Videos posted on Holistic Medicine Chats Youtube Channel
MAPS Conference Fall 2019
Discussing topics covered at the Fall 2019 MAPS conference. Topics include mast cell activation, histamines, food sensitivities, epigenetics and more!
Videos posted on Holistic Medicine Chats Youtube Channel
Can Dementia Be Reversed?
A new treatment paradigm for Alzheimer’s disease and other forms of dementia
For decades, conventional medicine has offered little regarding the treatment of patients suffering from dementia or cognitive decline. Alzheimer’s disease is now the third-leading cause of death in North America, after heart disease and cancer. But treatment is possible.
It is estimated that dementia will afflict approximately 50 percent of the next generation of senior citizens (that would be every other person between the ages of 40 and 60 reading this article right now). Most seniors today feel utterly helpless as they witness the deterioration of their cognitive abilities. Some even accept this as a normal part of aging. But dementia is not a normal part of aging and should not be accepted as such.
And while we’ve all met cancer survivors, no one has ever met an Alzheimer’s survivor—until now.
The ReCODE program (or Reversal of COgnitive DEcline) was developed over the past decade by Dr. Dale Bredesen, the director of research for neurodegenerative disease at UCLA and the author of “The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline.”
This treatment program is based on addressing the several dozen mechanisms responsible for the expression of Alzheimer’s disease and is completely in alignment with the principles of integrative and functional medicine.
So what exactly is the ReCODE program? To quote Bredesen: “Imagine you have 36 holes in your roof—because we initially identified 36 different mechanisms involved—if you patch one hole, that’s not going to help you much. You want to patch all the holes. Now, a drug typically patches one hole … [but you need to] patch the other 35 as well.”
The ReCODE program is a full-spectrum, functional medicine approach for addressing all the physiological dysfunctions and imbalances that ultimately present as Alzheimer’s in the patient.
Your brain’s ability to perform its various activities requires connections between brain cells (also known as neurons). You have approximately 100 billion neurons in your brain, and each neuron has approximately 10,000 connections, called synapses. That’s more than 100 quadrillion synapses per brain.
When your brain is in a state of good health, this massive number of connections maintains a balance between cultivating new connections and pruning old connections that are no longer needed. Looking at this problem from a root-cause perspective, Alzheimer’s begins with an imbalance between synaptoblastic activity (building or cultivating synaptic connections between neurons) and synaptoclastic activity (destroying or pruning synaptic connections between neurons). It’s all about restoring balance to the brain.
Alzheimer’s patients are on the wrong side of this balance. Their synaptic building activity (synaptoblastic) is too low and their synaptic pruning activity (synaptoclastic) is too high. Bringing this synaptic dynamic back into balance is the final goal of the ReCODE approach.
Many patients ask what the differences are between Alzheimer’s disease, dementia, and cognitive decline. Cognitive decline is a general term denoting any loss of cognitive function of which dementia is a part.
Dementia is a syndrome used to describe symptoms that impact memory, communication, and performance of daily activities of which Alzheimer’s disease is a part. Alzheimer’s disease is the most common type of dementia, associated with beta-amyloid plaque deposits in the brain and characterized by progressive worsening of memory, language, and thought. Since the term Alzheimer’s is used by the general public to denote any form of dementia, that’s the term I use.
One of the first steps of the ReCODE program in restoring this balance is determining what subtype of Alzheimer’s the patient has:
Type 1: Inflammatory or ‘Hot’
These are patients with mainly inflammatory symptoms. They have a brain that is figuratively “on fire” and balance cannot be restored until the inflammation has been brought under control. There have been many similarities observed between adults with this type of Alzheimer’s and children on the autism spectrum—with some overlap of successful treatment modalities for both.
Type 1.5: Glycotoxic or ‘Sweet’
This is a mixed subtype in between inflammatory and atrophic. This is typically associated with diabetes and insulin resistance and is the most common form of Alzheimer’s that we see and treat.
Type 2: Atrophic or ‘Cold’
These are patients in which disease is driven by a lack of essential nutrients, hormones, or other growth factors. Withdrawal of any of these factors (such as testosterone, estrogen, vitamin D, or essential fatty acids to name a few) will unfavorably alter the synaptic balance.
