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The Brain Therapeutics Medical Clinic From LET’S LIVE Magazine
By David Steenblock, D.O. David A. Steenblock M.S., D.O., H.MD
Personalized Regenerative Medicine
26381 Crown Valley Parkway, Ste. 130, Mission Viejo, CA 92691
Things You Can Do Right Now:
Fighting The Big Red Wolf Of Diseases Naturally
WOULD YOU BELIEVE that the big, bad wolf is still in pursuit of grown up Red Riding Hoods? Lupus comes from the Latin “fox wolf”, while erythematosus means “red”. This red wolf primarily attacks women between the ages of 20 and 40, but may occur between childhood and old age in both sexes. The name is derived from the characteristic red face rash and the skin changes, which may resemble the bite of a wolf. The disease can produce a number of problems for the victim, including fever, arthritis, anemia, kidney dysfunction, and heart, lung, nerve and gastrointestinal inflammations. The disease comes and goes and the person may be totally healthy for years and then have a return of the problem. The severity ranges from a very mild illness with little effect on the person to an acute, severe disease afflicting many organs simultaneously. The disease seems to be activated by infections, sunlight, surgery, pregnancy, physical or emotional stresses and certain drugs. Treatment for lupus has varied somewhat over the years but most authorities now recommend bed rest for days when the disease is active, the use of aspirin, and in severe cases – cortisone. The immune system is the key to understanding the cause(s) of lupus. The immune system includes those cells of your body involved with attacking bacteria, viruses, foreign proteins (e.g., ragweed), and cancer. There are three main types of “immune cells” and all circulate in the blood and body fluids. These include the Blymphocytes, the Tlymphocytes, and the macrophages. The B-lymphocyte is a bone marrow derived cell and is responsible for the production of antibodies. Antibodies are specific proteins produced by these cells to fight off foreign invaders. If for any reason these B-cells become more excited than they should be, they will produce more antibodies than normal; and diseases such as lupus, allergies, rheumatoid arthritis, scleroderma, etc., may occur since all of these diseases have the common property of having too many antibodies present! At times of stress, injury, infection, sunburn, and possibly menstruation, the blood will contain injured and freshly killed antibody cells due to any of these harmful factors. If at the same time the B-cell is “hyper” and ready to make antibodies in great quantities, there is a good possibility that the B-cell will begin to make antibodies against some of those injured or dead body cells. If that happens, the beginning of an autoimmune disease is in the making! Auto refers to “self” and the disease is thus an immune attack directed against your own normal body cells. The T-lymphocytes are of great importance to all of us since they protect the body from viruses and help with the body’s surveillance against cancer. Besides those important functions they help regulate the B-cells. A certain type of T-cell called a suppressor cell appears to not be functioning well in lupus. The suppressor cell’s job is to suppress the activity of the Bcell. If the suppressor cells are not functioning correctly, they will not suppress the B-cells, which in turn will tend to begin to make too many antibodies. Macrophages are another type of cell that is involved with immune regulation. The macrophage is a phagocytic cell (phago = to get, cyte = cell) and is responsible for picking up foreign proteins that enter into the body and delivering these to the B and
Increase Sulfurcontaining amino acids: cysteine and methionine RAST & Cytotoxic Tests Avoid Caffeine Avoid Alcohol Tryptophan-poor diet Thera-Comp Diet Evening Primrose Oil Vitamin C Vitamin A Biotin, B1, B5, B6, Niacin Zinc L-Glutamine
T-cells. All three types of cells (B,T and macrophages) work together in mustering the correct attack against whatever foreign invader is present. The headquarters for their interaction and planning of the body’s attack is the thymus gland, which is a gland that is present in the neck close to the thyroid. It appears that for correct function and balance of the immune system, the thymus gland has to work correctly. The thymus gland is large in the child, reaches its peak at the time of puberty and gradually diminishes in size and function as we get older. In lupus the thymus gland has been shown to be abnormal in appearance1 and have a premature loss of thymus hormones.2 These deficiencies of thymus function are very important since if the thymus gland doesn’t work properly, the suppressor T-cells will not work properly and hyperreactivity of B-cells will result, setting the stage for the development of lupus. Dr. Jerry Daniels and his colleagues at the University of Texas Medical Branch in Galveston have given thymus hormone to patients with systemic lupus and have found evidence that it will correct certain immune imbalances. They are currently doing a randomized study to see if thymus hormone will help. Since the disease tends to run in families, a genetic tendency may be responsible for many of the thymus gland abnormalities, however the thymus gland also can be injured by a number of things. In childhood, if not enough protein or calories are present the thymus gland will not develop properly. Lack of vitamins, minerals, and
