December 15, 2011

Allergies, Sensitivities, and Intolerance

In the last post i talked about the association between a leaky-gut and a leaky-brain, and that the nexus is inflammation.   Inflammation, again, is part of an allergic reaction, which is narrowly defined as symptoms following a histamine response.

Since we have been focusing on food, nutrition, and gut health, i wanted to spend a few moments clarifying food allergies,  which are becoming a major concern in our society, so much so that peanuts are now banned in public schools. in fact, the incidence of food allergies has increased by 8% from 1997-2007 in children under 18 years of age.  There are many theories as to why food problems are on the rise, from our overly hygienic society to the surreptitious use of GMOs (genetically modified organisms), but that is for a later posting. Continue reading… »

Category: Nutrition

November 18, 2011

Fire in the Whole

There is a phrase in functional medicine that says: fire in the gut, fire in the brain.

What this means is that inflammation (Latin for ignite or set alight) in the GI system will lead to inflammation in the brain (and body systemically).   GI irritation can come from multiple factors- food sensitivities, bacteria, yeast, medications, stress, etc. The intestinal wall is just one cell layer thick and bound together by “tight junctions.”  Just beneath this cell layer lies the GALT, or Gut-Associated Lymphoid Tissue), which constitutes approximately 60% of our immune system.  When the gut becomes inflamed or irritated, these tight junctions become permeable, allowing food-stuff, bacteria, yeast, etc -essentially anything in your intestine that is small enough to fit through that space- into your body, setting off the immune response cascade.  This process is commonly referred to as the  leaky-gut syndrome. Continue reading… »

Category: Nutrition

November 10, 2011

TRUE HOPE (Part III)

So if we begin with the idea that we are likely all malnourished, and that nutrient deficiencies play a role mental illness, an obvious and safe place to begin would be with replacing those nutrients to see what emerges.  Given the interplay of all of the micronutrients, including essential fatty acids and amino acids, moving beyond the single nutrient interventions except where obviously devoid (i.e. beriberi) to utilize a potent micronutrient mixture in a somewhat sawed-off shotgun approach would make the most sense as a first line strategy.  To first use what your body has evolved to run on optimally, but may be missing, and thus give your body a chance to heal itself, before inserting some foreign chemical in there to literally alter neurological functioning (in the case of most psychotropics which alter neuronal firing, receptor expression and sensitivity, neurotransmitter expression, etc).  Medicines do have a place in mental health care and often times are necessary to quell urgent problems.  They can be life saving.  But as a first line remedy, nutrients make natural sense. To FIRST DO NO (p)Harm and to begin by replenishing the body and brain completely. Continue reading… »

Category: Nutrition, Treatment

October 27, 2011

True Hope (Part II)

As I said previously, about 92% of children do not get their basic, daily nutrients.  When looking at the population at large, most Americans do not meet their recommended daily allowances.   According to the USDA, the percentages of US population not getting the RDA for a given micronutrient is as follows:

  • Calcium                     72.9%
  • Folate                        75.1%
  • Iron                             34.3%
  • Magnesium                68.0%
  • Niacin                          24.2%
  • Phosphorus             21.7%
  • Riboflavin                  21.8%
  • Selenium                    14.8%
  • Vitamin A                     54.7%
  • Vitamin B6                   35.3%
  • Vitamin B12                 29.9%
  • Vitamin C                    48.3%
  • Vitamin E                    85.9%
  • Zinc                             42.0%
  • Copper                       30.7%

(Data borrowed from a presentation by David Hardy, cofounder of Truehope, at the Micronutrients in Mental Health conference 2011). Continue reading… »

Category: Nutrition, Treatment

October 7, 2011

True Hope (Part I)

“Leave your drugs in the chemist’s pot if you can heal the patient with food” – Hippocrates

It is possible to use micronutrients to treat mental illness.  This is a topic that I will come back to frequently as it is something in which I strongly believe and cannot emphasize enough.  Especially when it comes to first line remedies and our mandate to “first, do no harm.”   If we can use vitamins and elements that our body already naturally runs on to heal someone’s illness, rather than inserting some foreign chemical to block or alter a receptor  (the reality is we that we don’t really know how most psychotropics really work), it would be a far healthier, safer, and natural means of treatment, in spite of supposed industry standards of care.   Especially as a first line remedy, as we can always move on to the industry standard of care next if need be. Continue reading… »

Category: Nutrition, Treatment

September 30, 2011

Bacteria and Behavior

Recent research in the realm of gut bacteria has revealed amazing connections between your gut and your behavior.  Practitioners in functional medicine have long known about the gut-brain axis, as has really anyone dealing with irritable bowel syndrome. We have approximately 3 pounds of bacteria in our GI system which function synergistically to help us regulate digestion, absorption, and protection (from infection).  Bacteria also have a role in vitamin synthesis and regulation, like vitamin B6 (which is also an essential component in our body’s synthesis of neurotransmitters, like serotonin).    It appears that the bacteria in your GI system (your microbiome) might also have influence over your  biochemistry and brain development. Continue reading… »

Category: Nutrition

September 16, 2011

“Blessed are the sleepy ones…”

“Blessed are the sleepy ones, for they shall soon fall off.’

