Sunday, November 24, 2013

Testing for serotonin receptor activity

"the serotonin transporter gene (SLC6A4) which has variants that have been shown to influence the clinical response of patients of European ancestry when they are treated with selective serotonin reuptake inhibitors. Genotyping of some of the serotonin receptor genes is also available to guide clinical practice [ ... ] Given the increasingly clear cost-effectiveness of genotyping, it has recently been predicted that pharmacogenomic testing will routinely be ordered to guide the selection and dosing of psychotropic medications.

 As I'm working to revise most of my web site's material on mental illness, one of my colleague's calls me up to tell me about serotonin testing. Apparently there are tests coming to test sensitivity of serotonin receptor sensitivity.

Doing some quick research, seems people want to run genetic tests to predict how well patients will response to psychiatric drugs. Well, if this helps to prevent some of the worse reactions to psych drugs it's not all bad, HOWEVER...

This has little to do with what "depression" and "mental illness" is. It is also guiding people in a direction that is leading them further away from the real problems.

Depression is not a disease. It is a feeling. Feelings are not pathologies. Feelings are not supposed to be treated. The whole train of thought makes no sense.

Feeling depressed all the time is a problem. Feeling suicidal is a problem. But the thing to treat is the patient, not the feeling itself.

What can cause depression? Well, what causes disease in general?
  • Nutritional deficiency
  • Toxicity
  • Structural issues (ie. car accident, joint sublexation, etc...)
  • Emotional trauma/stress
How should the patient who feels depressed be treated? By taking a full history and treating what is wrong! Sorry, you do not treat depression in naturopathy.  Naturopathy, like all other holistic healing disciplines is patient focused, not disease focused.

Do people have genetically faulty serotonin receptors?

Perhaps there are some people who do. There are some uncommon genetic diseases. However, most illnesses with a genetic component will only be expressed in the right environment. So the real question is not if people have faulty serotonin receptors. It's better to ask if some people are more genetically predisposed to feeling depressed, given a set of environmental stresses.

That may be so. But I wouldn't call that having a defective brain that needs to be treated with psych drugs. We all have genetic predispositions. Also, often these supposed weak genes that make us susceptible to certain disease serve important other functions as well (the most well known examples is perhaps sickle cell anemia as protection against malaria).

What should be treated is the cause of illness. Nutrition, toxicity, emotional trauma and physical structure. I doubt that many people would feel depressed if those needs could be taken care of. Personally, I wish as a ND I could do more, I can work with nutrition, detoxification and help the body deal with emotional stress, but I can not remove my clients from bad jobs, bad relationships, bad parents, etc... I wish I could, as sometimes it's clear that is most what they need, not some supplement or drug.

We are not born with defective brains, defective genes, or defective serotonin receptors. If we simply give our body's what they need, we will feel fine. Depression is the body's feedback mechanism that something is wrong. 

The above article I link to mentions "serotonin receptor genes." They can give a gene whatever arbitrary name or label they wish. However the very idea that there is a point to point relationship between genes and one specific function has been dis-proven. Since researchers know the body is far more complex, I wish they would use language that better reflected the way they body worked, instead of deceptive names.




Wednesday, October 2, 2013

linoleic acid and psychiatric medications

Was doing some research after noticing someone having a very remarkable reaction to conjugated linoleic acid (which is often used as a weight loss supplement).

In terms of people on psychiatric medications, this study says:

"Regarding LA levels, antipsychotic-treated patients showed significantly reduced levels compared with controls, whereas antipsychotic-naïve patients showed no such reductions"

 While the role of fish oil and particularly DHA is often cited for "mental illness" perhaps this is indicated CLA should be a consideration for those on anti-psychotic medication?

Of course everyone is different, and one must treat the person, and not the disease, but looks like CLA may be a consideration when working with people who are coming in on anti-psychotic medication.

Is nutritional lithium safe?