essential fatty acids in a growing child can injure the immune system’s regulating ability – possibly for life. Beside having adequate levels of protein and calories in the diet it has been shown that vitamin B-5, B-6, and B12, vitamin C, zinc, biotin, iron, selenium, essential fatty acids, vitamin A and folic acid3 are essential for proper immune system development. Vitamin B-6 deficiency, for example, causes decreased thymus hormone while a vitamin A deficiency decreases the actual number of T-cells in the blood. During an active flare of the disease the number of circulating T-cells is diminished in the blood while the number of auto-antibodies is increased. Since anything which will diminish the activity of T-suppressor cells will lead to hyper-reactivity of the B-cells the importance of adequate vitamin A and other nutrients in optimizing immune regulation is clear. The main essential fatty acid in food is linoleic acid and this is present primarily in vegetable oils. Once taken into the body linoleic acid is converted into gammalinolenic acid and then into prostaglandin E-1. Prostaglandin E-1 (PGE-1) has many beneficial attributes and a deficiency of this has been linked with a great variety of illnesses. The highest concentration of PGE-1 in the body is found in the thymus! PGE-1 has an effect very similar to thymus hormone in producing growth and development of T-cells. A deficiency of PGE-1 occurs with dietary lack of vegetable oil or when a certain enzyme (delta-6-desaturase) is not working in the body, which normally converts linoleic acid into PGE-1. Hydrogenation of
vegetable fats (as in some margarines) converts a portion of cis-linoleic acid into translinoleic acid, which cannot be used by the body to make PGE-1. Saturated fats, cholesterol, and sugar will inhibit the function of the delta-6-desaturase enzyme and lead to deficiencies of PGE-1. Deficiencies of vitamin B-6, vitamin C, zinc, magnesium and niacin have all been shown to impair the enzyme and result in decreased tissue levels of PGE-1. In 1982 there were no studies on PGE-1 levels in lupus, but many studies have been conducted since then. In one 1995 study, rats treated with the antiinflammatory prostaglandins (PGE-1) had a prolonged survival rate and amelioration of kidney disease4 associated with lupus, suggesting that there is, indeed, a deficiency of these beneficial prostaglandins in lupus sufferers. A related disease (scleroderma) has been treated with some success by giving evening primrose oil orally. This oil has a high concentration of gammalinoleic acid and will increase the body’s levels of PGE-1 since it can sidestep the blocked delta-6-desaturase enzyme. Most people with lupus tend to be women (nine to one) and more depressed and anxious than people with other types of chronic illnesses. Women are most often afflicted with the problem in their childbearing years (20 to 40), and these are the years of greatest stress. Society’s and her own expectations of herself are best exemplified by the saying “A woman is expected to act like a lady, think like a man, and work like a dog.” Stress in excess can precipitate disease in anyone. During the
childbearing years a woman has to take care of her children, husband, the house, the checkbook, the groceries, and the babysitters while working at her own job, menstruating monthly, and always being rushed. Combine all these with the overwhelming feeling of being on a treadmill for which you receive little reward (lack of job satisfaction) and you have a person who is under tremendous stress. Add a virus, injury, sunburn, poor diet, surgery, pregnancy, lack of sleep, poor life habits, etc., and the “spring will have been wound too tight” causing disease to appear. Is it any wonder that the main treatment for lupus is rest? Excessive stress activates the adrenal glands to produce adrenaline and cortisone. Cortisone has an inhibitory effect on suppressor T-cells while adrenaline activates the Bcells to make more antibodies. Stress also causes a decrease in serum zinc as does estrogen and pregnancy. The white spots seen in the fingernails of people under great stress are indicative of this deficiency. Zinc deficiency causes a loss of lymphocyte function and especially of the of the thymus gland cells and the T-lymphocytes.5 This lack of zinc may be one of the reasons why women are so much more susceptible to lupus than men. Addition of zinc to the diet increases the size of the thymus,6 improves the immune system, and facilitates the formation of prostaglandin E-1 from the essential fatty acids. 7
Stress can produce stomach and intestinal spasms or irritability. This irritability of the gastrointestinal tract causes the release of histamine and serotonin into the circulation. These substances directly inhibit the function of suppressor T cells. These observations would indicate that treatment of lupus should be directed at least in part toward inhibition of the production of adrenaline, serotonin and histamine since that will tend to correct the immune imbalance. Adrenaline is produced by both adrenal glands and nerve tissue in response to something perceived as dangerous to you. This produces the well known “fight or flight” bodily responses including the liberation of stored sugar (glycogen) from the liver so that there is enough sugar for the muscles to use if we need to run fast to get away from the perceived danger. If you substitute the word anxiety for danger here, you can appreciate that chronic anxieties will keep your adrenaline pumping hour after hour, day after day. This constant bombardment of adrenaline on the liver causes the eventual depletion of the liver’s stored sugar reserves. When the blood sugar starts to fall a few hours after eating, there is little stored sugar in the liver to be put back in the bloodstream. Hypoglycemia symptoms then begin to appear. Some of the symptoms of hypoglycemia are due to the release of more adrenaline since the body perceives the low blood sugar as another stress. This causes even more loss of the liver stores of sugar leading to more and more problems. Adrenaline itself has a direct stimulating effect on the Bfurther cells and this
