April 6, 2009
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.)
http://www.ncbi.nlm.nih.gov/pubmed/19028145?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
published in Clinical Immunolog.
T
Saturday, May 9, 2009
Neuroelectrical stimulation of muscles
March 23, 2009
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.
tw
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
Multiple Sclerosis
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
doi:10.1177/1352458508101320
* To whom correspondence should be addressed.
Background
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.
Objective
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).
Methods
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.
Results
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.
Conclusion
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.
t
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.
tw
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
Multiple Sclerosis
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
doi:10.1177/1352458508101320
* To whom correspondence should be addressed.
Background
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.
Objective
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).
Methods
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.
Results
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.
Conclusion
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.
t
More on Vitamin D
March 7, 2009
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.
Study details
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.
t
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.
Study details
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.
t
Neurostim - is it safe for me to try on my own?
February 22, 2009
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.
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
Researchers Find Link Between Oxidative Stress and MS in the spinal fluid of MS patients
Link between MS and oxidative stress documented in spinal fluid
This article was published December 2008
the link below should take you to the article --
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2584157#id409706%23id409706
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.
T
This article was published December 2008
the link below should take you to the article --
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2584157#id409706%23id409706
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.
T
Mitochondria and chronic fatigue link found
This article was forwarded to me - and I am providing a link below. It adds more credence to the importance of mitochondria as a factor contributing to fatigue.
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.
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.
Int J Clin Exp Med (2009) 2, 1-16
www.ijcem.com/IJCEM812001
Original Article
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
http://www.ijcem.com/files/IJCEM812001.pdf
Food Matters in MS
Food Matters in MS
The etiology of multiple sclerosis remains unknown. Likely there are several different pathways to developing multiple sclerosis of MS. The factors which are likely playing roles in MS are the interaction of the following: 1) DNA, 2) Toxin exposures (eaten, inhaled or absorbed through skin), 3) Infection 4) Micronutrient intake (food), 5) Allergy or sensitization (to food), 6) Stress level (physical, psychological and spiritual) and 7) Insulin production each day. The cause of injury has been identified as antibody complexes which destroy myelin. The loss of myelin leads to breaks in the communication between the brain (and spinal cord) and the body. The result is weakness and or disturbed sensation (blind, dizziness, pain).
In this blog I will talk food and multiple sclerosis. There are three main ways food can get individuals into trouble. First – is toxins from the use of herbicides and pesticides. Second is micronutrient intake and third is food allergy and sensitization. Third is the effect of maintaining high insulin levels on the level of inflammation in our body. I’ll conclude the article with a brief synopsis of what I have done personally regarding food.
Toxins are present in and on the food that has been grown with the help of pesticides and insecticides. Best options to deal with this is grown your own food, or buy local organic when you can. Wash all food carefully. If you buy non-organic wash carefully. The more gently you have to wash something, such as berries, the more likely it is that you can’t get the pesticides off the food. Lettuce, berries, and celery have high amounts of pesticide residue. If you can – go organic for those.
Micronutrients have been discussed previously. The standard American diet (SAD) is below the recommended daily intake for many vitamins, minerals and phytonutrients that our brains need. We often do eat enough omega 3 fatty acids (fish & fish oil, flax & flax oil) for making a key myelin. Neither do we eat enough of the correct amino acids (especially sulfur) for making key neurotransmitters. Diets with 9 cups of fruits and vegetables, 3 of which are rich in sulfur such as the onion and cruciferous family of vegetables will greatly improve the micronutrient content of the diet.
Food allergies and sensitivities are also a contributor. Celiac disease which is gluten (found in wheat, rye and barley) sensitivity causes the body to make antibodies against gluten. The symptoms are not just belly stuff. People can have skin problems, joint problems, fatigue, personality changes, mood problems, weakness, and pain. People have come in with severe neurological problems, severe changes on their brain MRIs and have been diagnoses with multiple sclerosis. But when someone considered the possibility of gluten sensitivity and had the patient faithfully follow gluten-free diet, their neurological problems began to resolve over the next year. The brain MRI improved. The large white scars on the MRI disappeared. The patient actually had gluten sensitivity, not multiple sclerosis. That is why anyone who has been diagnosed with multiple sclerosis would benefit from eating a very stringent gluten-free diet for at least a month to help determine what role gluten-sensitivity has in their disease.
If we can have that level of damage and response in the brain to sensitivity to wheat, it is logical to consider sensitivity to other foods can likely generate similar levels of damage to the body and brain. That means that anyone with MS who is not doing well would likely benefit from considering the possibility of food sensitivities as a factor that keeps their disease active.
That is a complex issue to solve because people can end up sensitized to multiple food items. We know that in those with gluten sensitivity, 70% have their symptoms completely resolved with gluten avoidance. The other 30% have additional food sensitivities which must be identified and also eliminated to do well. So how do we figure out who is sensitive to what foods? That is not easy for several reasons. 1) The blood tests can capture some of the sensitivities, but not all, and 2) Although most reactions occur quickly, some reactions to food occur up to 72 hours after ingestion. As a result the most effective way to confirm food sensitivities is through an elimination diet, food diary and symptom diary for a minimum of one month. The next several paragraphs describe two approaches to identifying what sensitivities a person may have.
