Tag Archives: Crohn’s Disease

Rosacea: A Matter of the Microbiome

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Rosacea: A Matter of the Microbiome

Rosacea is an inflammatory skin disease with an elusive pathology that is thought to include a combination of microorganisms, genetic predisposition, abnormal neurological signaling, a disrupted innate immune system, and dysbiosis. The clinical presentations can differ slightly between individuals and help classify rosacea into one of four subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular.

Traditional therapy has focused on anti-inflammatory antibiotics, but long-term pharmaceutical therapy is rarely a desirable option due to the risk of gastrointestinal distress and antibiotic resistance. It is also well known that there are specific triggers that exacerbate rosacea including heat, sun exposure, spicy foods, alcohol consumption, exercise, and heightened emotions. Given the fact that none of these are modulated by antibiotics, questions are raised regarding other treatment modalities that may more effectively address the underlying causes of rosacea. Diet is increasingly becoming the focus as we learn more about the gut-skin axis and its influence upon many of the elements of rosacea including the microbial, inflammatory, and immune components.

Diet is unquestioningly becoming an aspect of managing all subtypes of rosacea. According to a survey by the National Rosacea Society, 78 percent of the 400+ patients surveyed had altered their diet due to rosacea; and of this group, 95 percent reported a reduction in flares. Of the dietary triggers reported in this survey, most fell into 4 groups: heat-related (hot coffee, tea), alcohol-related (wine, hard liquor), capsaicin-related (spices, pepper, hot sauces), and cinnamaldehyde-related (tomatoes, citrus, cinnamon, chocolate). One explanation for the triggering effects of these foods is their ability to stimulate vanilloid channels which are active in patients with rosacea. When these channels are activated, they increase blood flow to the skin via neurogenic vasodilatation, which causes the flushing and burning associated with this condition.

In a multicenter retrospective case-control survey of 2637 subjects (controls and patients with rosacea) that sought to find a relationship between diet and rosacea, a high-frequency intake of fatty food and tea was associated with rosacea, while a high-frequency  of dairy products negatively correlated with it (and may have actually been linked to a reduction in rosacea severity).

The gut-skin axis is another explanation for the link between diet and rosacea. Anecdotally, many patients with rosacea also experience gastrointestinal conditions. A population-based cohort study of nearly 50,000 Danish patients with rosacea discovered a high prevalence of celiac disease, Crohn’s disease, ulcerative colitis, Helicobacter pylori infection, small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome. Research has already confirmed a direct link between the microbiome of the gut and the robustness of the immune system. Additionally, since the body’s inflammatory response is a role of the immune system, these cannot be treated separately. Therefore, it should be no surprise that rosacea – a condition with immunological and inflammatory-based pathology – is also associated with gastrointestinal conditions that are rooted in an unhealthy microbiome. This association is further strengthened by the fact that antibiotics often lead to short-term improvement but are not a long-term solution. Initially, antibiotics eradicate the pathogenic organisms from the gut, but without adequate probiotic and dietary support to rebuild a healthy microbiome, the positive effect of the antibiotics diminishes and eventually has an opposing effect on the gut.

The microbiome of the gut has also been shown to influence the microbial composition of the skin, which may affect the bacterial component of rosacea. Further, the skin microbiome modulates the immune response at the surface of the skin. Since the pathology of rosacea involves a dysregulated innate immune response, including enhanced expression of toll-like receptor 2 in the epidermis of rosacea patients, correcting the gut microbiome may be a foundational process for rebalancing the microorganisms and immune response of the skin.

Dietary patterns that support a balanced microbiome include 1) fermented, probiotic-rich foods such as yogurt, kefir, miso, kimchi, and sauerkraut; 2) dietary plant fiber to serve as prebiotics; and 3) cold-water fish and seafood, and/or omega-3 fatty acid supplements as substrates for anti-inflammatory prostaglandins that competitively inhibit pro-inflammatory pathways. Low-carb, high-protein diets, such as a Paleolithic diet, have been shown to positively modulate the microbiome since they eliminate sugar sources that foster the growth of pathogenic bacteria while providing nutrients that modulate the inflammatory response and promote a favorable environment for beneficial organisms.

Individuals suffering from rosacea often groan as the summer months progress since the heat and sun often exacerbate the flare-ups; however, rosacea is far less of a seasonal problem and more of a year-round gastrointestinal problem, meaning its management needs to begin with a closer look at the diet.

The Real Truth about Osteoporosis

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The real truth about Osteoporosis

Osteoporosis literally means porous bone. The word refers to a horrible disease in which bones become fragile and much more likely to break, and the skeleton looses its integrity and turns into a terrifying time bomb inside of you. Osteoporosis makes an everyday act, like going to the mailbox, fraught with the danger of a hipbone snapping simply from the act of walking. Osteoporosis is seen much more often in women than in men, and it can begin when you least expect it.

Though osteoporosis is generally considered an old woman’s disease, this is not actually the case. The most recent data from the National Osteoporosis Foundation shows that about 12 million people in the U.S., age 50 or over, already have full blown osteoporosis, and another 40 million are on the doorstep of the disease because they have low bone density, a condition known as osteopenia. Unless proper intervention is taken, women with osteopenia almost always slide into osteoporosis.