Type 3: Toxic or ‘Vile’
These are patients with toxic exposures ranging from heavy metals to persistent organic pollutants to biotoxin illnesses such as mold toxicity or Chronic Inflammatory Response Syndrome. Treatment success for these patients is paramount in identifying and removing the toxic exposure.
Type 4: Vascular or ‘Pale’
These are patients in whom their Alzheimer’s is driven by poor circulation of the brain. These patients will frequently have other vascular issues as well, such as coronary artery disease or peripheral vascular disease.
Type 5: Traumatic or ‘Dazed’
These are patients in which disease is driven by traumatic injury to the brain. It can be one large traumatic injury, but more commonly is a result of multiple, recurrent, minor head traumas, such as those seen in professional football players.
These subtypes are not mutually exclusive of one another, and having one subtype doesn’t exclude a person from having another subtype. Most patients will have one predominant subtype driving their disease and then have varying degrees of the other subtypes as contributing factors to their dementia. A successful ReCODE program will address all the patient’s problems in due course.
A frequently asked question is, “What will I be given or what will I need to do for the ReCODE program to work for me?”
The answer to that question is different for every individual. For one patient, the foundational treatment piece may be following a low-glycemic diet far beyond the expectations of the patient’s primary care physician or endocrinologist. For another, it may be correcting their nocturnal oxygenation as a result of their untreated sleep apnea for the past decade. For another, it could be detoxifying them of the lead they had accumulated from a youth spent breathing in leaded gas fumes. Another may require balancing their hormones, and another, controlling their inflammation from their autoimmune disease, and so on and so on. That question cannot be answered until the individual patient has had a complete functional medicine evaluation.
The core treatment strategies of the program are based on diet, lifestyle, supplements, herbs, and medications—usually in that order. This program has no magic bullets, and if that is what you are looking for, then you should look elsewhere. This is a full-spectrum, multi-faceted approach to your neurological health in specific and your overall health in general.
Originally posted on The Epoch Times.
A Wider Path To Wellness
Functional medicine offers patients a uniquely broad approach to wellness
Conventional medicine leaves many patients looking for answers and relief. Even after multiple prescriptions, several tests, and many of those 8–10 minute doctor visits, someone suffering an ailment can be left asking themselves, “Why don’t I feel good?”
If a patient complains long enough, they may receive a psychiatrist referral from their doctor.
This is not a critique of conventional Western medicine, which is responsible for saving thousands of lives on a daily basis. Instead, I want to focus on the patients for whom conventional medicine hasn’t provided the answers or relief they were expecting.
For that sizable group of patients, finding a practitioner of functional medicine can be invaluable. Functional medicine is a personalized and integrative approach to health care that involves understanding the prevention, management, and root causes of complex chronic disease.
By taking the best aspects from conventional medicine, naturopathic, genomic, integrative, and various other modalities, it offers one of the most comprehensive and effective approaches to health care in the 21st century.
The focus is the patient and their unique presentation and response. Practitioners of functional medicine are flexible and results-driven, using whichever medical approach suits the personalized needs of the patient and addresses the cause of their problem.
Some critics who don’t understand functional medicine say it rejects conventional medicine, but that is untrue for the majority of practitioners. According to the Institute for Functional Medicine (IFM), the leading provider for functional medicine education to health care practitioners in the world, more than 75 percent of their current trainee’s have an underlying training in conventional medicine as a medical doctor, doctor of osteopathy, nurse practitioner, or physician’s assistant. They don’t throw away those years of conventional medical training, rather, they educate themselves further in order to add more tools to their toolbox when evaluating and treating their patients.
What makes functional medicine so effective?
To start is the concept of systems biology, which is the study of the interactions and behavior of the components of biologic entities, including molecules, cells, organs, and organisms. This is the philosophical foundation of functional medicine and all of the patient’s symptoms and complaints are seen through this lens.
There is also much more focus placed on determining the state and balance of the various foundational systems within the patient’s body rather than simply giving a diagnosis paired with a symptom-suppressing treatment. These foundational systems include: mitochondrial function, methylation, hormone balance, gut microbiome, detoxification capacity, HPA axis, and the gut-immune-brain axis to name a few.
While the conventional diagnosis itself is sought after in some cases, it isn’t mandatory to establish root causation of the patient’s problems.