Gradual food reintroduction is the most stringent application of a food diet asks the individual to eat only the most non-sensitizing food available in
Elimination diets are a more moderate approach. The person with MS is advised to eliminate the most common sources of food allergy from their diet initially. These include: wheat, eggs, milk, and legumes (which includes peanuts and cashews). They are then given a chart which lays out a 4 day rotation plan and menu suggestions. The goal here is to have the individual eat from different food families every day so that you do not eat a food more frequently than every 4 days. The individual is to keep a food and symptom diary. Because symptoms occur within 72 hours, the individual who has kept their food diary knows all of the food items they have eaten in the prior 3 days. They can identify what foods have been safe in the past, and what foods were new in that time period. They are advised to eliminate that food from their diet. If the person wishes, they could try that food again in 4 to 6 months. It turns out that for some people we have a few severe food allergies that we can never eat, and others which are milder allergy. If we eliminate the mild allergy food for 6 months, the lining of our gut heals. Then if our gut sees the mild allergy food only on occasion the gut cells can tolerate it without causing a major antibody response. The other benefit of an elimination diet is that it tends to increase the variety in our food intake often improving the micronutrient content in the long run.
Books are available on the issue of food sensitivities and micronutrients to help you design menus that can work for you. These include The Worlds’ Healthiest Foods http://www.whfoods.com/, The MS Recovery Diet http://msrecoverydiet.com/ and Restoring Your Digestive Health http://www.amazon.com/Restoring-Your-Digestive-Health-Transfom/dp/07582028220 . Gluten-free diet resources can be found at http://www.celiac.com/catalog/index.php?cPath=48_50. Asthon Embry has written extensively on connections between diet and MS and has a web site http://www.direct-ms.org/bestbet.html.
Celiac Disease and gluten-free diets have a larger collection of books devoted to that topic. Google the terms and you will find many sources of additional information.
Eating out and processed foods are a challenge for those who are using an elimination diet. You need to read labels carefully, and ask the waiter about what food item may be included in the dish you are ordering. The simplest approach is to avoid eating processed food, or eating out, particularly while you are first going through the elimination diet.
What did I do regarding my food consumption? In 2003 I began the Paleolithic diet. I eliminated grains, milk and legumes. I continued to eat meat, poultry, fish, vegetables (including white potatoes), fruit, and eggs. By 2007 I had gone back to eating rice, and occasional beans. Summer of 2007 I took a blood test for food allergies which identified marked sensitivity to eggs, pinto beans, and milk. I eliminated those from my diet in October. I started the four day rotation diet but did not maintain it. I was not keeping a food symptom diary. November 2007 I started neurostim. At the end of December I started the intensive diet rich with 9 cups fruits and vegetables a day minimum. I ate 4-6 cups of cruciferous or onion family vegetables each day, and 3 cups of brightly colored vegetables or fruits. January 2009 I went back to creating a food, symptom diary and began the elimination diet with the four day rotation of foods.
Why was I able to go from four years dependent on a scooter, back to walking, bicycling and skiing?
Since I don’t have serial blood tests to identify how much nutritional status changed, the inflammatory status, or biological changes that were occurring it is hard to say what precisely what happened as I got stronger. I do have several theories which I’ll share.
First – the neurostimulation that I started in November 2007 coupled with exercise produced stronger larger muscles and generated growth factors in the brain which stimulates repair of myelin, and growing new connections between brain cells. That priming made my brain more ready to do the repair work. The food made it possible for the brain cells to use the growth factors.
Second – I eliminated more vigorously the foods to which I had documented food sensitivity on the blood tests in the summer of 2007.
Third – I greatly increased the intake of B vitamins, co-enzyme Q, antioxidants and organic sulfur though food. This resulted in a big boost of the micronutrients I was eating.
Fourth – I switched to entirely organic foods.
Fifth – I focused on getting every color each day.
Sixth – Because I eliminated white potatoes, grains etc, - the amount of insulin my body makes each day is quite low.
Seventh – I now keep a food / symptom diary and follow a four day food rotation.
What about supplements?
While there may be benefits in supplements – they are not without risks. Supplements are not regulated by the FDA. There are many reports of supplements not containing what they label claims to be inside. In addition there are problems with the purity and contamination. If the herbs or foods listed on the label are not grown on organic farms, there is a risk of heavy metal contamination (also present in our food). But since the food is concentrated to very high levels for the supplement – the previously trace levels of contamination can become quite high. Another important difference is that nearly every study has shown that the whole food is associated with superior outcomes to specific nutrients. That is likely because we absorb nutrients better when they are in food. Higher blood levels are consistently seen in comparison to food versus supplementation. Also we get the additional hundreds of other phytonutrients in food all of which are likely playing contributory roles in health. My recommendation is to focus first on using an elimination diet and food/ symptom diary to maximize your micronutrient intake and lower inflammation.
Food matters. If you can, grow some of your own food. Buy organic. Try eliminating the most common offenders – gluten, eggs, milk, and legumes. Keep a food, symptom diary. Try an elimination diet with a four day food rotation. Consult with a nutritionist or other healthcare provider familiar with elimination diets. Exercise can help increase the brain growth factors and speed healing. But without the needed micronutrients and lower levels of inflammation – you wont’ get far. The quality of the good and the avoidance of foods to which you are sensitive can make a big difference in your ability to improve.
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