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ASYMPTOMATIC DISC HERNIATIONS: THE IMPLICATIONS OF DISC HERNIATIONS IN THE ABSENCE OF PAINRead Now
What you have to do is figure out how big a wrench it's going to take to jam the gears and stop this vicious cycle. Remember, drugs might change your symptoms, but they never stop the cycle. What I would like to do right now is take a quick look at some of the studies that show this cycle, and how this dysfunction all works together in unison (I chose these particular studies because if you are interested, you can look them up and read them in their entirety). The point of doing this?
For those of you who are deep into these and other similar disease processes, you need to realize there is hope (stick around and I'll prove it to you). One critical fact you must grasp before we begin is that it is not as likely as you have been led to believe that your children will be condemned to the same fate as you simply because of their genetics. Why not? Science has given genetics way too much importance as far as the development of most diseases is concerned. What do I mean by this? If you don't understand the difference between genetics and epigenetics as related to chronic inflammatory degenerative illnesses and autoimmune diseases, it is imperative that you take five minutes to read THIS POST on the topic. Also, if you are not sure what INFLAMMATION is (hint; it's not swelling or infection), don't bother continuing because it won't make sense.
- PARKINSON'S DISEASE: Listen to the conclusions from a two year old issue of the World Journal of Gastroenterology (Brain-Gut-Microbiota Axis in Parkinson's Disease). Make sure to look for all five entities mentioned in the cycle above (BTW, this is quoted word-for-word). "Parkinson's disease (PD) is characterized by alpha-synucleinopathy that affects all levels of the brain-gut axis including the central, autonomic, and enteric nervous systems. Recently, it has been recognized that the brain-gut axis interactions are significantly modulated by the gut microbiota via immunological, neuroendocrine, and direct neural mechanisms. Dysregulation of the brain-gut-microbiota axis in PD may be associated with gastrointestinal manifestations frequently preceding motor symptoms, as well as with the pathogenesis of PD itself, supporting the hypothesis that the pathological process is spread from the gut to the brain. Excessive stimulation of the innate immune system resulting from gut dysbiosis and/or small intestinal bacterial overgrowth and increased intestinal permeability may induce systemic inflammation, while activation of enteric neurons and enteric glial cells may contribute to the initiation of alpha-synuclein misfolding." Why am I at least somewhat concerned about this nasty creature named by doctor Parkinson? I undoubtedly carry the gene (HERE). And for those who are not sure what GLIAL CELLS are (you'll see them come up time and time again), just click the link.
- NEUROPSYCHIATRIC DISORDERS: This collaboration (Gut-Microbiota-Brain Axis and Effect on Neuropsychiatric Disorders with Suspected Immune Dysregulation) between Greek and American scientists / physicians was published in HHS Public Access, and is one of the most amazing put-it-all-together studies I have yet to see on this topic. "Brain function and psychological make-up are now increasingly considered to have a reciprocal relationship with the gut. Disruption of the gut microbiota (dysbiosis) is known to contribute, among others, to the pathogenesis of GI diseases, and reported to directly induce inflammation and pain. Accumulating evidence suggests that the gut microbiota maintain bidirectional interactions with critical parts of the central nervous system (CNS) and the immune system through direct and indirect pathways. These involve the endocrine (hypothalamic-pituitary-adrenal (HPA) axis), immune (chemokines, cytokines), autonomic nervous system (ANS), and enteric nervous systems forming the microbiota-gut-brain axis. Antibiotics, environmental and infectious agents, intestinal neurotransmitters / , sensory vagal fibers, cytokines, essential metabolites, all convey information about the intestinal state to the CNS. Such interactions appear to influence the pathogenesis of a number of disorders in which inflammation is implicated such as mood disorder, autism-spectrum disorders (ASDs), attention-deficit hypersensitivity disorder (ADHD), multiple sclerosis (MS) and obesity (Obesity has been called a psychiatric disease) and is associated with depression and other neuropsychiatric disorders). Neuro/immune-active substances derived from the intestinal lumen can penetrate the gut mucosa, be transported by blood, cross the blood-brain-barrier (BBB) and affect the CNS. Acute stress increased GI and BBB permeability. Moreover, chronic stress disrupted the intestinal barrier and permitted penetration of luminal antigens, microflora metabolites, toxins and lipopolysaccharide (LPS) into the systemic circulation and the CNS." Did you notice that all five aspects of the cycle were present in full-blown Technicolor and Dolby Surround Sound?
- MULTIPLE SCLEROSIS: So, in light of everything that I've shown you, should we be even bat an eye when articles like STAT'S Gut Germs Play Role in Multiple Sclerosis, are published? No way! While it's certainly good to know (I've discussed this link at least twice before --- HERE and HERE), the real question remains; what are you doing about this since your doctor isn't doing much of anything other than prescribing more drugs? In the first of two brand new studies, both from last month's issue of PNAS, researchers compared the MICROBIOMES of 71 people with MS and 71 without MS. What they found was that "specific bacterial taxa were significantly associated with MS" (dysbiosis). But interestingly enough, they also found that there was a certain strain of bacteria that was "reduced in MS patients." Because the researchers believed this bacteria was associated with antiinflammatory properties, they introduced feces from the MS group into mice that had been genetically raised to be "germ free". The result was mice with fewer TREGS (T-suppressor cells that dampen immune system responses as to prevent autoimmunity) and fewer antiinflammatory cytokines, leaving them with symptoms of MS ("experimental autoimmune encephalomyelitis"). In the second study, the authors took identical twins, where one had MS and the other did not. They noticed that when they transplanted feces of the MS twin into mice that had been genetically raised to express "spontaneous brain autoimmunity," those mice were much more likely to develop an "MS-like autoimmune disease." I need to note to you; one major difference in MS patients is that they tend to have low sympathetic function (as opposed to high), which often results in heart, bladder, and bowel issues. By the way, I found studies over two decades old (Digestive Diseases and Sciences --- Multiple Sclerosis Patients Have Increased Intestinal Permeability) that showed this link via their title. The moral of this story is NEVER underestimate the importance of GUT HEALTH in dealing with chronic conditions!
- CHRONIC "LEARNED" PAIN: This two year old study was done at St. Louis' Washington University and published for the International Anesthesia Research Society (Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea). "Complex regional pain syndrome (CRPS), formally known as reflex sympathetic dystrophy, is a neuropathic pain disorder that may fail to respond to current therapy... There is a known relationship of CRPS and the gastrointestinal tract. Dysbiosis (alterations of the microbiome) and increased intestinal permeability (which is present in SIBO) have been reported in CRPS, and these two conditions also cause chronic systemic inflammation. IBS is common in CRPS although the relationship has hitherto not been elucidated. In multiple studies, SIBO was found to be present in up to 50% of IBS-d patients." IBS and IBD are both known to be autoimmune, while SIBO is typically the result of a sensitivity to FODMAP-CONTAINING carbohydrates. And as you might imagine from its old name (Reflex Sympathetic Dystrophy), the sympathetic side of the ANS is hyped to the max in those with CRPS.
- INTENSE EXERCISE: Just ten short months ago, the Journal of the International Society of Sports Nutrition published a study called Exercise-Induced Stress Behavior, Gut-Microbiota-Brain Axis and Diet: A Systematic Review for Athletes. The European authors concluded that "The demands during intense exercise can initiate a stress response activating the sympathetic-adrenomedullary and hypothalamus-pituitary-adrenal (HPA) axes, resulting in the release of stress and catabolic hormones [these break your body down], inflammatory cytokines and microbial molecules. The gut is home to trillions of microorganisms that have fundamental roles in many aspects of human biology, including metabolism, endocrine, neuronal and immune function. The gut microbiome and its influence on host behavior, intestinal barrier and immune function are believed to be a critical aspect of the brain-gut axis. Recent evidence in murine models shows that there is a high correlation between physical and emotional stress during exercise and changes in gastrointestinal microbiota composition. Diet is known to dramatically modulate the composition of the gut microbiota. Due to the considerable complexity of stress responses in elite athletes (from leaky gut to increased catabolism and depression), defining standard diet regimes is difficult." There are the five; together again for what hopefully turns out to only be a 'limited engagement'.
So, what are you supposed to do if you have these or other inflammatory, degenerative, or autoimmune disease? The first thing you must is learn everything you can about it you can and make yourself an expert. Thanks to the internet; some diligent study on your particular condition (use PubMed or other databases of medical studies, as well as message boards), and a large percentage of you will be as knowledgeable as your doctor(s) on your particular issue. Face it; the gap between the cool stuff coming out of medical research (the stuff I showed you today) and the standard fare of CRAPPY DRUGS or WORTHLESS TESTS you get at your doctor visits makes the Grand Canyon look like the tiny ditch in your front yard. Be willing to step out of the box just a bit and watch what happens!
Secondly, using said information, sit down and create yourself a top-to-bottom EXIT STRATEGY. Although you may have to modify your plan along the way for any number of different reasons (including new information coming available) purpose in your heart to stick with it and work it as though your life depends on it --- because it probably does. Fortunately, I have created an extremely generic template for making this happen (HERE). For many of you, this is all you'll need. For the rest, there are people out there versed in FUNCTIONAL NEUROLOGY and FUNCTIONAL MEDICINE that can likely help. One last thing. If you are chronically ill, DO NOT go to sleep tonight without learning the basics of one of the hottest topics in the medical research field right now --- FECAL MICROBIOTA TRANSPLANTS.
NEW STUDY TALKS ABOUT THE RELATIONSHIP BETWEEN DIETARY CARBS, DIETARY FATS, CARDIOVASCULAR DISEASE, AND DEATHRead Now
"The great enemy of truth is very often not the lie—deliberate, contrived and dishonest—but the myth—persistent, persuasive and unrealistic. Too often we hold fast to the cliches of our forebears. We subject all facts to a prefabricated set of interpretations. We enjoy the comfort of opinion without the discomfort of thought." From President John F. Kennedy's Commencement Address at Yale University, June of 1962
The Lancet has long been considered one of the most prestigious medical journals in the world (established in 1823, it also happens to be one of the oldest). In light of the direction the journal has taken over the past several years, I was surprised to see their latest issue carrying a massive study called Associations of Fats and Carbohydrate Intake with Cardiovascular Disease and Mortality in 18 Countries from Five Continents (PURE): A Prospective Cohort Study.