This from Nutrition Journal

"Prescription lithium is in the form of lithium carbonate, and doses can be as high as 180 mg. It is these high doses that are responsible for most of lithium's adverse side effects. Some of the more common side effects include a dulled personality, reduced emotions, memory loss, tremors, or weight gain [5,6]. Another form of lithium called lithium orotate, is preferred because the orotate ion crosses the blood-brain barrier more easily than the carbonate ion of lithium carbonate. Therefore, lithium orotate can be used in much lower doses (e.g. 5 mg) with remarkable results and no side effects [49,50]. Clinical trials involving 150 mg daily doses of lithium orotate administered 4 to 5 times a week, showed a reduction of manic and depressive symptoms in bipolar patients [50]. In addition, lithium orotate is available without a prescription, unlike lithium carbonate, which is considered a prescription drug by the Food and Drug Administration (FDA). Studies have also shown that the amino acid-derivative, taurine, as an alternative to lithium, blocks the effects of excess acetylcholine that contributes to bipolar disorder [51]"

While most information on nutritional lithium is for it's use in helping people with mental symptoms (and many practitioners in natural health will use lithium for that), I have primarily seen it help people with Grave's disease. While herbals for Graves disease (ie. bugle-weed, lemon balm, mother wort) help the cardiovascular symptoms lithium is my starting point for a supplement that will help with other symptoms.

Unfortunately many people are afraid of taking lithium because they have heard it is dangerous. Lithium is a trace mineral, our bodies need it. It is not dangerous in low dose. Any mineral, vitamin or substance (including air and water) is dangerous in too high a dose. That's what happens with prescription lithium carbonate. The dose is too high and creates toxic side effects.

However, this should not scare people away from using low dose nutritional lithium, which is available as a non-prescription supplement.



Another article from 1986

Lithium orotate in the treatment of alcoholism and related conditions

In this there was some minimal side effects, although they gave a much higher does than lithium oratate is usually given in (they used 150 mg per day - instead of 5 to 20 as in most supplements).

Study noted many benefits from lithium - including helping some with hyperthyroidism

"Further advantages for this lithium therapy were noted, i.e., improved liver and cardiovascular functions, reduction (and in some cases abolishment) of migraine headaches, alleviation of the Meniere's symptoms, and amelioration of seizures. There were increases in the white blood cell counts in the patient with chemotherapy-induced leukopenia and reduction of edema and ascites in patients with liver cirrhosis, as well as the pleural effusions and lymph node swelling in the patient with lung cancer. No manic episodes occurred during lithium orotate treatment in three patients with this affective disorder. The hyperthyroid condition was also improved in four patients"

What Happens When You Are Diagnosed With Hyperthyroidism

Most people diagnosed with hyperthyroidism and Graves Disease tell very similar stories. 

Symptoms seem to come on very suddenly, racing heartbeat, sweating, anxiety or panic attacks, weight loss, digestive symptoms, swelling on neck. Not everyone has all those symptoms, but most have some of them.

Usually a medical doctor will run a lab for TSH (thyroid stimulating hormone), and find it quickly. Sometimes this lab is run as part of an emergency room visit. Sometimes it take some time to get the diagnosis and the patient may have been treated for a wrong diagnosis.

Diagnostic measures for hyperthyroidism

Typical labs ordered to confirm a diagnosis include:
  • TSH, T3 and T4
  • Radio-active uptake scan test (to differentiate graves disease from other causes of hyperthyroidism, such as a thyroid hormone secreting nodule)
  • Anti-bodies. These include thyroid stimulating immunoglobulin (also called TSH receptor antibody)
Suggestion of the radio-active uptake test makes many patients worried about radiation. The medical doctors are typically dismissive about such concerns and tell patients there are no side effects to worry about.

Anti-body tests may be run. Sometimes medical doctors want to run an uptake scan. Other times people are given a Graves disease diagnosis without it. 

Where almost everyone with Grave's disease ends up

Eventually patients are given these options:
  • Have the thyroid gland destroyed with radio-active iodine, or removed surgery
  • Treat with drugs which are toxic to the body - although typically the medical doctors will push patients to have the thyroid gland destroyed. 
It doesn't seem to matter much how severe symptoms are, these are the only options conventional medicine gives patients.