Natural treatments are strongly preferred within functional medicine with an emphasis placed on nutrition, lifestyle, and exercise. We aim to use treatments which work with the natural rhythms and cycles of the body rather than against them. Pharmaceutical medications are also used, but only after we have exhausted or failed natural means.
Mental complaints in many cases are seen as a potential equivalent to neurological physical symptoms and treated as such. The root cause of many mental health diagnoses, such as depression and anxiety, can be found outside the brain and successfully treated. Emotional, mental, and spiritual components are always considered in every workup, in addition to the more obvious physical components.
And importantly, functional medicine is more health-oriented and patient-centric than conventional medicine. The ultimate goal of functional medicine to optimize each patient’s health. This is unique to each person and goes beyond only ensuring the absence of disease.
Functional medicine expands a physician’s toolbox beyond pharmaceuticals and surgery. It also includes botanicals, supplements, therapeutic diets, exercise plans, functional neuro-rehabilitation, detoxification programs, stress management techniques, and much more.
One of the goals is for the physician and patient to become active partners. Such a partnership allows the patient to truly be in control of improving their health and achieving optimal wellness.
Originally posted on The Epoch Times.
Childhood Brain Development and Autism
Many areas of autism spectrum disorder (ASD) are still widely misunderstood. However, great strides have been made in recent years, and doctors have much more information regarding childhood brain development and its relationship to autism.
While autism awareness has become more prevalent over the last decade, much of the research has focused on syndromic ASD, which accounts for approximately 25% of the diagnosed cases.1Syndromic autism, such as fragile X syndrome and tuberous sclerosis complex, has a genetic component that has allowed scientists to confirm the root cause of the disorder through targeted genetic tests. However, with 75% of ASD children falling into the non-syndromic autism category, scientists and clinicians are using the data learned from syndromic ASD to extrapolate relevant theories for what may be driving the brain development of the majority of diagnosed children.2
Chronic Inflammation and the Development of Non-Syndromic ASD
A prominent theory suggests that chronic inflammation in the brain may cause damage to neurons during the early years of development. The brain contains groups of cells, called microglial or astrocytes, and they function like neuron helper cells. They work by removing any debris or dead neurons from the nervous system by a process called pruning.
These cells are essential between the ages of 1.5 and 2.5 because, during this time, there is a significant amount of cellular and synaptic pruning that occurs naturally in the brain for proper development. Pruning can be considered a time when the brain is deciding which areas it needs to focus on with its resources. This is one of the reasons why it’s rare for children to have any real active memory earlier than the age of two.
A study found that the brains of children affected by ASD have excessive excitatory neuronal synapses due to a lack of brain pruning from poorly functioning microglial cells. One of the theorized causes of dysfunctioning microglial cells is chronic inflammation produced by an overactive immune system. 3
GABA and Glutamate Imbalance in ASD
Autism is characterized by deficits in social communication and repetitive behaviors often associated with emotional withdrawal or emotional outbursts.4 Our brains have over 100 neurotransmitters involved in various aspects of our physical and psychological functioning, including our sleep, appetite, heart, and mood, while GABA and glutamate have opposing effects, where GABA is calming and glutamate is activating.
Normally, we are constantly balancing the activation and deactivation of various neurotransmitters. When it comes to children with ASD, however, there is a preponderance of excitatory glutamate over the GABA, so they tend to have more issues with self-stimulatory behaviors, anxiety, and temper tantrums.5 When people stereotype children with ASD as being withdrawn or unemotional, it may just be that they are experiencing an overwhelming sensation of stimuli due to the lack of brain pruning and an imbalance of glutamate in the brain.
How Brain Structure Affects Function
The first few years of a child’s life are crucial to the proper development of the nervous system, as well as the brain. As mentioned previously, brain pruning and excessive inflammation can lead to a disruption in the appropriate formation of neuronal synapses that become the information highways of the brain.
A study looking into the early pathology of children with autism showed that during the first two years of a child’s life, there is an atypical overgrowth of the brain in the cerebral, cerebellar, and limbic parts. In particular, an enlarged amygdala—a part of the limbic system in the brain responsible for emotional processing—is associated with an increase in emotional responses and behavioral disorders. The overdevelopment of certain brain regions in ASD is followed by a premature slowing in brain development.6
Another critical factor is the role of microtubule scaffolding. A neuron has three types of necessary building block materials that help maintain its proper structure and function: actin, microfilament, and microtubules. Actin helps neurons grow dendrites and an axon, microfilaments help with the neurons’ flexibility and strength, and microtubules are the circuit boards and structural scaffolding of the neuron.