Over 40 authors from universities and labs around the world crunched a decade's worth of data from the dietary intake questionnaires of over 135,000 people (both males and females between the ages of 35 and 70) from five continents, looking chiefly at ratios of carbs to fats to protein as related to....
- Fatal Cardiovascular Disease
- Fatality From All Causes
- Non-Fatal Heart Attacks
- Strokes
- Congestive Heart Failure
Before we look at their conclusions, I want to share some history on this topic. To do that, I am going to take you back to 1988; the year I finished at Kansas State University (Nutrition / Exercise Physiology) and started the CHIROPRACTIC PROGRAM at Logan University. Because I remember years by music or sporting events (HERE), here are a few songs that were playing on the radio back then to help your mind drift back in time three decades.
By 1992, the USDA had put out their now infamous Food Pyramid. While the idea of using diagrams to simplify the process of helping people make smart dietary decisions was nothing new, the Food Pyramid (picture below) attempted to simplify things even further, and was nothing if not simple. The Pyramid's insinuation was that since it was fat that made you fat as well as being the causal factor behind just about any disease process you cared to mention, you could eat as much of the bottom row (grains) as you wanted. The problems is, as a person who grew up on a Kansas beef farm, I can tell you exactly what happens to cattle if you feed them unlimited quantities of grain. And unfortunately, it's no different for people.
Furthermore, we were told to use fats and oils "sparingly". Again, the insinuation was that since dietary fat was the cause of our collective health problems, the less you could eat the healthier you would be, with many touting novel ways to eat totally "Fat Free". Interestingly enough, in the pre-WW II dietary recommendations, the government was already touting FORTIFIED MARGARINE as a healthy alternative / equivalent to butter (any time you see the word "fortified," run far and run fast because it means that any real nutrition has been removed and replaced with SYNTHETIC NUTRITION, usually for the express purpose of increasing shelf-life). Who invented this pyramid that has wreaked so much havoc on American health, leaving in it's wake a path of disease and death?
The original recommendations of up to 4 servings of grain a day was replaced with up to 11 servings (GULP!). And that's not all, the final pyramid even had a picture of saltine crackers --- something for years touted as a "healthy snack" on the AMERICAN HEART ASSOCIATION'S sample diet and dietary recommendations (I used to keep a copy in the office but am not sure what happened to it). I am cherry-picking her article here (for the record, realize that the primary aim of the USDA has nothing to do with safety or health, but instead to promote US agriculture in America and around the world).
"When our version of the Food Guide came back to us revised, we were shocked... As I later discovered, the wholesale changes made to the guide by the Office of the Secretary of Agriculture were calculated to win the acceptance of the food industry. For instance, the Ag Secretary's office altered wording to emphasize processed foods over fresh and whole foods. Where we, the USDA nutritionists, called for a base of 5-9 servings of fresh fruits and vegetables a day, it was replaced with a paltry 2-3 servings. Our recommendation of 3-4 daily servings of whole-grain breads and cereals was changed to a whopping 6-11 servings forming the base of the Food Pyramid as a concession to the processed wheat and corn industries. Moreover, my nutritionist group had placed baked goods made with white flour — including crackers, sweets and other low-nutrient foods laden with sugars and fats — at the peak of the pyramid, recommending that they be eaten sparingly. To our alarm, in the "revised" Food Guide, they were now made part of the Pyramid's base."
Unfortunately, having been fed the "eat-all-the-carbs-you-want-it's-fat-that-makes-you-fat" message from professor after professor, I bought in, even though looking back, I had more than enough knowledge of physiology to have known better. Stupid me; I didn't question what I was being taught (I am actually BEATING MYSELF right now like Edward Norton in Fight Club). Fast forward eight years to 1996. I saw a picture of myself in shorts and a T-shirt and realized I was starting to put on some pounds and it freaked me out a bit because I had always been thin (mirrors will lie to you in ways that photographs will not).
I got my hands on Atkins' original book (1971), and not too long after that started attending seminars by Dr. Janet Lang. Needless to say, except for the occasional "CHEAT" (yes, I have been on more than one carb-induced "bender"), I've been trying to follow a LOW CARB, WHOLE FOOD, NO-GRAIN, PALEO, and at times even a high fat (KETOGENIC) approach ever since. And although I would certainly not call myself "shredded" like I was back in 1988, I feel good, and by the grace of God have managed to stay strong and healthy. But since this sort of evidence is anecdotal (BTW, I am not necessarily against ANECDOTAL EVIDENCE), let's take a look at what the PURE study had to say about diet and disease as related to the Fats -vs- Carbs -vs- Protein debate.
- THIS TOPIC IS CONTROVERSIAL: Heck yes it is! Other than maybe politics or religion, it's about as controversial a topic as you can find. In fact, I'm not sure of anything that researchers agree on less than nutrition (maybe everyone can agree that TRANS FATS CAUSE HEART DISEASE?). The authors also mentioned some of the highly confounded studies that our current dietary guidelines are based on (can anyone say Ancel Keys?). Stick around for three more minutes to see what I am talking about.
- THE ORGANIZATIONS THAT FUNDED THIS STUDY HAD NO PART IN DESIGN OR CARRYING IT OUT: How big is this today? In light of the vomit-trough we ironically refer to as "EVIDENCE-BASED MEDICINE," it's absolutely huge! and for those of you who believe that just because a government entity does / checks the study (for instance, THE FDA) that this automatically makes it "unbiased," have I got a deal for you. You see, there's this bridge in Brooklyn.....
- MOST OF THE DATA THAT CURRENT GOVERNMENTAL RECOMMENDATIONS COME FROM IS FROM WESTERNIZED NATIONS WHERE OVER-CONSUMPTION IS THE NORM: This is particularly true of the United States, where overeating has become a national past time. Be sure to tune in next week because I am working on a post that shows the metabolic / physiological consequences of overeating (the problems that go beyond blood sugar and obesity), as well as what happens to health and lifespan when people decide to eat less.
- HIGHER INTAKE OF CARBS ARE ASSOCIATED WITH A HIGHER OVERALL DEATH RATE: Since this higher mortality rate was not associated with either cardiovascular disease or dying of cardiovascular disease, there are two diseases that immediately come to mind --- diabetes and cancer. While most people realize that diabetes is the end result of living the HIGH CARB LIFESTYLE (functional doctors would argue the same thing is true of PRE-DIABETES as well), most people do not realize that this is even more true of cancer (HERE), which has taken over the number one spot as far as American mortality rates are concerned. This is interesting considering that the picture I used at the top of this post came straight from our own government's NIC (National Institutes of Cancer), touting dinner rolls (whole grains) as a dietary cancer-preventative. Oh, higher carb intake was also associated with high BP, higher triglycerides, and lower levels of the so-called "good cholesterol" (HDL), as well as a screwed up Apiloprotein B to A1 ratio; which according to NUMEROUS STUDIES, is possibly the single best predictor of having an Adverse Cardiovascular Event. "ApoB-to-ApoA1 ratio is the strongest lipid predictor of myocardial infarction and ischaemic strokes."
- TOTAL PROTEIN WAS INVERSELY ASSOCIATED WITH TOTAL MORTALITY RISK: This study showed that animal protein was associated with a diminished risk of all-cause mortality, while interestingly enough, plant protein was not.
- THE TYPE OF FAT YOU EAT REALLY DOES MATTER: This should not be too surprising to most of you (see my earlier Trans Fats link). Even though we see the AHA continuing to beat their "anti-saturated fat" drum, that bus left town a long time ago. "Higher saturated fat intake was associated with lower risk of stroke. Total fat, saturated fat, and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality." I give you a better picture of this principle in THIS POST on Fatty Acid Metabolism. These authors also noted that replacing carbs with saturated fats decreased strokes by 20%, also revealing that LDL levels (the so-called "bad" cholesterol) were not an accurate predictor of cardiovascular disease or death rates.
- WE NEED TO RETHINK OUR CURRENT DIETARY GUIDELINES: The study ended with the authors saying, "dietary guidelines should be reconsidered." The thing is folks, we don't need to reinvent the wheel --- these guidelines are already out there (HERE they are from a post I wrote three years ago). The very simplest guidelines for eating an ANTIINFLAMMATORY DIET come from Functional Neurologist, Dr. David Seaman --- "eat vegetation or animals that ate vegetation".
Ah, there it is folks --- "selective emphasis". This is simply another way of letting us know that INVISIBLE & ABANDONED research is alive and well, and as real as a proverbial heart attack. I cherry-pick what I give you simply because as much as I may want to, I can't share it all. Read between the lines and you'll see that these authors are (much too gently) accusing authors of similar studies, both recent and in the past, of cherry-picking. Why? As Dr. Light showed us, it's the same reason it always is; the money.
If you are wanting to turn your life around, lose weight, lessen your body's inflammatory burden, decrease your pain, and start addressing root physiological causes of disease processes (remember that drugs don't usually do this well -- HERE), I've created a GENERIC TEMPLATE for you to take a look at. No; it's not going to solve everyone's problem(s). Some of you may end up needing medical intervention or testing by a specialist in functional medicine. Or then again, your problem might be related to your fascia --- HERE. But how can you go wrong simply living a healthier lifestyle and eating healthier foods (HERE)? HERE is a crazy testimonial from a person that used these ideas to lose 100 lbs in seven months, and get off her meds for five (5) autoimmune diseases.
BRAND NEW JAMA STUDY EXPOSES AND EXPLAINS INVISIBLE AND ABANDONED RESEARCHRead Now
"A major aim of trial registration is to help identify and deter the selective reporting of outcomes based on the results. However, it is unclear whether registration improves the reporting of primary outcomes in publications."
I suppose that this would be a good time for me to brag a bit. Did you guys know that I was the world record holder for consecutively-made free throws (HERE)? Not to completely toot my own horn, but I've made over 43,000 free throws in a row; without a single miss. At least not misses that I count. You see, I've taken the same approach to my basketball game that BIG PHARMA has taken with their research. In my world misses don't count. This is the same premise that allows Invisible & Abandoned research to continue and thrive.
When researchers, most of whom are funded by industry (or by an institution that's being funded by industry), come up with findings that make their employer's products or services look bad --- or at least not look good --- they frequently halt the study midstream, figure out a different way to set up the study, and try again. In the meantime, said study gets buried so deep in the basement file cabinets that it will likely never see the light of day.