Common reactions to medical advice

  •  Fearful. The medical treatments are not benign. Patients worry about how their body would function without a thyroid. Also they are concerned about side effects from medications or radiation therapy. It seems that whichever direction they go has the potential for side effects.
  • Hopeless - in the conventional medical world there are no other options, which may make people feel they have no power to take control over their own health.
  • Being unsure of what to do.
Typically patients will be having one or more of these reactions. 

Is there an alternative option?

Many times there is. Conventional medicine lumps all people with Graves disease together, and offers them all the most radical treatment. Graves disease is a dangerous illness, which must be taken seriously. In some cases the conventional route has merit.

However, many cases are not so severe to warrant immediate destruction of the thyroid gland. What can be done through natural health?
  •  First, going over labs in detail. Many people with hyperthyroidism never get a full set of labs needed to assess their situation. This includes full thyroid pane (TSH, T3, T4 and antibodies to Grave's and Hashimoto's - as often both are elevated - this is TSI, TPO and anti-thyroglobulin antibodies). Additionally other labs such as CBC , WBC, and vitamin D are important.
  • Supplements to help control symptoms. There are many supplements that can be used to control symptoms.
  • Deeper work for the underlining cause of hyperthyroidism. This is beyond the scope of this article. For more information on this go to my video on Graves disease





Thursday, September 19, 2013

Sugar: The Bitter Truth




Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin. Series: UCSF Mini Medical School for the Public [7/2009] [Health and Medicine] [Show ID: 16717]

Commentary

The above video is an in depth look at what went wrong wtih dietary recommendations with regards to low fat diets. It dismisses popular misconceptions about sugar, fructose, fat, and especially what causes obesity.

The following is a brief summary I wrote while watching this. However, this only highlights some major points. the whole video is full of important information, and needs to be watched to appreciate it.
Obesity is not as simple as calories in versus calories burned. The standard model says if you eat it, you better burn it, or you gain weight. This is a mistake. Obesity is not a simple matter of too many calories, and not burning enough off.
Historical trends in fructose consumption:
Before food processing, fructose consumption would be about 15 grams per day.Prior to WWII 16 – 24 g/day.
1977 – 78: 37 g/day
1994 – 54.7 g/day
Adolescents today: 72.8 g/day – 25% consume at least 15% of calories from fructose alone.
It's not just that calories are going up, but fructose is going up.
Why did this happen? Fructose is so cheap, plus something had to be added into the diet to make up for the low fat diets which started in the 1980s. However, a review of the basic science and studies that led to low fat diet, show that theory is wrong. High fat diets do not lead to cardiovascular disease.
These change have led to an adulteration of the food supply through:
  • Addition of fructose
  • Removal of fiber
  • substitution of trans-fats
Key point: fructose is not glucose (table sugar).
  • Fructose forms Advanced Glycation End-Products (AGE's)
  • Fructose does not supress ghrelin (satiation hormone) so people eat more
  • Acute fructose does not stimulate insulin. If insulin doens't go up, leptin doesn't go up, so brain doesn't see you ate.
  • Liver metabolism of fructose is completely different than that of sugar.
  • Chronic fructose expose alone leads to Metabolic Syndrome.
Glucose can be used by every cell in the body. Excess glucose gets converted into glycogen in the liver. Glycogen is not toxic. Some glucose will get converted it fat, but not much. However, fructose can only be metabolized by the liver. Since the liver is forced to metabolized all fructose, this turns fructose into a poison.
He discusses the relationship between fructose, creation of uric acid, gout and hypertension. As sweetened sugared beverages goes up, so does uric acid, gout and hypertension. Studies have shown that reducing uric acid, will lower high blood pressure. Basically, the fructose (not table sugar) is cause hypertension. Fructose will also stimulate creation of fat “High fructose diet is a high fat diet.”
Fructose consumption leads to: hypertension, myocardial infarction, dyslipidemia, pancreatitis, obesity, hepatic dysfunction, fetal insulin resistance and habituation if not addiction.
His interventions:
  • Get rid of all sugared liquids, only water and milk.
  • Eat carbohydrate with fiber.
  • Wait 20 minutes for second portions.
  • Buy your screen time minute for minute with physical activity.
They found this works for childhood obesity, and analysis shows increased sugared beverage consumption is what will make it not work.
Why is exercise important? Not because it burns calories!
  • Makes skeletal muscle more sensitive to insulin.
  • Endogenous stress reducer, and if stress reduce, then appetite goes down.
  • It makes TCA cycle run faster (raises metabolism).
Why is fiber important in obesity?
In nature fructose always comes with fiber. That's why fruit is ok. Fiber limits amount of carbohydrate absorbtion. Increases speed of transit of intestinal content to ileum. Inhibits absorption of some free fatty acids to the colon, which are metabolized by colonic bacteria to short chain fatty acids, which suppress insulin.