While research is relatively new in the role of microtubule scaffolding in ASD, there is the theory that dysfunctional microtubule scaffolding in the neurons could manifest into more complex issues involved in social behavior or communication down the line.
Early Intervention Is Key
The brain is an incredibly complex matrix of chemical and electrical signaling. The neurobiological and genetic components involved in facilitating the development of autism are still being researched, as the majority of children with ASD have the non-syndromic, multifactorial form. For parents and clinicians alike, early intervention is key to improving the wellbeing of the child as they grow.
Chronic inflammation of the nervous system and its impact on microglial “housekeeper” cells – which reduce necessary brain pruning at an early age and results in excessive synapse connections– structural overgrowth of brain regions like the amygdala, and an imbalance of GABA and glutamate neurotransmitters are all potential targets for researchers to study and gain a better understanding of how and why autism occurs. Parents can stay optimistic in knowing that researchers are addressing issues in early childhood brain development and interventions with the possibility of reducing the severity of ASD symptoms are on the horizon.
Originally posted on DaVinci Labs.
Sources:
1 “Syndromic Autism Spectrum Disorders: Moving From a Clinically… – NCBI.” 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789213. Accessed September 20, 2019.
2 “Brain Cell Development Differs in Kids With Autism – WebMD.” 2018. https://www.webmd.com/brain/autism/news/20180330/brain-cell-development-differs-in-kids-with-autism. Accessed September 20, 2019.
3 “Microglia Gone Rogue: Impacts on Psychiatric Disorders… – NCBI.” 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758507/. Accessed September 20, 2019.
4 “Brain Development in Autism: Early Overgrowth Followed by… – NCBI.” 2004. https://www.ncbi.nlm.nih.gov/pubmed/15362165. Accessed September 20, 2019.
5 “GABA and Glutamate: Their Transmitter Role… – IntechOpen.” 2017. https://www.intechopen.com/books/gaba-and-glutamate-new-developments-in-neurotransmission-research/gaba-and-glutamate-their-transmitter-role-in-the-cns-and-pancreatic-islets. Accessed September 20, 2019. How F
Nutritional Deficiencies in Kids with Autism
Many autistic children struggle with chronic illness from a young age.
It may start as early as in utero and is often diagnosed within the first year and a half of life. These children often live with extreme inflammation in their bodies.
Generally speaking, kids with autism have a discrete immune dysfunction that can be associated with mitochondrial dysfunction and inefficiencies in methylation leading to a pro-inflammatory character.
People in a chronic inflammatory state may also chronic gut issues. Whether the problems start in the gut or gut problems are the result of the inflammation usually isn’t known without advanced testing. No matter which came first, the result of gut problems is reduced nutrient absorption and decreased utilization of nutrients.
Another factor that could exacerbate nutritional deficiency in children with autism is a sensory processing disorder. If a child has an adverse reaction to certain smells, tastes, and textures, it could result in a limited diet.
Parents may believe that it’s alright to let their kids eat only a few foods or that their diet, which may be mostly made up of simple carbs, isn’t a problem. For many years the food pyramid stated that 50% of our diet should be carbs and many people still follow this outdated guidance. Especially for someone dealing with gut issues and nutrient deficiencies, starchy foods can make the problem worse.
Vitamin D
It requires a lot of nutrients to remain in a chronic inflammatory state. For this reason, many children with autism have severe vitamin D deficiencies. Even kids who spend a lot of time out in the sun may have low levels of vitamin D. It’s being exhausted to maintain the inflammatory state.
Supplementing with 5,000 to 10,000 units each day would usually raise vitamin D levels, but in kids with autism, their nutrient levels may not rise enough with the same amount of vitamin D you’d give to a child that is outside of the autism spectrum.
Folate
Some kids in the autism spectrum have a cerebral folic deficiency, which is an autoimmune disorder. It shows up more frequently in autistic kids. These children’s bodies make antibodies to folate, preventing it from penetrating into the blood-brain barrier.