There are literally hundreds of different tricks that scientists can use to skew data and arrive at results that will keep the money flowing and keep everyone happy (except, of course, the unsuspecting public). I've talked about many of these tricks in my EVIDENCE-BASED MEDICINE POSTS. Listen to some of the cherry-picked tidbits that came from today's study.
- The authors accused industry of, "selective reporting of outcomes based on the results."
- Clinical trials were "often unregistered".
- Clinical trials were "often unpublished".
- Results of clinical trials were "often discrepant" (differing; disagreeing; inconsistent).
- Only 61% of the studies looked at were registered and only 57% were actually published.
- Primary outcomes being looked at were frequently changed or altered midstream. This allowed researchers to totally cherry-pick their results -- I am loosely quoting here ("outcomes being omitted, downgraded, or reported, but not specified as primary in the protocol").
- Primary outcomes were not defined 20% of the time.
- Discrepancies between the primary goals of the registry and the outcome were seen 23% of the time (this is like throwing a dart at the wall and then painting your target so that the dart is in the center of the bullseye).
- Discrepancies between the protocol and publication were seen in unregistered studies 55% of the time.
- "Intentional suppression from disclosure."
Oh, and just to let you know; even though this study was published in the Journal of the American Medical Association, it was done in Finland. Trust me when I tell you that this particular scenario is worse here in America than it is in Finland. Much of this has to do with the incestuous (financial) relationships between the FDA and Big Pharma (HERE). The point, besides the fact that we know drugs are dangerous whether pushed or prescribed (HERE or HERE), is in the final paragraph.
When it comes to drugs or procedures, you must be cautious about trusting what you read or hear as far as research goes. My favorite example of this has to do with antidepressants. After concerned scientists used Sunshine Laws and the RIAT Act (Restore Invisible and Abandoned Trials) to force drug manufactures to allow them to look at millions of pages of data from dozens of I&A studies on antidepressants, they determined that this class of drug carries virtually no benefit. And especially not the kind of benefit that's been widely touted by industry (HERE and HERE). Hmmmmm; I can't say that I'm surprised. I think I'll go shoot some more free throws!
"Spontaneous abortion was associated with influenza vaccination in the preceding 28 days. The association was significant only among women vaccinated in the previous influenza season."
There are several things I find intriguing about this study. The first thing you must realize is that even MAINSTREAM MEDICAL DOCTORS are starting to holler about the fact that our nation's flu vaccination policies are a scam. Despite what the government tells you, theses shots are not much more than 0% effective (see above link). On top of that, we know that if you got a shot last year, the efficacy of your shot this year will be significantly worse (HERE). And number three, despite the study's lead author saying there's no explanation for this, why would we be surprised for even for one second that intentionally putting toxic elements into the bodies of pregnant women (ALUMINUM, MERCURY, MSG, and God only knows what else), wouldn't result in higher levels of spontaneous abortion?
For Pete's sake, doctors themselves advise women to avoid virtually all drugs while pregnant. But we are supposed to believe that the toxic milieu found in most vaccines doesn't count or matter? It amazes me how many studies there are linking environmental pollution and toxicity to things like AUTISM and spontaneous abortion, yet we are repeatedly told that flu shots are safe for expecting mothers. And all this to attempt to prevent a "disease" that's essentially a bad cold. We have lost our collective minds! You bet we have.
An article from the University of Minnesota's CIDRAP (Study Signals Association Between Flu Vaccine, Miscarriage) quoted the study's author as saying, "There's no biological basis for this phenomenon." Really? Let's look at the conclusion of Neil Miller's well-bibbed study (Infant Mortality Rates Regressed Against Number of Vaccine Doses Routinely Given: Is There A Biochemical or Synergistic Toxicity?) in this month's issue of Human & Experimental Toxicology back in 2011. The author's conclusions?
"The US childhood immunization schedule requires 26 vaccine doses for infants aged less than 1 year, the most in the world, yet 33 nations have better IMRs. Using linear regression, the immunization schedules of these 34 nations were examined and a correlation coefficient of 0.70 (p < 0.0001) was found between IMRs and the number of vaccine doses routinely given to infants [this is a crazy high CC]. When nations were grouped into five different vaccine dose ranges (12–14, 15–17, 18–20, 21–23, and 24–26), 98.3% of the total variance in IMR was explained by the unweighted linear regression model. These findings demonstrate a counter-intuitive relationship: nations that require more vaccine doses tend to have higher infant mortality rates."
If you are as old as I am (HERE), you'll realize that it was not that long ago that pregnant women were warned against any drugs or vaccinations. If this topic interests you, you might want to read DR. DAVID MIHALOVIC'S 2011 article called Study Shows Influenza Vaccines Cause Spontaneous Abortions and Stillbirths. What you have to remember is that any time statistics from the Vaccine Adverse Event Reporting System (VAERS) is used in a study, beware.
Mountains of research (HERE, HERE, HERE, and HERE) have repeatedly shown that AE's ('adverse events') are only reported to the proper authorities about 1% of the time. Is it any wonder that FEMALE HEALTHCARE WORKERS are declining their flu shots in droves? That is until GOVERNMENT-MANDATES (your congressmen / women were probably successfully lobbied by BIG PHARMA) forced these vaccinations on healthcare workers (HERE). Not surprisingly, the CIDMAP article ended with the lead authors of the study making what amounts to an insincere and cheesy-sounding plea to pregnant women --- "this study in no way suggests reversing or revising the CDC's recommendations pertaining to pregnant women and flu shots."
If you want to see all the posts I've written, not only on Flu Shots, but on VACCINES IN GENERAL, as well as vaccines as related to autism, just click the links in this post. You might not agree with me, but once you realize the sorts of chicanery going on in the biomedical research community (code word: "EVIDENCE-BASED MEDICINE"), I won't be surprised if you change your mind. Just make sure to spend some time studying this issue using materials and studies not created by people wanting to force this stuff on you and your family for financial gain! And in response to the title of Helen Braswell's quote from the top of the page; don't worry Helen, they'll quickly figure out a way to redo the study to get the results they want. Just remember that the VACCINE INDUSTRY always figures out how to tip the scales in their favor.
What's my opinion of the results of this study? Firstly, in light of what we know from decades of previous research, their figure of one third is low. For example, when the giant actuarial firm ROBERTSON & MILIMAN was hired by the United States government to determine how many surgical procedures were unnecessary, the figure they came up with back in 1995 was about 6 of 10. Trust me when I tell you that things have not improved much since then. In fact, it's possible they're worse.
Furthermore, when we look at what the "best evidence" actually says concerning our current EVIDENCE-BASED GUIDELINES for various testing procedures, treatments, physical examinations, blood work, mammograms, female annuals, etc, etc, etc, what we find is that according to peer review, we are not even in the ball park as far as a practice based on evidence is concerned (see link).
The dirty little secret of Overdiagnosis & Overtreatment is that while the testing procedures mentioned in the previous link can sometimes lead to early detection of certain diseases that saves some people; in about the same number of cases, early detection ends up killing them via overtreatment. In other words, health issues (many pertaining to CANCER) that are slow-growing or even dormant, and would never present a problem in the average person's natural life-span can be awakened / provoked / stimulated, leading to the equivalent number of deaths on the back end as lives that were saved on the front end. It's just that the front end of this scenario is heroic sounding and plays well in people's minds, as well as in the media. To better understand what I mean, take a look at the EBG link in the previous paragraph.
Another proof of overtreatment has to do with a brand new 80 page study by Alan Krueger of Princeton called Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate. Krueger begins his paper by saying, "The labor force participation rate in the U.S. has declined since 2007 primarily because of population aging and ongoing trends that preceded the Great Recession." With approximately 7 million young American men that could be working but are not, I'm frankly interested in what these ongoing trends are. Listen to what Dr. K says.
"Labor-force participation has fallen more in areas where relatively more opioid pain medication is prescribed, causing the problem of depressed labor-force participation and the opioid crisis to become intertwined."
Just how big is this "intertwining" as related to OPIOIDS? An extremely similar 2016 study by Dr. Kreuger showed that about half of all "prime-age" working males that have dropped out of the work force are addicted to opiods (for the record, the only Westernized country with a higher rate of "non-participation" of young, healthy, males in the work force is the PIGS nation; Italy). Who is prescribing these opiods? Certainly not me. If you want to see how freaky this problem really is in your county (my county is the tall one in the center of southern Missouri that borders Arkansas --- as you can see, things are bad here concerning addiction to prescription pills), just take a peek at Fred Dews' How the Opioid Epidemic has Affected the U.S. Labor Force, County-by-County, writing in an issue of last week's issue of Brookings --- the official publication of Princeton's Brookings Institute.
I've written scores of posts showing why it's tenuous accepting our biomedical community's research findings as fact ("EVIDENCE-BASED MEDICINE"). What do I like instead? For almost six years I have been doing (when I'm not too busy) VIDEO TESTIMONIALS. While it's not exactly peer-review, I'm not sure there's better "proof," that what I'm doing clinically works; and some of these probably pertain to the very same problem(s) you yourself have been dealing with.
SYMPATHETIC DOMINANCE LEADS TO INFLAMMATION: CONTROL YOUR NERVOUS SYSTEM AND CONTROL YOUR INFLAMMATIONRead Now
Beyond diet and then dealing with junk like BLACK MOLD, DYSBIOSIS, PARASITES, ALUMINUM or OTHER METALS, or numerous others, a huge driver of inflammation that few people ever contemplate is SYMPATHETIC DOMINANCE as measured in the medical community by something known as HEART RATE VARIABILITY or HRV (HRV is the basis for biofeedback). When the "Sympathetic" side of the ANS or Autonomic Nervous System (the side that controls your fight-or-flight response) is dominant over the "Parasympathetic" side (relaxation and digestion), the body becomes perpetually stimulated into anxiety and the feeling that everything in life is a crisis. It typically also leads to exhausted people who are unable to effectively rest of sleep. Be aware that this is not simply a mind-over-matter issue. It's real, and if you don't figure out how to stop it or at least dramatically slow it down, it will eat your lunch. Allow me to prove it to you by showing you some diseases associated with function of the Autonomic Nervous System (Sympathetic -vs- Parasympathetic). Before we get there, however, you must know just a bit about the Vagus Nerve.