- Nietzsche

An attending physician once told me that if a child isn’t sleeping, all bets are off on an accurate diagnosis. Because I myself was so severely sleep deprived at the time, that adage didn’t immediately penetrate my mental fog; but as I’ve practiced medicine and started raising my own kids, the paramount importance of sleep cannot be overemphasized.

Our society as a whole seems to be sleep deprived, a trend likely reflected in our excessive caffeine consumption/dependence (estimates are that between 80-90% of adults and children habitually consume caffeine).   It is no coincidence that mental illness diagnoses are also on the rise, especially the concerns for overly hyperactive children.   According to the Sleep in America polls, about 20% of Americans report getting less than 6 hours of sleep per night (on average).  Surveys from the National Sleep Foundation estimate that half of all adolescents get less than 7 hours of sleep on weeknights, with high school seniors averaging just slightly more than 6.5hours/night. Continue reading… »

Category: Sleep

September 6, 2011

You are what you eat

In the documentary “Super Size Me,” Morgan Spurlock explores the ramifications of a 100% fast food, super-sized diet on his physiology and psychology over the period of one month.  Although it is not a new movie, his message is still worth reiterating.

In one telling scene, he visits an “alternative” school in Wisconsin for kids with behavior problems who couldn’t function in a traditional school setting.  The school was alternative in another major way as well.  It provided a healthy lunch program and removed the school’s vending machines.  The school noted improvements in focus, behaviors and mood.  The changes were astounding.  And, at least for the movie, the supposed troublemakers and delinquents walking the halls were calm, polite, and in control.   The change was likely not entirely attributable to diet, but certainly worth a consideration, especially when you consider the amount of trouble our nation’s youth face in terms of obesity, diabetes, depression, anxiety, ADHD, and the whole cadre of other mental and medical ailments that, in all seriousness, might just have a root in the standard American diet- or SAD diet as Dr. Mark Hyman calls it. Continue reading… »

Category: Nutrition

September 6, 2011

The Triage Theory

There are many theories of developmental psychopathology and much has been written on the meaning of mental illness, spanning religion, science, philosophy, economics- essentially almost all disciplines have looked into this.  Where there is any type of philosophy, there is also psychology; the same goes for great literature.  For a particularly thorough- and disturbing- history of psychiatry and mental illness, one should delve into Madness and Civilization by Michel Foucault, or his Birth of the Clinic, which traces a more general development of hospital systems and health-care.

But rather than lose myself in the debate on the question of “Is there mental illness?”- I want to talk about a triage theory of aging and illness that might be particularly apropos in our graying society, as indeed, aging, mental decline, and mental illness are in fact all related. Certainly in the case of dementia, they are practically inseparable. Given enough time, we will all lose are minds. Continue reading… »

Category: Nutrition

September 6, 2011

Primum non nocere

Primum non nocere.
First, do no harm.

The Hippocratic oath is recited by rising physicians upon completion of their medical training and signifies the demarcation point of accepting the responsibilities of a medical degree.  It is often oversimplified with the simple phrase: first, do no harm. Primum non nocere.   Although these words do not appear exactly in the oath, this notion of nonmalficience forms the cornerstone of medical ethics.  Nonmalficience is generally balanced with beneficence, which describes actions done for the benefit of others. A far simpler way to state this idea is as risks verse benefits.   In the notion of treatment, and especially pharmacology, this balance IS the guiding principal.  If the risk of a medication outweighs the benefit gained by taking it or is more noxious than the illness being treated, you don’t prescribe it; but if the illness is so odious that peril in the lack of treatment outweighs the potential treatment’s side-effects, the medication is administered. A typical case in point is with most chemotherapy for cancer.  Chemotherapy essentially works by targeting and killing fast growing cells. In addition to the cancer cells, other fast growing cells are in the hair and gut- thus, the more obvious (side)effects of alopecia and anorexia, the usual outward manifestation of the cancer victim’s private fight. Untreated cancers usually have a high death rate.  In general, most people find hair loss better than dying, so chemotherapy, in spite of, or actually because of, its toxicity, is usually administered.    Where this balance becomes much grayer is in the field of psychiatry and mental illness, and especially child and adolescent psychiatry. Continue reading… »

Category: Introduction