stimulation of the B-cells will aggravate allergies and in the case of lupus will worsen the condition. Oftentimes a simple change in diet with avoidance of all sugars, sweet foods and high carbohydrate foods will improve the allergic state! To counteract the excesses of adrenaline there are a number of tricks that can be employed. Raising the intake of the sulfur-containing amino acids (Cysteine and methionine) works by increasing the detoxification system of the liver. Vitamin B-1 (thiamine) is normally the fastest vitamin to be destroyed in the body with a “half life” of 20 minutes. Vitamin B-1 is also used up faster by the body when there is increased sugar or carbohydrates in the diet or when there is more stress and adrenaline in the system. The body must receive adequate levels of vitamin B-1 in order to counteract these increased demands to help normalize the metabolism. Vigorous physical activity is also capable of reducing adrenaline levels and is usually quite helpful at reducing stress levels; but in lupus it is not recommended unless advised by your physician. Food allergies can be of great importance in lupus as well as other chronic diseases. Patients with lupus have indeed been shown to have more food allergies than most people.8 Food allergies are difficult to diagnose and there is a continual controversy over what tests to use if any. In my experience I have found that the use of both RAST and cytotoxic tests give the most accurate results and help the patient the most. If only one or the other is used, often a serious allergy will be missed. This will hamper the healing
process since eating that one food may well produce a tremendous stress on the body and worsening of the condition. Caffeine tends to further stimulate the action of adrenaline in the body and therefore should be avoided (coffee, tea, chocolate, soda pop, etc). Alcohol also must be avoided in all forms since it tends to release adrenaline in the body and also injures the liver, further worsening the problem of hypoglycemia. By interfering with the liver, spleen, bone marrow and lymph node’s phagocytosis actions, alcohol also allows foreign proteins to circulate longer in the body, which tends to produce more allergies. Alcohol also damages small blood vessels (venules) and makes them “leaky” which allows fluid from the blood to escape into the tissues. Once in the tissues this “edema” fluid causes the breakdown of a type of cell called a mast cell, which then liberates its stores of histamine. Histamine aggravates all allergies by causing more leakiness of the small blood vessels (giving the clinical symptoms of water retention, runny nose, welling of tissues and weeping mucous membranes) and by inhibiting the suppressor T-cells. 9 Stress induced adrenaline paralyzes the intestine and interferes with digestion. As food passes into the paralyzed bowel the food will “sit” in one place until such time as the amount of food is great enough to physically irritate the bowel and then the bowel will contract spasmodically. This combination of paralysis and spasm results in the clinical picture of constipation, diarrhea, or alternating bouts of each, which is called the irritable bowel syndrome.
Since 40 percent of the normal population suffers from this condition more or less, the likelihood is that people with lupus may well have the problem also. If the irritable bowel syndrome is present certain changes occur in the bowel. First, the pH gradually changes from the optimum of six to an undesirable eight or nine. These changes occur because the decreased peristalsis allows the food to putrefy and ferment. This allows an overgrowth of harmful anaerobic bacteria and these cause the formation of harmful, toxic, metabolic poisons to be formed from bile salts, foodstuffs, and the bacteria themselves.10 These substances decrease the liver’s ability to detoxify foreign proteins and other poisonous material. Tryptophan is an essential amino acid, which is present in dairy products, nuts and bananas. Once eaten and absorbed tryptophan is converted into serotonin, and 95 percent of the body’s content of serotonin is contained in the bowel wall. When the bowel contracts spasmodically, this serotonin can be released into the blood. Serotonin is thought to be inactivated by a liver enzyme system, which also inactivates adrenaline and related compounds. If the liver has been injured by alcohol, toxic material from the bowel, stress, or has lost its stores of sugar (glycogen) as in hypoglycemia; this adrenaline and serotonin inactivating enzyme system will become overloaded and the blood concentrations of