The Vagus Nerve is the 10th Cranial Nerve (CN X), meaning it's one of the 12 nerves that comes directly off of the brain. After leaving the Medulla Oblongota (the area of the brain that controls unconscious activities such as breathing), it exits a tiny hole in the bottom of the skull called the Jugular Foramen, where it runs between the jugular vein and carotid artery (this helps explain the VASOVAGAL RESPONSE that the occasional patient will have in response to SCAR TISSUE REMODELING done in the neck area). From there, the Vagus Nerve winds its way down, controlling all the organs in it's path, down to almost the end of the colon. As for the problems associated with having a an overstimulated SNS (Sympathetic Nervous System) and/or understimulated PNS (Parasympathetic Nervous System), including the Vagus Nerve, they are many and diverse. Also notice that this is a two-way street --- a vicious cycle if you will. A hyped SNS will lead to inflammation, but inflammation leads to a hyped SNS. All research below is cherry-picked due to constraints on both time and space.
- DIABETES AND SUGAR DYSREGULATION: Why do I start here? Because as I've shown you over and over again, most health issues (including ENDOCRINE and CANCER) start with sugar issues --- even in the absence of full-blown DIABETES (which happens to be one of the numerous "inflammatory" diseases). The sugar / sympathetic dominance connection was explored in a study from 1995; that's right, over two decades ago. The journal Diabetes Research and Clinical Practice (Association of Vagal Tone with Serum Insulin, Glucose, and Diabetes Mellitus) concluded that, "Reduced vagal activity assessed by heart rate variability (HRV) has been observed in studies of diabetics. This first population-based study on this subject confirmed that diabetics have significantly lower vagal activity than non-diabetics. In individuals not diagnosed as diabetics, serum insulin, and, to a lesser degree, serum glucose were inversely associated with vagal function, suggesting a role in the pathogenesis of diabetic neuropathy." What's this really saying? That even if you don't yet have a high enough blood sugar level to be "officially" labeled as a diabetic, these higher levels of blood insulin (INSULIN RESISTANCE / PRE-DIABETES) are associated with both lower vagal function and NEUROPATHY. It's why LIVING THE HIGH CARB LIFESTYLE will always catch up with you and make your life suck in the end.
- ALLERGIES & ASTHMA: When it comes to ALLERGIES and ASTHMA, this well-bibbed study (Neural Pathways in Allergic Inflammation) from the 2010 issue of the Journal of Allergy is spot on. "It is estimated that approximately one-third of the general population is affected by allergic diseases. Asthma, food allergy, dermatitis, and systemic anaphylaxis are amongst the most common allergic diseases. A plethora of epidemiological and clinical data suggests higher incidence of anxiety and increased emotional reactivity in individuals suffering from allergies. In studies of food allergy, specifically, it has been shown that the prevalence of anxiety or depression is higher in adults with food allergy. In summary, this paper showed that allergic inflammation conveys information to the central nervous system that, in turn, sends information back to the inflammatory site by releasing neural mediators such as acetylcholine." As you'll notice throughout this post, acetylcholine is a neurotransmitter and arguably the biggest regulator of the ANS.
- RHEUMATOID ARTHRITIS: Although I have shown you some very cool stuff in regards to RA, the August 2014 issue of Best Practice & Research Clinical Rheumatology published a study called Vagus Nerve Stimulation: A New Bioelectronics Approach to Treat Rheumatoid Arthritis? in which these European authors "discovered that knockdown of the nicotinic acetylcholine receptor type 7 (α7nAChR) in RA fibroblast-like synoviocytes results in an increased production of mediators of inflammation and degradation. The α7nAChR is intimately involved in the cholinergic anti-inflammatory pathway (CAP)." In other words, certain specific neurotransmitter receptors for (Ach -- Acetylcholine) are anti-inflammatory. The authors activated these pathways via stimulation of CN X (Vagus Nerve), and then turned around and suppressed them by removing the Vagus Nerve. "Various observational studies have demonstrated that RA patients have lower vagus nerve tone shown by reduced HRV compared to age-matched controls. This phenomenon has also been observed in other autoimmune diseases, such as systemic lupus erythematosus, ankylosing spondylitis, and chronic inflammatory bowel diseases. Activation of the vagus nerve, which is a part of the parasympathetic nervous system, was found to dampen inflammatory processes." How freaking big a deal is this bullet point? I'll sum it up with the conclusions of a study from a 2011 issue of Biomed Central (Can Vagus Nerve Stimulation Halt or Ameliorate Rheumatoid Arthritis and Lupus?). "This implies that therapies directed at regulation of the cholinergic and alpha7nAChR-mediated mechanisms... may halt and/or ameliorate rheumatoid arthritis, lupus and other rheumatological conditions." Are you reading this SF and DH?
- ANKYLOSING SPONDYLITIS: Two years after this, the journal Acta Rheumatology Portugal (Autonomic Functions and their Relations with Disease Activity in Ankylosing Spondylitis) revealed that, "Cholinergic neurons control TNF synthesis by means of acetylcholine (ACH). ACH is the main neurotransmitter of the parasympathetic system. This relation between the autonomic nervous system and immune system has been called the 'cholinergic anti-inflammatory pathway'. Inflammatory stimuli stimulate vagal afferents [sensory nerves] and then the hypothalamus [brain]. Experimental stimulation of the vagus caused decreased TNF synthesis in liver, spleen and heart, and serum TNF levels decreased in endotoxemia, ischemia / reperfusion injury and hemorrhagic shock. After vagotomy, animals showed an exaggerated TNF response to an inflammatory stimuli." By the way, TNF (Tumor Necrosis Factor) is an extremely potent inflammatory mediator commonly seen in AS.
- ARTHRITIS IN GENERAL: A year later, the journal Nature Reviews: Rheumatology published a study called Role of Peripheral Nerve Fibres in Acute and Chronic Inflammation in Arthritis. While this study did not delve as deeply into the whole Vagus Nerve Stimulation thing (VNS) as other studies did, it provided some amazing clarification and insight into what we've been talking about. "During acute inflammation, rapid neuronal reorganization and change of activity takes place. The hallmarks of this process are an increase in systemic sympathetic activity, a decrease in systemic parasympathetic activity and loss of sympathetic nerve fibres from sites of inflammation concomitant with increased innervation with sensory nerve fibres and increased sensory nerve fibre activity. In locally inflamed tissue, the decrease in sympathetic nerve fibre density results in reduced anti-inflammatory signalling and, together with neuropeptides released from sensory nerve fibres, promotes local inflammation." Be aware that this is a vital and necessary thing as inflammation is the primary method of beginning the process of healing damaged tissue of all sorts. "However, in chronic autoimmune inflammation, these changes of the peripheral nervous system lead to an unfavourable situation with ongoing energy reallocation and continuous local destruction. As an example of a chronic inflammatory condition, we discuss evidence for neuroimmune regulation in autoimmune arthritis with a focus on the sympathetic nervous system." Stick around because in just a bit, I am going to show you how to tip the balance of the ANS toward the parasympathetic side. Oh, and for those of you who think you need an x-ray or MRI to see just how much arthritis you have, READ THIS FIRST.
- ABNORMAL GUT FUNCTION: The two sides of the "Gut Dysfunctions" coin are dysbiosis (which I've already mentioned) and LEAKY GUT SYNDROME. Also remember that 80% of your entire immune system is in the Gut (HERE). Dr. Esmerij Vander Zanden, a Gastroenterologist / Hepatologist in Amsterdam, wrote a 150 page paper in 2011 called The Vagus Nerve as a Modulator of Intestinal Inflammation, in which she stated, "A decade ago, Borovikova reported that acetylcholine, the principle neurotransmitter of the vagus nerve, can attenuate pro-inflammatory cytokine release... Moreover, they demonstrated that electrical stimulation of the vagus nerve attenuates the systemic inflammatory response... Acetylcholine, the principle neurotransmitter released by the vagus nerve, can exert its anti-inflammatory effect via binding to nicotinic acetylcholine receptors (nAChRs), which are expressed on macrophages and other immune cells. The cholinergic nervous system attenuates the production of proinflammatory cytokines and inhibits inflammatory processes. Ingestion of dietary fat stimulates the production of cholecystokinin (CCK), which is a characteristic hormone released during ingestion to trigger several digestive functions including pancreas secretion, and activation of afferent vagus nerve signals to induce satiety [fullness]. Interestingly, a recent study indicated that CCK, released as a result of high-fat nutrition, inhibited hemorrhagic shock-induced TNFα and interleukin-6 release [inflammation]. This anti-inflammatory effect of CCK release is mediated by the vagus nerve. Both acute and chronic exposure to stress can increase epithelial permeability via cholinergic mechanisms. cholinergic stimulation increases epithelial transport by disrupting tight junction integrity [Leaky Gut]. On the other hand, other animal studies show that vagus nerve activity can be protective in maintaining gut barrier function under pathological conditions." This study is a veritable goldmine, and I just barely scratched the surface. Among other things, the good doctor is showing us that a HIGH FAT diet might not be so bad after all (as long as it's based on GOOD FATS), in that it has the potential to stimulate the parasympathetics (PNS) via CCK. The study also discussed the PNS' ability to clear out harmful bacteria. Can anyone say SIBO?
- INFLAMMATORY BOWEL DISEASE / IBS / SIBO: Speaking of SIBO..... IBS and IBD covers a lot of ground. A two year old study in Frontiers in Immunology (The Neuromodulation of the Intestinal Immune System and Its Relevance in Inflammatory Bowel Disease). After talking at length about the importance of HOMEOSTASIS, these authors stated, "One of the main tasks of the immune system is to discriminate and appropriately react to "danger" or "non-danger" signals. This is crucial in the gastrointestinal tract, where the immune system is confronted with a myriad of food antigens and symbiotic microflora that are in constant contact with the mucosa, in addition to any potential pathogens. This large number of antigens and commensal microflora, which are essential for providing vital nutrients, must be tolerated by the intestinal immune system to prevent aberrant inflammation. In order to maintain homeostasis, the immune system has diverse regulatory strategies including additional non-immunological actors able to control the immune response. Accumulating evidence strongly indicates a bidirectional link between the two systems in which the brain modulates the immune response via the detection of circulating cytokines and via direct afferent input from sensory fibers and from enteric neurons." This is cool because it's talking about the continuum between the brain, the ENTERIC NERVOUS SYSTEM (about 90% of the Vagus' traffic to the brain is from the ENS), the MICROBIOME, and cytokines / inflammation. What did these authors talk about as a potential solution? Among other things the stated, "we and others have extended the concept of the vagal anti-inflammatory pathway to the GI tract by showing the beneficial effect of electrical VNS......" What if there were ways to stimulate the Vagus Nerve without invasive surgical implants?
