psychiatry, and the Baltimore Veterans Affairs Medical Center, Research Service, Baltimore, MD 21201, USA
2University of Maryland School of Medicine, Department of Neurology, Comprehensive Multiple Sclerosis Center Baltimore, MD 21201, USA
3National Institute of Neurological Disorders and Stroke, Neuroimmunology Branch, Bethesda, MD, USA
4Wyeth Pharmaceuticals, Division of Clinical Translational Medicine. Formerly, National Institute of Mental Health, Clinical Neuroendocrinology Branch, Bethesda, MD, USA
This was published in the Journal of Neurological Sciences in December 2008. These authors talk about the evidence of mitochondrial dysfunction in those with progressive MS. Quoting from their abstract: "... the extra-mitochondrial glucose metabolism increases with impaired mitochondrial metabolism of glucose, these findings implicate mitochondrial dysfunction in the pathogenesis of MS disease progression. CSF metabolic profiling may be useful in clarifying the role of mitochondrial pathology in progression and in targeting and monitoring therapies for disease progression that aim to preserve or boost mitochondrial glucose metabolism."
This is yet another bit of evidence which supports my theory that mitochondrial health have a large role to play in progressive multiple sclerosis. It may not be the whole story - inflammation is probably a factor also. But fixing one's mitochondria is probably a very important long term strategy.
Quick summary - link to full text is below.
Mitochondrial dysfunction noted in individuals with chronic fatigue syndrome. Those with more severe dysfunction had more severe fatigue.
See an attached PDF of the actual article. While this is not a multiple sclerosis patient population - it does lend credence to theory that mitochondrial dysfunction has a role in the disabling fatigue in worsening MS.
My advice -- eat specifically for your mitochondria. Be sure you've got a rich source of B vitamins (mushrooms, dark green leafy vegetables), co-enzyme Q (wheat germ or organic liver), and antioxidants (intense colors, preferably some purple-black, red, and yellow-orange each day). Spending most of your calories each day on organic vegetables, fruit, seeds/ nuts is a great way to add to your micro-nutrient content.
The link below should get you to the article
Int J Clin Exp Med (2009) 2, 1-16
Chronic fatigue syndrome and mitochondrial dysfunction
Sarah Myhill1, Norman E. Booth2, John McLaren-Howard3
1Sarah Myhill Limited, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK; 2Department of Physics and Mansfield College, University of Oxford, Oxford OX1 3RH, UK; 3Acumen, PO Box 129, Tiverton, Devon EX16 0AJ, UK