He compares fructose to alcohol and called fructose, " ethanol without the buzz.” Makes the point that biochemically, they are basically the same thing in terms of A low fat diet is not really a low fat diet, because the fructose doubles as fat. So its a high fat diet. In addition, fructose is also a toxin.

Saturday, August 17, 2013

Cutting and Self-Harm - A Naturopathic Perspective

The purpose of this article is not to write a comprehensive review of causes and all treatments for cutting and self-harm. Rather this is simply insights from my perspective as a Naturopathic doctor.

Cuting and self-harm is a coping mechanism for mental symptoms such as depression. Depersonalization can be described as feeling disconnected from one's physicality. This can be related to self-harm as well.
There are some basics aspects of self-harm which I'll review first:
  • Self harm is not a suicide attempt, and does not mean someone wishes to die.
  • Self-harm injuries are generally superficial (it's very unlikely that one will accidentally kill themselves).
  • People who self harm are often embarrassed by cuts/scars, try to hide them, and are not seeking attention.
  • Self harm is addictive – it involves release of endorphins, and as someone self harms, over time they will tend to need to do it more often, or more severely in order to get the same release.
  • Stopping self-harm can be a slow process, with occasional relapses just like other addictions.

Self Harm Is A Symptom – Not A Disease, Nor Is It A “Mental Illness”

People who self-harm do so out of inner distress. This may be depression, or even a self-inflicted punishment.
Often depressed people feel nothing, or numb. The physical pain at times may feel better, than feeling nothing at all.
Regardless of the cause, it should be obvious that “self-harm” is not a “disease” or “mental illness” in and of itself. What should be treated are the causes of emotional distress which lead to self-harm.

Self harm is not an enjoyable act. Generally people do not enjoying sticking themselves with sharp objects or other forms of self injury. When the mental symptoms are relieved, then the self-harm will stop.

Psychiatric Drugs For Self Harm

The psychiatric bible known a the DSM contains all the psychiatric “diagnoses.” This book explicitly states that “diagnoses” are not medical conditions. A psychiatric label is simply a description of symptoms and behaviors. The DSM does not list objective medical tests for any supposed“chemical imbalance” because such tests do not exist.

Nonetheless, patients are still told that psychiatric “diagnosis” represent biological diseases and which are treated with psychiatric drugs.

Our society tends to fight against problems, rather than holistically appraising (and addressing) the cause.
It is certainly much more profitable to create billion dollar industries to fight a problem, rather than fixing the causing. But also, when we “fight” a problem, we take away the need to reflect on the cause.
So, following this tendency, psychiatrists prescribe drugs for “chemical imbalances” that have never been proven.


So what does this say about taking a psychiatric medication for self-harm?

1) In no way do psychiatric drugs address the causes of self harm.
2) Psychiatric drugs are in themselves a form of self harm! We need to ask, what does it say about a society that so willing give ourselves (and children) neurological toxins that do harm the body, just in a way that is not visible to the eye.

Self-harm causes physical damage to the body (typically skin) in order to help cope with emotional distress. Psychiatric drugs cause physical harm to the brain and nervous system (and other system) in order to help cope with emotional distress.

What is the difference?

Perhaps with self-harm is is clear that the emotional distress is still there and scars may be discomforting. With psychiatric drugs, we can pretend things are better because they appear to be.