- AUTISM: Over the years I've written a heck of a lot of articles pertaining to AUTISM. What seems to be the common denominator? Two things; issues with GUT HEALTH and inflammation (debate abounds about where said inflammation comes from --- i.e. VACCINES). In the March 2011 of Neuropsychology Reviews (The Immune System's Moderating Response to Inflammation Relieves Autistic Behavior: Response to Peter Good) the authors talked about why autistic behavior tends to improve when these kids have a FEVER. Of course it boiled down to inflammation ("absent inflammation, heat stress does not improve behavior in autism."), but listen to what the authors concluded. "The inflammatory reaction with its sympathetic activation is buffered by the vagal cholinergic anti-inflammatory system (CAIS). Electrical vagal stimulation is used to treat inflammatory diseases, including depression, which features neuroinflammation. Vagal stimulation also increases heart rate variability, as autonomic tone veers from sympathetic toward parasympathetic dominance. In controlling inflammation and sympathetic predominance, the CAIS may lower arousal level. Much autistic behavior appears to be a compensatory reaction to chronic pathologically heightened arousal. Vargas discovered neuroinflammation in people with autism, both in vivo and at autopsy. An outpouring of cytokines from activated microglia, the CNS counterparts of macrophages, involves the excessive release of glutamate, the preponderant excitatory neurotransmitter, increasing the brain activation toward hyperarousal." Although they were not mentioned by these authors; besides staying away from known exciteotoxins such as MSG and ASPARTAME (not to mention consuming anti-inflammatory diets like PALEO or GAPS), there are certain things that might make a real difference for those with autism. These authors mentioned Vagus Nerve Stimulation (VNS). Dr. Stephen Porges has some extremely cool info on this topic as well. Oh, and don't forget Microglial Activation as we will deal with it two bullets down.
- DEPRESSION: Although this study acted more like a commercial for SSRI ANTIDEPRESSANTS, a 2008 issue of the Journal of Clinical Investigation (Impaired Parasympathetic Function Increases Susceptibility to Inflammatory Bowel Disease in a Mouse Model of Depression) concluded that (notice once again the link to Gut Health), "Evidence indicates that intestinal inflammatory conditions can be exacerbated by behavioral conditions such as depression. We recently provided proof of concept that depressive-like behavior is associated with an exaggerated response to inflammatory stimuli in the gut. The recent demonstration of a tonic counter-inflammatory influence mediated by the vagus nerve in experimental colitis provides a potential link between behavior and gut inflammation. Depression results in autonomic imbalance, with impaired parasympathetic functions and a dominant sympathetic drive, contributing to cardiac pathophysiology. The notion that depression is associated with parasympathetic dysfunction has led to the exploitation of vagal electrical stimulation as a novel treatment for refractory depression." None of this should come as a total shock considering DEPRESSION is one of the myriad of diseases that fall under the category of "inflammatory".
- CHRONIC FATIGUE AND PTSD: An article from the site Healing Histamine (Harvard Neuroscientist Dr. Michael Van Elzakker: Chronic Fatigue Vagus Nerve Link) expounds on this, sounding at times like the awesome histamine / inflammation / microbiome researcher, DR. ART AYERS. Listen to what Dr. E says as it relates to infections of the Vagus Nerve. "Chronic Fatigue Syndrome is a neurological condition. It's a disease that one of the main symptoms is a long-lasting, severe fatigue. Again, this is medical fatigue. It's not the kind of fatigue that I have after a day at work where I need to just recharge for a few minutes. there are a lot of pathogens that really like nerve tissue. That includes chicken pox, the herpes zoster virus, Epstein-Barr, HHV-6, some kinds of enterovirus, even the Lyme bacteria is a bacteria that really likes nerve tissue. I would say, not coincidentally, all of those are also pathogens that are linked to Chronic Fatigue Syndrome. All of us have herpes viruses in our body. More than 90 percent of human beings have more than one strain. Chicken pox, HSV-1, the simplex. We're all walking around with these viruses in our bodies, but most of the time, they're latent. People may have had the experience when they start to get a cold or a flu and they get a little cold sore on their tongue, that means when you're immuno-compromised, these herpes viruses can come back out of latency." He goes on to talk about GLIAL CELL ACTIVATION and tons of other cool stuff. How big a deal is this? Take a look at my response to a physician who contacted me about some chronic issues that had to do with EBV (there are many physicians who believe that occult EBV (Epstein Barr Virus) or CMV (Cytomegalo Virus) --- both of which are of the herpes family and are the cause of mono --- are the root of any number of other chronic illnesses (HERE).
- TINNITUS: Tinnitus, or ringing in the ear, affects between 10 and 15% of the population. More studies are underway after initial research showed that Vagus Nerve Stimulation reduced tinnitus by as much as 50%. Remember that "itis" = inflammation.
- REFLEX SYMPATHETIC DYSTROPHY / COMPLEX REGIONAL PAIN SYNDROME: CRPS (it used to be called RSD) is nasty stuff. Listen to what Wikipedia says. "CRPS is a long term pain syndrome that often worsens with time. It is characterized by severe pain that's out of proportion to the original injury and often accompanied by sensitivity, swelling, and changes in the skin. It may initially affect one limb and then spread throughout the body; 35% of affected people report symptoms throughout their whole body. The cause of CRPS is unknown though it is associated with dysregulation of the central nervous system and autonomic nervous system, resulting in abnormal temperature control and pain of the affected limb(s), leading to functional impairment and disability. Precipitating factors include injury and surgery." Want a good reason to keep your body inflammation-free? CRPS! "Clinical features of CRPS have been found to be inflammation....." South of us in Fayeteville Arkansas is the office of Functional Neurologist, Dr. Katinka van der Merwe, who specializes in treating people with CRPS. Listen to what she says in an article on RSD dot org called Putting Out the Fire: A Brand New Approach to Treating RSD/CRPS. "One of the first techniques I learned centered around restoring balance to the Autonomic (automatic) nervous system, specifically the Vagus nerve. The Central Nervous System (CNS) is the system that runs everything in your body. It controls movement, function, your immune system, and pain. It also controls healing. The Autonomic Nervous System (ANS) is a subsystem of the CNS. It is the part of your brain that runs everything automatically, without you having to think about it. It is divided into the Sympathetic (fight or flight) Nervous system (SNS), and the Parasympathetic (rest or digest) nervous system (PNS). The SNS is responsible for saving our lives when we are being attacked. It is vital, but not overly concerned with healing, sexual function, digesting food, or relaxing. The PNS is. The one thing every CRPS patient has in common is that they are stuck in Sympathetic overdrive, meaning, instead of their nervous system being nicely balanced between these two states, they are stuck in Sympathetic overdrive. This often happens long before they ever develop CRPS." What's she doing? Among other things, she's treating these people with Frequency Specific Microcurrent, something I have been using in my clinic since 1991 (Mens-O-Matic).
- HEART DISEASE / HEART FAILURE: A study published in a 2013 issue of Annals of Thoracic Surgery (Cardiac Autonomic Nerve Stimulation in the Treatment of Heart Failure) had some interesting things to say on this subject. After revealing that, "Heart disease is the leading cause of death worldwide," and then talking about numerous medical interventions (mostly drugs and surgery), these authors made a confession of sorts when they revealed that drugs and surgery don't work very well (something confirmed by a comment from a cardiologist near the bottom of YESTERDAY'S POST). "Currently available HF (heart failure) therapies have limited efficacy." So, listen to what they suggest instead. "HF pathophysiology is associated with neurohormonal activation of the sympathetic nervous system, resulting in increased plasma levels of... inflammatory biomarkers and cytokines increase (tumor necrosis factor and C-reactive protein), as do markers of systemic and cardiac oxidant stress. Use of vagus nerve stimulation (VNS) as a medical therapy to counter sympathetic nervous system activation in HF has yielded encouraging results. It is clear that optimal cardiac neurostimulation therapy varies, based on the type and severity of HF and on the individual balance of sympathetic and parasympathetic autonomic activity." Things that make you go hmmmm.
- CANCER: Less than a year ago, Dr. Grace Bullock published an article reviewing some studies on ANS dysregulation as related to CANCER (specifically BREAST CANCER) in an article called Vagus Nerve Activity May Impact Cancer Prognosis. Listen to her conclusions. "To date, cancer prognoses have largely been determined by tumor stage, age, genetic expression, inflammatory parameters and organ functioning. Now, new research suggests that vagal nerve activity may also predict survival in patients with metastatic or recurrent breast cancer more reliably than cancer stage alone. It has been proposed that high vagal tone may slow down tumor growth because it inhibits mechanisms responsible for tumor progression including oxidative stress, inflammation and excessive sympathetic nervous system (SNS) activation. In addition the vagus nerve also innervates major visceral organs where many cancers develop, including the lungs, gut, pancreas and colon." She then goes on to talk about low HRV seen in Cancer patients, which is the classic marker for Sympathetic Dominance, as well as mentioning some things that can be done to stimulate the Vagus Nerve and tip the ANS toward parasympathetic dominance.
- HPA AXIS DISRUPTION, TISSUE DEGENERATION, AND AUTOIMMUNITY: The December 2014 issue of the Journal of Arthritis Research Therapy provided an amazing study about the way this all relates to the HPA AXIS called The Sympathetic Nervous Response in Inflammation, which reviewed over 100 other studies on the topic. Listen to these cherry-picked conclusions. "Inflammation causes increased activity of the sympathetic nervous system (SNS) Upon initiating an inflammatory process, the body adopts an 'inflammatory configuration' with increased systemic SNS and HPA axis activity. This reaction can be interpreted as an 'energy appeal reaction' resulting in the provision of enough energy-rich fuels, like glucose and free fatty acids, to fulfill the needs of an activated immune system." What the authors are talking about here is the ADRENAL GLANDS kicking in to boost production of cortisol --- the stress hormone, whose purpose is simply to jack your blood sugar as quickly as possible. While in the right circumstances, this is normal physiology, when people become stressed out emotionally, mentally, physically, dietarily, etc, bad things happen hormonally and immunologically. "If inflammation becomes chronic, as in chronic inflammatory illness [HERE is a list of them], the system changes into a 'chronic inflammatory condition' that is characterized by increased activity of the HPA axis without immunosuppression. If a 'chronic inflammatory configuration' persists, as in autoimmunity, the effects are detrimental because of the persistently increased SNS activity, HPA activity, and the resultant chronic catabolic state." In other words, your body is constantly "suppressing" or dampening your immune system responses to keep it from attacking itself (AUTOIMMUNITY). Rampant inflammation from any source, including Sympathetic Dominance, potentially leads to a freaky number of Autoimmune Diseases (HERE is a list of some of the more common ones) as well as living in a "catabolic state" (your body breaking itself down) because it hinders the body's ability to regulate (dampen / soften) immune system responses.