It may be necessary to supplement folinic acid or other activated forms of folate in an amount that’s thousands of percent higher than the recommended daily allowance (RDA) to combat this problem.
Methylated B Vitamins
A general inefficiency in methylation, which is the economy of metabolism, requires additional B vitamins. This would include B12, folate, B6, and B1. Without efficient methylation, it’s challenging to get a child into a healthy state. DMG is another essential nutrient that can be used to support B family vitamins and methylation pathways.
Zinc
It is common for children within the autism spectrum to have Zinc deficiencies. As this essential mineral affects taste and smell, supplementing can help increase the variety of foods a child will eat. A critical co-factor for hundreds of metabolic pathways in the body.
Magnesium
Magnesium is another essential co-factor for countless metabolic pathways in the body. A side-effect of magnesium supplementation is that it moves the bowels. So magnesium supplementation is critical for children with chronic constipation. Magnesium can also help with brain fog, anxiety, agitation, and irritability.
Omega 3 Fatty Acids
Diets high in fish aren’t typical for most children, so it’s crucial to supplement omega 3 fatty acids to support neurological health. This can also help with dry hair and skin, problems focusing on the tasks and attention span. It may take a few months to see results with omega 3 fatty acid supplementation takes time to change the fatty acid content of the cell membrane.
Conclusion
When nutritional therapies start to work to help “wake up” an autistic child, they become more engaged in their surroundings. This may lead to increased speech and the ability to communicate with parents, family members, therapists, and teachers. Improved eye contact, social engagement, and communication for purposes other than getting their needs met are signs that therapies are working.
Another indication that nutritional therapies are useful is a reduction in self-soothing behaviors, which indicates a decrease in the overall levels of inflammation in the brain.
Kids who are well past the regular potty-training age may be able to attain some age-appropriate activities of daily living when their gut begins working correctly. Things they were cognitively capable of but didn’t have the skills or mitochondrial energy efficiency to achieve may become attainable. This can include everything from being able to use the bathroom on their own to the development of age-appropriate social skills.
With a broad-spectrum approach, a functional medicine doctor may try to locate the source of the inflammation and reverse it. However, with a young child presenting symptoms of autism, it’s essential to act quickly. Gut health is a primary concern because, without it, supplements can’t do their job.
Some doctors prefer to move through the process faster by correcting everything they can and then working on the subtler points with additional testing or by withdrawing single supplements to measure their effectiveness better.
Mitochondrial support, methylation support, gut support, and fish oil are reasonable first steps to helping a child with autism manage their symptoms.
Originally posted on DaVinci Labs
Critical Tests a Functional Medicine Practitioner Provides
One of the most telling differences between conventional medicine and functional medicine is how diagnostic testing is approached.
In conventional medicine, the focus centers on the patient’s presenting symptoms, and then medications or treatments are prescribed to help alleviate or manage the symptoms. Functional medicine is more concerned with a systems approach to medicine, in which all aspects of a patient’s profile—environment factors, emotional factors, toxins, gut health, food sensitivities—are considered before prescribing remedies.
How L-Glutamine Improves A Leaky Gut
Gut health is slowly but surely taking center stage in the quest to identify the root causes of inflammatory diseases.
Science continues to connect myriad chronic health conditions to inflammation spurred by irregularities in the digestive tract. These conditions include a variety of chronic gastrointestinal issues, including irritable bowel syndrome, small intestinal bacterial overgrowth (SIBO), dysbiosis (imbalance in gut bacteria), and leaky gut.
How To Create A Plan For Metabolic Health
Only 12% of Americans have ideal metabolic health—an alarmingly low number (source).
Recent calculations showed that just one in eight Americans had good metabolic health. But on the bright side, more people than ever are aware of the effects that the metabolism has on their overall vitality. Patients now seek out functional medical practitioners in higher numbers to help guide them along the path towards a better quality of life through improved metabolic health.
Natural Strategies for Circadian Rhythm Disorders
Across the board, sleep disorders are one of the top complaints healthcare professionals hear from patients.
When seeking natural methods that can improve sleep quality, frustrated patients commonly report difficulty falling asleep or staying asleep. Sleep disorders often result from a disordered circadian rhythm, but sleep aid medications can come with a host of undesirable side effect. So finding new, natural ways to recalibrate this important system and achieve sound sleep is a top priority.