Are there cases of self-harm that are so severe psychiatric drugs are warranted? This is a subjective question, and I think best answered by the patients themselves, based upon their individual situations. If someone finds a psychiatric drug helpful, who has any right to tell them otherwise. However, the truth doesn't change – these are basically poisonous substances that are not fixing the the real problem.

Psychiatry And Mental Illness Theory – Society Not Looking At Anything But Itself

One of the worst things that can be told to someone who self-harms (or who has another “mental illness”) is that this is a biological disease.

When we tell someone they have an inherent, biological condition brain disorder, that in effect dis-empowers them. How is it helpful to say, based on zero objective evidence whatsoever, that someone has an inherent brain disorder?

For from taking away the stigmatizations of metal illness, this reinforces it! It is telling people they are inherently defective!

The only person who can ever heal anyone, is the individual acting in concert with the healing power of nature. The practitioner should be there to act as a guide and assist the body in this process.
But this model, of inherent brain disease this transfers power to heal – away from the patient – and to the practitioner. Thus it serves the psychiatrist and whole mental health field much better than it serves the patient.

But even worse, this is simply not true. Psychiatry has no evidence whatsoever that conditions they claim are biological, and have biological treatments for, are in fact biological.

If they did, they would give patients biological tests. They don't, because they have no tests.
Furthermore, when society as a whole adopts this stance that mental symptoms such as depression and self-harm are in fact biological, it's a way of defending society itself.

No longer are we confronted with questions of how our society produces so many mental disorders. No longer must we ask why so many young people are resorting to self-harm!

At this point I am diverging from my role as Naturopathic Doctor and into social criticism. However, if Naturopathy has taught me anything, is is the interconnectedness of the whole unit. You can not study “mental illness” (or any illness) as somehow separate from the rest of the body. Likewise, we can not fully understand the illnesses of the individual, unless we account for the environment the whole person lives in.

The rise of certain illnesses must be put into context. Just as the epidemics of autism and auto-immune disease reflects problems with the environment, so too do the many young people who are engaging in self-harm.

The larger question is how has society itself failed young people?
But if believe this is all due to inherent biological brain illness, then there is no reason to put the question up to society as a whole.

How Do I, As A Naturopathic Doctor Help Someone Who Self-Harms?

I can not speak for all of Naturopathy. But this is what I do:

TREAT THE PERSON AND NOT THE SYMPTOM

Symptoms are the body's best attempt to deal with the totality of current stresses.

There are two things with cause “disease.” It does not matter if symptoms are physical or mental.

Deficiency – or not giving the body what it needs.
Toxicity – or giving the body things it doesn't need.

Psychologically speaking, children can be put into very toxic environment. Abusive parents, or social abuse (bullying) at school are common. However, children may have symptoms not due to abuse, but simply because they were given the emotional support needed. There is a phenomena of “proximal abandonment” where perhaps the parents are physically present, but not emotionally available.

Physical toxicity or deficient may be easier to understand. B12 deficiency can cause depression. Lead toxicity can cause a number of mental symptoms.

for more I suggest this video from psychetruth

Wednesday, December 12, 2012

Natural Health And A Culture Of Fear

Magnesium Stearate Is Not Dangerous - Stop The Hype


Earlier this week I received an email from a supplement company whose products I use with clients very often about magnesium stearate.

It was about misinformation being spread online that stearic acid is some sort of poison which damages the digestive system and prevents absorption of nutrients.

The email stated:

It seems that a very small minority of nutritional supplement marketers and manufacturers, including a brand in the professional supplement realm, have decided it is in their best interest to disparage the vast majority of nutritional supplement companies.  They are doing so by reporting false claims regarding a formulation ingredient that supplement manufacturers use to assure homogenous, multi-ingredient nutritional supplement blends.  Without optimal blending of therapeutic agents one cannot consistently produce products with maximum health benefits, and which meet label claims.
 
The ingredient in question is stearic acid, also commonly referenced as vegetable stearate and/or magnesium stearate.  I fear the net effect of these negative marketing efforts is to scare the general consumer away from the use of any nutritional supplements.