- OTHERS: Honestly, there are too many others to mention, with two of the biggies being FIBROMYALGIA and MIGRAINE HEADACHES right at the forefront (see Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part I, II, and III) in last March's issue of Headache.
"The ventral vagal system is involved with most aspects of social contact and pleasure. It guides eye contact, hearing, eating, speech, singing, nursing, kissing, smiling, and some would say, direct heart to heart contact. The social engagement system is a two way interaction system (receptive and expressive) based mainly in the eyes, ears, larynx, and mouth, but incorporating the entire face and the torso above the diaphragm. All twelve cranial nerves participate in the social and expressive functions. However, only four of these nerves have both motor (efferent) and sensory (afferent) functions. They are the trigeminal, facial, glossopharyngeal, and the vagus. Interestingly enough, it is also these four, along with the oculomotor nerve, that carry most of the parasympathetic fibers involved in the cranial nerve system!" From Michael Samsel's Finding Feeling and Purpose
"The sympathetic and parasympathetic components of the autonomic nervous system control and regulate the function of various organs, glands, and involuntary muscles throughout the body (e.g., vocalization, swallowing, heart rate, respiration, gastric secretion, and intestinal motility). The vagus nerve is a mixed nerve composed of 20% "efferent" fibers (sending signals from the brain to the body) and 80% "afferent" (sensory) fibers (carrying information from the body to the brain). The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation." Dr. Robert Howland from his 2014 study published in Current Behavioral Neuroscience Reports (Vagus Nerve Stimulation).
Did you catch the last sentence of Dr. H's statement above? Re-read it. In essence, what Howland is saying is that you don't necessarily need to have a Vagus Nerve Stimulator (VNS) surgically implanted into your body (chest) to activate your vagus nerve. (For the record, there are several devices that work transcutaneously in similar fashion to a TENS unit, which don't require surgery, although some require a prescription from a physician.) Bottom line, there are some simple DIY things that have the ability to stimulate the Vagus Nerve, and at least in theory, create an anti-inflammatory effect, helping tip your ANS away from the fight-or-flight sympathetics, toward the rest-and-digest parasympathetics. For the record, none of this is new. These are things that the brilliant Functional Neurologist, DR. TED CARRICK, was teaching over three decades ago (and touted by the equally brilliant DR. KHARRAZIAN in the video above).
- GARGLING OR GAGGING: Either of these activities (gagging is not so much an activity as it is a reflex) are neurologically controlled by the Vagus Nerve. Just be aware that this is the sort of full-on kind of thing you might want to do while in the shower, as you need to be intense enough to make yourself tear if possible (watch the video above). Also, because the Vagus is one of the six Cranial Nerves used in swallowing, if you are alone and in your car, repeatedly making the "GULP SOUND" could prove beneficial as well. I also found several studies showing that chewing gum can be beneficial as far as VNS is concerned. Want to see the best and easiest way to gag (as well as laugh, which is also a PNS stimulant)? Watch THIS HILARIOUS FAMILY-FRIENDLY VIDEO.
- HUMMING, SPEAKING, SINGING, TALKING: Not only are these activities typically associated with relaxation, they stimulate the Vagus Nerve because the vocal cords are innervated by the recurrent laryngeal and superior laryngeal nerves, which are branches of the Vagus Nerve. As far as listening to music, the studies I looked at seemed to be a wash. I did, however, find a study showing that New Age music decreased sympathetic response by about a third --- maybe it's why I've always liked ENYA so much.
- AVOID SUGAR AND JUNK CARBS / CONSUME A HEALTHY DIET: A cruddy diet is an ANS disaster! Why do people get ADDICTED TO sugar, soda, junk carbs etc? Research has shown they have drug-like properties that are more powerful than cocaine or methamphetamine. One of the reasons is that the these metabolic pathways crank the adrenals, providing a short-term boost of energy (can anyone say Energy Drink?), while actually burning out these organs and glandular systems. For instance, if I eat very many carbs, my heart races. Can anyone say fight-or-flight? Just remember that because sympathetic stimulation tends to increase inflammation, and inflammation tends to increase sympathetic tone (the self-perpetuating cycle we spoke of earlier), diet can be a beautiful way to help balance the ANS. There are mountains of online information about what foods to eat and what foods to avoid. A simple rule of thumb, however, is that SUGAR IS INCREDIBLY INFLAMMATORY, while ANTI-INFLAMMATORY DIETS tend to tip your ANS away from sympathetic control, toward the PNS. There are also a number of studies showing that VARIOUS FORMS OF FASTING can be beneficial. Another thing to at least contemplate is a KETOGENIC DIET. Why? Take a look at the results of this study (Short-Chain Fatty acids and Ketones Directly Regulate Sympathetic Nervous System...) published in a 2011 issue of PNAS. "Under ketogenic conditions, ketone bodies produced in the liver from fatty acids are used as the main energy sources. To balance energy intake, dietary excess and starvation trigger an increase or a decrease in energy expenditure, respectively, by regulating the activity of the sympathetic nervous system (SNS). Here, we show that SCFAs and ketone bodies directly regulate SNS activity via GPR41, a protein-coupled receptor for SCFAs, at the level of the sympathetic ganglion. A ketone body, β-hydroxybutyrate, suppressed SNS activity by antagonizing GPR41. These findings establish that SCFAs and ketone bodies directly regulate GPR41-mediated SNS activity..."
- OMEGA THREE FATTY ACIDS: It's fairly simple folks; fat is good for you --- even (gulp) animal fat --- as long as it's the right kind of animal fat (HERE). Allow me to show you something that's super cool. If you cruise on over to Oil of Pisces or PubMed, you'll notice that there are dozens of studies on EPA / DHA (the active Omega-3 oils) for treating people with various sorts of arrhythmias (problems with hear rate --- can anyone say HRV?). Not surprisingly, a 2006 issue of Vascular Health and Risk Management (A Review of Omega-3 Ethyl Esters for Cardiovascular Prevention and Treatment of Increased Blood Triglyceride Levels) let the cat out of the bag by revealing "The two marine omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), prevalent in fish and fish oils, have been investigated...... Pro-atherogenic cytokines are reduced, as are markers of endothelial activation. Endothelial function is improved, vascular occlusion is reduced, and the course of coronary atherosclerosis is mitigated. Heart rate is reduced, and heart rate variability is increased by EPA and DHA. An antiarrhythmic effect can be demonstrated on the supraventricular and the ventricular level." Less inflammation, lower heart rate, increased HRV. It's a pretty darn good combination. But these don't necessarily have to come from fish. Around here, farm eggs (high in Omega-3's) can be purchased just about anywhere. As for meat that's high in Omega-3's, hunt your own deer (HERE), or get your meat / poultry from the Clucks, Frescolns, Protivas, or Clingmans.
- GUT HEALTH: When it comes to health, the Gut is everything. It houses the biggest part of your immune system (80%), and makes something like 90% of your body's serotonin / melotonin (HERE). And that's just for starters. If your Gut is screwed up, you are going to have all sorts of health issues. All sorts. Period. Issues that can neurologically reflex back to the brain via the Vagus Nerve. It's why I continue to beat the twin drums (call them bongos if you want) of GUT HEALTH and FECAL MICROBIOTA TRANSPLANTS (FMT). For those of you who think this bullet is as easy as simply taking some probiotics, you might want to read THIS POST.
- COLD SHOWERS / COLD BATHS / COLD WATER ON THE FACE: Exposure to cold water causes the body to kick in its anti-drowning self-preservation machinery (the "Diving Reflex") by slowing the heart rate and generally increasing vagal / parasympathetic tone. And for you guys reading this, exposing the jewels to cold water can be a great TESTOSTERONE BOOSTER as well. Between the parasympathetic boost from the cold water (stick around and you'll see that sex is mostly a parasympathetic function) and the testosterone boost from the cold water, it's no wonder that the CURRENT RIVER has been known to provide "Super Powers".
- DEEP BREATHING USING THE DIAPHRAGM: There are essentially three types of breathing; ACCESSORY BREATHING done with the neck and shoulders, chest breathing, and deep breathing that comes from the belly or diaphragm. Deep Breathing generally involves slowing your rate of respiration to about half of normal, using your stomach / diaphragm, and making sure you exhale slowly. Along these same lines, restricting your breath and bearing down like you are on the toilet (a Valsalva Maneuver --- something we use to give us an idea whether or not a disc might be herniated) can be of benefit as well. I have actually seen devices that purposefully restrict breathing for this very purpose. Although the diaphragm itself is innervated by the Phrenic Nerve (from the mid-cervical spine), the Vagus Nerve passes through it, which typically indicates some degree of neurological control. There is a COOL LITTLE E-BOOK on Amazon by computer guru, Michael Phoenix, that you can look at as well (The Theory of Body Integration & the One Minute Workout). Let's be honest; who in their right mind would not want to know about a one-minute workout? Besides dealing with breathing, Michael's book focuses on PROPRIOCEPTION as well, which brings me to my next point.
- EXERCISE / YOGA / STRETCHING / TAI CHI / MOVING: I will warn you, there are many types of exercise that stimulate the sympathetics as opposed to the parasympathetics. It's probably why when I head into the gym (at least to WHEN IT COMES TO STRENGTH TRAINING), I'm listening to THIS, THIS, THIS, THIS THIS, or even THIS or THIS (instead of Enya, THIS, THIS, or THIS) in order to temporarily crank my energy levels by juicing my sympathetics. Because so much proprioception is on or near the spine, CHIROPRACTIC ADJUSTMENTS, various sorts of body work, or even Tissue Remodeling (see last the link in the previous bullet) have great potential to be helpful as well. Although I do not do it in my clinic, a significant number of natural healers (including chiros -- especially those doing Ulan's work) actually measure the effects of their treatment via HRV --- the medical standard for determining the state of the ANS. A high HRV is good, indicating parasympathetic dominance, while a low HRV shows sympathetic dominance. Again, HRV the basis for biofeedback.