serotonin and adrenaline will rise. Injection of adrenaline and serotonin into human volunteers causes severely constricted skin blood vessels to the point of cyanosis.11 Serotonin and adrenaline are both powerful blood vessel contractors. Elevated levels of serotonin have been demonstrated in patients with irritable bowel syndrome.12 The irritable bowel syndrome is most often due to nervous tension or food allergies both of which produce excessive levels of adrenaline. This combination of elevated adrenaline and serotonin levels is probably the reason people will have cold hands when they suffer from constipation. From the above you could be led to believe that patients with lupus have elevated levels of serotonin but in fact they have decreased levels! Apparently these people have a decreased ability to convert tryptophan into serotonin in the body due to malfunction of various enzymes. The mechanism for this enzyme inhibition is not clear but a case can be made for tryptophan metabolites as a generalized poison to the body. Injection of adrenaline into human volunteers causes large increases in plasma free tryptophan.12 Stress releases nonesterified free fatty acids from fat and these substances raise the levels of tryptophan. Lack of proper nutrition (proteins-caloriesvitamins) also can raise blood levels of tryptophan. Tryptophan breakdown products have carcinogenic causing properties13 leukemia and tumors in mice. When tryptophan is
exposed to sunlight (UV) in the presence of oxygen as found in and around the capillaries of the skin, a number of poisonous and carcinogenic compounds may be formed. One of the most serious is hydrogen peroxide. If any of these compounds come into close contact with a cell, that cell’s vital structures may be chemically altered to the point that the body no longer recognizes that cell as normal. These changes could then result in the development of autoantibodies. 14 In summary, a person may develop lupus from the complex interactions of stress, injury, anxiety, sunlight, diet, genetics, viruses, etc., all of which raise tryptophan levels either directly or by inactivation of the enzymes that degrade or convert tryptophan into serotonin. The excess tryptophan is partially broken down to form protein damaging chemicals especially in areas of the skin, which are sun exposed and where the circulation is slowed due to blood vessel constriction. The same factors of stress, excess adrenaline, poor nutrition, injuries, etc., also create an imbalanced immune system that is over-reactive in terms of seeking out foreign proteins to destroy. Treatments of lupus should take all of these factors into account. From a dietary point of view the worse the disease is, the more rigid and strict the diet must be. As the disease improves dietary controls can begin to be relaxed. In lupus the use of a diet that is deficient in tryptophan and related compounds is
important as illustrated by the increased survival of animals with lupus on such a diet.15 Removal of saturated fats, chocolates, cholesterol, dairy products, wheat, nuts, pineapple, bananas, sugar, sweet foods, alcoholic beverages, caffeinecontaining drinks and all foods one is allergic to is of great importance when the disease is active. The only possible way of following such a diet is with the help of a computer-selected recipe program such as offered by THERA-COMP P.O. Box 6083, Santa Ana, CA 92706. They are working on an on-line therapeutic dietary program that eliminates foods you are allergic to, or which may aggravate some physical problems. Thera-Comp will prepare a 14-day diet, which excludes whatever foods you wish to exclude. Thera-Comp then tries to construct your diet so that none of the remaining foods is repeated more than once in four days. When this service is ready, the complete diet can be sent to you by priority mail, or by email. The cost will be $12.95. Taking daily supplements of evening primrose oil, vitamin E (non-wheat derived), vitamin C, methionine, cysteine, vitamin A, biotin, Vitamin B1, B5, B6, niacin and zinc will help correct the underlying biochemical abnormalities. L-glutamine may be helpful since it has been shown recently to have a marked anti-inflammatory action comparable to phenylbutazone – a cortisone type of drug. L-glutamine
antagonizes the effects of tryptophan, serotonin, and histamine. 16 In severe cases the use of plasmapheresis is producing beneficial results by actually removing the excess quantities of antibodies.17 The immune system is then suppressed with cortisone to prevent further antibody production. Perhaps the addition of the concepts of stress reduction, a specific diet for each person, nutritional supplements and rest will be of additional benefit and we can chase that old red wolf away once and for all!
1. Arch. Intern. Med. 124: 60-63, 1969. 2. J. Urol. Nephrol. (Paris) 78:994, 1972. 3. JAMA 245(1): 53-58, 1981. 4. Clin Immunol Immunopathol. 1995 May:75(2):125-30 5. Lancet, 7917, 1973. 6. Lancet, 8047, 1977. 7. Med. Hyp. 7: 1211, 1981. 8. J. Allergy Clin. Immunol. 50: 1830, 1972. 9. Amer. J. Med. 71: 100-104, 1981. 10. “Colon Cancer, Part 1,” Let’s Live, November 1981, 11-14. 11. Trans. Ass. Amer Physicians 79: 54-63, 1957. 12. Ann. Intern. Med. 59: 164, 1963. 13. Clin. Sci. and Mol. Med. 53: 227232, 1977. 14. J. Cancer Res. Clin. Oncol, 96: 163-168, 1980. 15. Science 191: 468-469, 1976. 16. Agents and Actions 11, 3: 243249. 17. Dubois, Lupus Erythematosus, 2nd Ed., 121.
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