I have three points to make out this.
1) Stearate acid is safe
2) The dangers of using fear to sell product
3) Should I be scarred to say anything about this?

Stearate Acid Is Safe

A  Dr. Myatt has posted an extensive and very scholarly video on youtube about this. Click here to watch.

If you have any questions on magnesium stearate please watch above video. There is really no need for me to repeat the same information put forth by D. Myatt.

Designs For Health also has a fact sheet available at this link

Not to mention the anecdotal evidence

If magneseum stearate was so dangerous, it would cause illness among all the millions of people consuming supplements with it.


Besides, I (and lots of my colleagues) have helped many people who have digestive issues with these supplements. I am repeat lab tests of clients, showing huge changes in secretory IgA and inflammatory markers for GI after taking supplements with magnesium stearate. And I'm just one of thousands of practitioners who sees this.

Using Fear To Sell Product

When people start educating themselves about health, something happens... they learn our world is full of poisons; Flu shots, GMO foods, xeno-biotics in plastic, metals in tap water, amalgam fillings, antibiotics, pesticides, acrlyimides, etc...

The fact of the matter is that our species has created a very toxic world, and now we are paying for it with our health.

With that being said, is there really any reason for people to spread fear about things that are safe?

Honestly, it seems that a reflex develops where you just tell someone some sort of chemically sounding name is dangerous and they'll jump on board.

This has been somewhat demonstrated with the hydrogen dioxide petition experiment. This was made more well known when Penn and Teller got people to signs a petition to ban water, by calling it "hydrogen peroxide."  In some respect I find this piece to be a propaganda smear against environmentalism, as I think members of any philosophy (environmentalism, a religion, libertarianism, the democrats, the republicans, or any of "ism") will tend to just automatically jump on board with other people claiming to be of the same philosophy.

Nonetheless, the point is that simply telling people who are interested in natural health that some dangerous sounding chemical is dangerous, will get many to believe it, regardless of the actual science.

What I see with the magnesium stearate smear campaign is a few people in the field of natural health, trying to make money, by telling the public that what I, and my colleague recommend to patients is dangerous.

Just about anyone in natural health who uses supplements, is recommending products with magnesium stearate. So while it is not an attack against naturopathy, it is my extension an attack on the supplements recommended and sold by most naturopathic doctors.

Seriously. Most Naturopathic Doctors are good hearted people. Most put themselves tens of thousands into debt, in order to get a degree because they want to help other people. I think it's disgusting to claim that the products they use are dangerous. I don't want people who are taking supplements given by a qualified practitioner to flip out and throw them away because of something they read from Dr. Mercola. I'm sorry, but I think sabotaging patient relationships with their doctors, with false information is dangerous. Dangerous because we are talking about supplements that people need.

Should I be afraid to voice my opinion?


A major person who has pushed the attack on magnesium stearate is Dr. Mercola. My first thought honestly, was that I should say nothing. Because Dr. Mercola is very popular. Maybe someone who is considering making an appointment with me will see I don't agree with Dr. Mercola and then not see me. After all (as stated in above video that I linked to), many people will automatically believe anything Dr. Mercola says, without any fact checking.

Well, this is my opinion of Dr. Mercola:
  • 99% of the information he puts out in his newsletter is great. Dr. Mercola is one of the leaders in this country when it comes to spreading information on natural health. Personally, I've read his newsletter for years.
  • I also believe that Dr. Mercola is a good person, who is doing his best to help people improve health. Because I have issues with his views on magnesium stearate, that doesn't take away from everything else he has done.
  • Dr. Mercola uses fear to sell product. For example, the headline of his latest newsletter was
    "The Popular Meat That May Be Too Contaminated to Eat." The newsletter uses fear to pull in the reader. But it's not just this days newsletter. It's virtually every days newsletter. After a while I stopped reading most of his newsletters. Often by the fear mongering headline I can guess what the article is about. I also don't think it's healthy to start each day with fear and negativity. I mean, sure vitamin B12 deficiency is common, but do we really need to read "Warning: Potentially Life Threatening Vitamin Deficiency Affects 25% of Adults."