- TAKE CARE OF YOUR THORACOLUMBAR SPINE: The first video in this post ("Crash Course" videos are incredible and I highly recommend you take the eight minutes or so to watch it) mentions that the sympathetic nervous system originates in the THORACOLUMBAR SPINE. In essence, this means that if you have FASCIAL ADHESIONS in this area, you are not only likely causing pain, you are likely perpetually stimulating your sympathetics to some degree or other. Once things get real bad (like say failed back surgery syndrome), this effect can actually start to inhibit sympathetics (like HERE). However, for the average, everyday, run-of-the-mill chronic low back pain person, you are likely stimulating your SNS via this ultra-common dysfunction.
- POSITIVE THINKING, LOVE, LAUGHTER, AND RELATIONSHIPS: Proverbs 23:7 says, "For as a man thinketh in his heart, so is he." Thoughts are real and they have consequences --- something that one of my coaches is always talking about (HERE). I'll throw prayer and meditation into this bullet as well, as there are plenty of studies showing that they also increase vagal tone and HRV. On the other hand, are you stimulating your sympathetics with an addiction to PORN OR SCREENS? Stop it already! And what about love? Four years ago, eight researchers from the University of North Carolina published a study in Psychological Science (How Positive Emotions Build Physical Health: Perceived Positive Social Connections Account for the Upward Spiral Between Positive Emotions and Vagal Tone) in which they talked about a very cool self-perpetuating cycle. "participants were randomly assigned to an intervention group that self-generated positive emotions via loving-kindness meditation or to a waiting-list control group. Participants in the intervention group increased in positive emotions relative to those in the control group, an effect moderated by baseline vagal tone, a proxy index of physical health. Increased positive emotions, in turn, produced increases in vagal tone, an effect mediated by increased perceptions of social connections. This experimental evidence identifies one mechanism-perceptions of social connections-through which positive emotions build physical health, indexed as vagal tone. Results suggest that positive emotions, positive social connections, and physical health influence one another in a self-sustaining upward-spiral dynamic." If you did not grasp the amazing implication of this paragraph, re-read it until you do. One of the coolest relationships my family is currently developing is with THIS AMAZING LOCAL MINISTRY to trafficked women and girls.
- SEX: Hopefully for you, this bullet goes along with the previous bullet. Although both sides of the ANS (the PNS and the SNS) are used in sex, THIS CHAPTER of the book Neuroscience (Autonomic Regulation of Sexual Function) shows that even though it can certainly get your heart racing, sex is much more a function of the PNS than the SNS. This is why the PNS is often times called the "feed and breed" portion of the ANS. I'm not sure I can think of a better way to stimulate the parasympthetics!
- ACUPUNCTURE: Having been certified in acupuncture since 1992, even though I do little of it any more (unless it's with my microcurrent unit), some of the wildest and most amazing things I've ever seen in the field of natural health were accomplished using acupuncture. There are tons of articles on using acupuncture to tone down the Vagus Nerve, and many DIY videos on YouTube on hitting certain points with simulators (hand-held sparkers) to increase PNS tone.
- MASSAGE OR RUBBING THE SIDES OF YOUR OWN NECK: When it comes to relaxation, why does massage or rubbing the sides of the neck work so well beyond the mechanical and proprioceptive aspect of rubbing the tissue? Can anyone say VASO-VAGAL RESPONSE?
- GET AN HRV APP FOR YOUR PHONE: Because HRV has been the standard for testing the ANS for decades, and because apps for your phone are abundant (and in many cases, free), consider tracking your HRV. Also, there are a growing number of electrical VNS devices on the market as well, many that do not require surgery. No, I cannot vouch for the veracity of any of them.
- OTHERS: This list is by no means the last word. However, it will provide you a good starting point.
Today's post is just one aspect of what it might take to reclaim your health start taking your life back. If you want to see a post that contains the whole enchilada, take a look at THIS. Nope; I'm not telling you it's a cure-all. But before you spend a bundle with a SPECIALIST IN FUNCTIONAL MEDICINE, realize that this simple protocol has a great potential to effectively address your problems and save you a bundle in the process!
What causes the body to start attacking itself? In other words, what drives autoimmunity? That's easy; the same thing that drives most health-related problems --- INFLAMMATION. The problem is that there are about a million things that can drive inflammation. And here's the kicker. While said inflammation can certainly cause autoimmunity, it doesn't end there. Inflammation always leads to SCAR TISSUE or FIBROSIS, and fibrosis always leads not only to degeneration (HERE), but is the very thing that kills the majority of Americans (HERE and HERE).
Although there are almost an unlimited number of these unnamed autoimmune, there are some named autoimmune diseases that are intimately associated with FASCIA. The one that comes immediately to mind is one that my sister had called Scleroderma that SHE TOOK CARE OF IT NATURALLY. Sclero = scar tissue, and Derma = skin. Some of the biggest names in fascia research (Schleip, Findley, Chaitow, and Huijing) discussed the relationship between fascia and autoimmunity as related to scleroderma in 2012's 550 page behemoth, Fascia, The Tensional Network of the Human Body.
Because slceroderma is characterized by a thickening of the skin, it affects fascia (see how the fascia is related to the skin HERE). As you can imagine, this not only causes a host of problems, but in some cases can actually attack and thicken organs as well. In scleroderma, inflammation causes the skin to become "LEAKY," which leads to more inflammation, eventually causing significant dysregulation of FIBROBLASTS. Scleroderma is also related to MCTD (Mixed Connective Tissue Disease), which has characteristics of it, as well as of lupus, MYOSITIS, and RHEUMATOID ARTHRITIS (and sometimes Sjögren Syndrome, which causes dry eyes, dry mouth, CHRONIC FATIGUE and joint pain, as well as problems with organs, blood vessels, and the central nervous system). Speaking of RA...
The brilliant HELENE LANGEVIN wrote an article for The Rheumatologist (What Role Does Fascia Play in Rheumatic Diseases?) in which she essentially asked why fascia is being ignored in rheumatic diseases even though it, "should fall squarely within the purview of rheumatology." Instead, she said that the tissue is, "barely mentioned". She went on to say (I'm cherry-picking)......
"Can pain come from fascia? fasciae are substantially innervated, and there are sensory receptors within fascia that respond to mechanical and chemical stimuli. Furthermore, the receptive fields of these sensory neurons enlarge in the presence of inflammation, supporting the potential role of fascia as a 'pain generator.'"
Dr. Langevin went on to discuss the pathological "thickening" of fascia that's most commonly seen in the THORACOLUMBAR FASCIA of in people with chronic low back pain. She then asked whether or not it would be possible that, "inflammation may also be present in fasciae? Could fascia involvement in rheumatoid arthritis contribute to pain and the diffuse 'morning stiffness,' even before overt joint pathology has occurred?" She cites two studies as proof that this is likely then talks about the importance of STRETCHING (a standard component of MECHANORECEPTIVE REHABILITATION). And finally, after talking about fascia's relationship to the immune system, she says, "If this is true, body movements (change in position, exercise, stretching) could play an important role in immune surveillance mechanisms and possibly in autoimmunity." Speaking of autoimmunity as related to fascia, listen to what professor, author, researcher, and physician, Rula A. Hajj-ali of the Cleveland Clinic said in the Merck Manual --- the world's oldest and best-selling medical textbook since 1899.
After talking about connective tissues in terms of LIGAMENTS, TENDONS, and others (not shockingly he left out fascia), he stated, "In autoimmune disorders, inflammation and the immune response may result in connective tissue damage, not only in and around joints but also in other tissues, including vital organs." Why would this be? Why would this doctor mention things like heart problems, kidney problems, or lung problems as associated with autoimmune connective tissue issues and joint pain? Only because virtually all of your body's tissues and organs (not to mention joints) are wrapped in fascia! This fascia goes by dozens of different names (usually according to where its found), but are all composed of essentially the same 'stuff'.
Although this next study pertains to DUPUYTREN'S CONTRACTURE of the palmar surface of the hand, the sequence of metabolic pathology leading to the thickening and contracture will be similar in all autoimmune issues (numerous studies have characterized DC as an autoimmune disease). Last July's issue of Current Molecular Biology Reports (Connective Tissue Degeneration: Mechanisms of Palmar Fascia Degeneration) revealed that, "The early phases of the wound healing response are dependent on inflammation and fibrogenesis, recruitment of platelets, immune cell and fibroblast invasion, pro-inflammatory cytokine secretion, differentiation of fibroblasts to myofibroblasts and fibrin clot formation. If the damaging stimuli are repetitive, this will lead to persistent inflammation; higher levels of interleukins, tumor necrosis factor alpha (TNFα) and pro-fibrogenic transforming growth factor beta (TGFβ) [all in the family of inflammation] and therefore scarring. Although acute tissue injury is resolved completely, repetitive chronic injury, the addition of other factors such as age or diabetes or chronic inflammation have the potential to interfere with the correct remodeling of tissue and are contributing factors to persistent scarring. Mast cells [they release histamine, another inflammatory mediator] could also be involved in the inflammatory response leading to the development of fibrosis." Bottom line, while ACTIVATION OF FIBROBLASTIC ACTIVITY is typically a good thing, when these processes turn pathological, too much of a good thing becomes a bad thing --- potentially a very bad thing.
Here's one that will knock your socks off. Dr Langevin (an endocrinologist and neurologist) just showed us that fascia is essentially an immune system organ (something I've talked a bit about HERE). As far as the immune system goes, we already know that something like 70 or 80 percent of it is found in the Gut (HERE). An article called The IBS/SIBO-Psoas Connection and Why It's Important for Highly Sensitive People calls this relationship into play. As you read this, you need to be aware that the vast majority --- some studies say 85% --- of THOSE WITH SIBO HAVE IBS (the former is believed by many to be autoimmune, while the later is known to be autoimmune), and both are intimately related to a host of other autoimmune diseases. The author simply connected the dots (quotes below are cherry-picked). Side Note: You will see how important this relationship really is when you see my next post on the relationship between inflammation and SYMPATHETIC DOMINANCE.
"The psoas bridges the belly's enteric brain, central, and autonomic nervous systems. The large nerve ganglion located within the belly core going to the digestive and reproductive organs passes over, embeds into, and through the psoas. When looking at issues in the gut, including IBS/SIBO, I think the psoas may be a big contributor. When fascia is unhealthy, largely due to inflammation or injury, it becomes sticky and can form adhesions. Many sources cause the inflammation that leads to adhesions, the most obvious being direct injury or trauma. Other factors include infection, repetitive movement, poor diet, toxins, poor posture and emotional stress. Because fascia provides the atmosphere through which nerve interactions happen, it responds to stress and tension. Additionally, during an injury, it's common for fascia to constrict around the injury in order to provide structured protection, tightening the whole fascial system and potentially causing pain and discomfort in an area of the body not associated with the injury. The enteric nervous system functions without us thinking about it, but requires communication between this system and the CNS through sympathetic and parasympathetic fibers connecting the two. Through these links, the two systems can speak to each other. Generally, sympathetic stimulation (usually a stress response, indicating activity) inhibits gastrointestinal secretions and causes the digestive tract to constrict or close down. Parasympathetic stimuli (our "rest and digest" system) stimulates digestive activities."
The bottom line is that yes, I believe that fascia can be affected by autoimmunity. In fact, I believe that it's not terribly uncommon to see it attacked, whether via some of the known entities we discussed at the beginning of the post, or by inflammation induced by the unknown entities I touched on as well. I get slews of emails from people wondering if I can help them with _________ (insert problem here), many of which are various sorts of PAIN SYNDROMES. The things I am more likely to be able to help tend to be rather straightforward. For example, Mary gets in a car wreck, develops restriction, CHRONIC NECK PAIN (and probably HEADACHES), and contacts me to see if I think I can help. Probably so, and the cool thing is that she'll know in a single visit (HERE or HERE).
However, when people contact me with scenarios that look like THIS ONE --- pain all over the place, and a wide array of problems (like some of THESE) --- the odds that I can solve your problem without dramatic FM INTERVENTION shrink dramatically. The beautiful thing is that you can help yourself (I have provided a generic protocol HERE).
My rule of thumb (which is not always hard and fast) is that when people have known autoimmune diseases and/or pain that is both above and below the waist and on both sides of the body, I start thinking systemic issues such as autoimmunity (SYSTEMIC FASCIAL ADHESIONS among others). If this is the case, underlying drivers of inflammation must be addressed before TISSUE REMODELING is really going to help. Once you realize that there are those who believe that problems with fascia are the root of all sickness, disease, and pain, this post starts to make even more sense (HERE). If you know anyone who needs to see this material, be sure and get it in front of them by emailing them a link of showing us some love on FACEBOOK.
THE MEDICAL COMMUNITY IS GETTING HOT TO TROT FOR INFLAMMATION AS THE CAUSE OF CHRONIC DISEASE: WHY NOW?Read Now
The study (Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease), from the brand new issue of the New England Journal of Medicine, looked at just over 10,000 patients who had already had a heart attack and also had high levels of CRP and IL-6 --- common markers for inflammation --- and then gave them either a placebo or a drug called Canakinumab, intravenously, once a quarter, for four years. Not surprisingly (the study was funded by Novartis, manufacturer of Canakinumab) it led to "a significantly lower rate of recurrent cardiovascular events than placebo," without lowering CHOLESTEROL OR TRIGLYCERIDES. Because this study has been all over the news in recent days, we should discuss it just a bit.
The first thing I want to note is the excitement around this study. Why? Because the authors "proved" once and for all that inflammation is the cause of heart disease ("the inflammatory hypothesis of atherothrombosis had remained unproved"). While this many be technically true, it's not new information to my readers and it's certainly not new information the the medical community as a whole. All these researchers did was figure out another metabolic pathway of inflammation. That's it. That's all. Certainly cool, but not earth-shattering. Naturally however, in similar fashion to the way they discovered the COX II pathway of inflammation, work was immediately started to develop drugs to block it. And just like COX II Inhibitors, what did they find? They found SIDE EFFECTS.
Because inflammation is one of your body's many immune system responses, and because Canakinumab blocks inflammation, it stands to reason that this drug might be rough on the immune systems of those taking it. It was. The drug group had way more problems with infections than the placebo group. Some people might be willing to live with this if the drug really delivered on what's being claimed in all the PRESS RELEASES like that fact that other inflammatory diseases were positively affected by this drug as well. "significantly fewer reports of arthritis, gout, and osteoarthritis than did placebo. Cancer mortality was significantly lower with canakinumab than with placebo" (not surprising based on the first link in this post). But because the study of ANTI-INFLAMMATORY DRUGS is loaded with hype, hyperbole, and purposefully-created and overblown hope, let's dig a bit deeper.
Even though the study used the word "significant" numerous times in regards to results ('significant' is a mathematical word that has to do with the field of STATISTICS), an editorial in the same issue of the same journal by a Dr. Robert Harrington of Stanford, described the drugs as having, "modest absolute clinical benefit" (absolute benefit as opposed to relative benefit -- HERE). "Modest" is a way of saying that the drug worked, but not very much and not very well. This gets down to the ways that studies are set up and reported (HERE, HERE, and HERE). Even though this study reported that Canakinumab lowered incidence of second heart attacks by between 10 and 15%, it did not affect overall death rates ("All-cause mortality was neutral in the comparison of all canakinumab doses with placebo"). Health News Review put it like this...
"What does 15% translate to in absolute numbers? The way researchers measured results was in "events per 100 person-years", and the "events" were non-fatal heart attack, non-fatal stroke, or death from a cardiovascular-related cause. In the placebo group, there were 4.50 cardiac events per 100 person-years. In the group receiving 150 mg doses of canakinumab, there were 3.86 events per 100 person years. Of the various doses given (50, 150 and 300 milligrams), the 150 mg dose was the only statistically significant result, and it was only because of non-fatal heart attacks."
And what must we pay for such "modest" clinical benefits --- benefits that do not involve improving overall mortality rates? In other words, how much does this drug cost? To go through a grand total of sixteen infusions of Canakinumab (four per year) over the course of forty eight months, the cost would be $800,000. I'm not making that up folks; eight hundred thousand dollars, or two hundred grand per year. To attempt to do something that can only done with diet and lifestyle. Listen to what Meghana Keshavan wrote a few days ago in STAT (Tantalizing Clues Point to Inflammation's Role in an Array of Diseases. But Will Treatments Follow?), the medical news daily......
"Anti-inflammatory drugs have predictable and dangerous side effects, which showed up in the recent trial of the Novartis drug canakinumab in patients with cardiovascular disease. Some patients involved in the trial wound up becoming more susceptible to serious infections, such as the bacterial skin infection cellulitis, the deadly blood infection sepsis, and even tuberculosis. That's because the body relies on inflammation to trigger the immune system to fight such invaders. Tamp it down too much and the immune system may not leap to your defense. "The problem is if you block inflammation, you're blocking a primordial mechanism by which we are protected from the organisms that share the planet with us," said Dr. Clay Semenkovich, chief of endocrinology, metabolism, and lipid research at Washington University in St. Louis."
We should not be surprised at this when you consider that SUPPRESSING THE IMMUNE SYSTEM is our medical community's number one way of dealing with these sorts of problems. If you look at other immunotherapy drugs --- drugs with names that end mostly in "mab" or "mub" --- you see similar long-term consequences of blocking immune system function. All of this begs the question of how you can ethically hype a drug that has such minimal benefits, such large potential side effects, and such a huge price tag? Ethically, you can't. But for BIG PHARMA, revving up the hype machine is easy; the same way it's been done for decades. Get the media to buy in and promote for you --- for free. A great example of this can be found in Harlan Krumholz' article for Forbes last week (Inflammation: Is It the New Cholesterol?). Krumholz wrote...
"Paul Ridker, the principal investigator of the CANTOS trial and a cardiologist at Harvard, is the leading proponent of this inflammation hypothesis. [Disclosure: Paul is married to my sister (and I want to disclose that) and so I have had a front row seat in these developments over the last two decades.] His work and that of other scientists carefully and methodically laid the groundwork for the idea that giving people treatment that would quiet their immune systems would reduce their risk of heart disease."
The question that Krumholz and others should be asking is why our collective immune systems are so ramped up in the first place that they would need quieted or suppressed (think AUTOIMMUNITY here)? Why have we become the INFLAMMATION NATION? And just as importantly, is the trajectory we are on with our current form of medical care sustainable? I have argued in the past that it is not (HERE). And just the other day, Dr. Suneel Dhand, guest-writing for the blog Kevin MD, agreed with me in his fun little offering called What Happens When the Healthcare Bubble Bursts? In his article, the good doctor gave us his Top-3 ways of solving this problem before the bottom completely falls out. The second two included, "Some type of single-payer system that accepts rationing.... Eliminating bureaucracy and administration...."
Not that I'm a fan of private health insurance (they are the evil empire), but a government-run system that eliminates bureaucracy is the very definition of an oxymoron (for those of you who actually pay your own health insurance, just look at the colossal amount of bureaucracy and cost added by the ACA). What must happen (but probably won't) is that people start taking charge of their own health and the health of their families. Chiming in with a response to Dhand's article, Cardiologist, Dr. Wade Martin agreed with this assessment.
Please see my letter to the editor on page 33 of the April 10, 2017 Barron's regarding the fact that the U.S. healthcare system is one of the greatest bubbles in world economic history with cardiology at the epicenter because of its incessant obsessive focus on coronary artery revascularization and cardiac imaging, which frequently do not improve mortality or prevent myocardial infarction. This, in one of the most sedentary, obese, opioid-addicted nations in world history with "private" sector healthcare costs twice those of any other developed country and the worst longevity of all of them. Tulips anyone?
This, folks, is the ugly truth about the unsustainability of American disease management that no longer has the right or privilege to be called healthcare (HERE). It's the MYTH OF EVIDENCE-BASED MEDICINE. The brutal truth is that Inflammation always leads to fibrosis / scar tissue (HERE), which just happens to be our nation's number one leading cause of death (HERE). This isn't really news in any sense of the word. If you are looking for a better way to deal with your inflammation than DANGEROUS AND EXPENSIVE DRUGS, make sure to at least read THIS SHORT ARTICLE I wrote on what it takes to get healthy and stay that way. Unfortunately, all bubbles eventually burst, and healthcare as you know it won't be around forever.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).
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