Although the common wisdom says those younger than 50 only rarely exhibit symptoms of osteoporosis, a study from the University of Arkansas found the disease to be a greater risk than most women suspect. Researchers collected information on 164 women of typical collage age, and found that 2 percent of them had bone densities low enough for them to qualify for a diagnosis of osteoporosis, and 15 percent had bone densities low enough for a diagnosis of osteopenia.

There are no symptoms when osteopenia begins. There is no pain or change as bones becomes thin, brittle and less dense. As you progress to osteoporosis, the first signal of disease is often a bone breaking from only minor injury and in some cases, from no injury at all. Other symptoms include:

  • Back pain caused by a fractured or collapsed vertebra
  • Loss of height over time as vertebra deteriorate and compress
  • Stooped posture and distended abdomen (the body takes on the shape of an S)

Mainstream media and the medical establishment perpetuate the myth that osteoporosis is caused by a deficiency of calcium, and support the notion that calcium supplements are the answer. But this fails to explain why Americans, who have the highest rates of calcium consumption in the world, also have the highest rates of osteoporosis.

There is a psycho-social component to osteoporosis, as the disease is usually seen as a woman’s own fault. (She has osteoporosis because she doesn’t eat right, doesn’t take enough calcium pills, doesn’t exercise enough etc.) And nothing herald’s aging more than a stoop.

Factors that speed the way to a diagnosis of osteoporosis include:

  • Poor diet during formative years
  • Being athletically active as a young woman (results in low estrogen levels)
  • Radiation (including mammograms)
  • Use of synthetic corticosteroids such as prednisone
  • Being a thin white woman
  • Having Celiac, Crohn’s or any other disease that blocks nutrient absorption
  • Smoking
  • Eating disorders
  • Excessive alcohol consumption
  • Prolonged use of birth control pills
  • Chemotherapy

The truth about osteoporosis is that bone is an endocrine tissue. In both women and men, bone expresses receptors for the steroid hormones estrogen, progesterone and testosterone. This is undeniable full faced evidence that optimal and balanced levels of these hormones is essential for healthy bones, and it is the reason that osteoporosis, like all the degenerative diseases, does not show up until hormones have diminished.

Estrogen, progesterone and testosterone directly power the two essential components for the production of healthy bone. They are:

  • Osteoblasts–new bone cells
  • Osteoclasts–old bone cells

It is important at this point to realize that bone is not static. It is instead a dynamic process in which new bone is constantly being made, and old bone removed in a process known as resorption. When steroid hormones are at optimal levels and in balance, bone is healthy and strong. And when hormone levels decline and become unbalanced, the disease process begins.

In both women and men, osteoblasts are powered by estrogen and testosterone. Osteoclasts are powered by progesterone.

Osteoblasts are in charge of producing bone matrix and mineral. Ideally, they work as a team with components of bone marrow and osteoclasts for optimal bone formation.

The function of osteoclasts is critical in the maintenance and repair of bone. Bones are stronger than aluminum on a weight basis, and are a composite material of approximately equal amounts of hydrated protein and mineralization.   Osteoclasts disassemble this hardy composite at the molecular level by producing collagenase, an enzyme that destroys collagen.

Osteoblasts and osteoclasts together control the amount and quality of bone tissue you have in your body. This means that when you have optimal levels of balanced steroid hormones, osteoblasts and osteoclasts will work in harmony to produce healthy bones, and not a sign of osteoporosis will be seen, no matter what your age.

Hormones are essential to total body health and well being

There’s more to hormones than high quality bones. Hormones are of supreme importance to your overall health and well being. They are the great communicators of the body, by sending chemical messengers that transfer signals and instructions from one set of cells to another. When all hormones are present at optimal levels, not only is harmony restored to your osteoblasts and osteoclasts, but to your body as a whole. Developing osteopenia or osteoporosis is a signal that your hormones need attention.

Don’t discount hormones. They are so important that they have a branch of biological science devoted to them, known as endocrinology. Even the medical establishment grudgingly recognizes the tremendous importance of hormones, and labels doctors who specialize in them as endocrinologists.

Hormones influence and regulate almost every cell, tissue, organ, and function of the human body, including growth, development, metabolism, and sexual and reproductive function. Hormones orchestrate the maintenance and balance of our internal terrain, through a process known as homeostasis.

Yes, there has been much bad press about negative effects of hormones. This has been done intentionally to scare you away from hormone replacement. Selling drugs to the hormonally deprived is big business at its worst. However, more and more women are getting the message that optimal balanced hormones are key to wellness at all levels and the absence of osteoporosis.

This is what’s behind the new breed of physicians who are trained in anti-aging medicine. These doctors specialize in bioidentical hormone replacement, not the hormone substitution drugs we heard so much about a decade ago. Bio identical hormones are exact replicas of the hormones humans make naturally when they are young. Bio-identical hormones can be replaced at levels you had in your prime. The result is not only freedom from osteoporosis and other degenerative diseases. It is the only way to recapture some of yourself as you used to be.

NOTE: For decades I have recommended the DPD Urine Pyrlinks Test which measures the amount of Osteoclasts vs. Osteoclasts.  As long as there are more Osteoblasts then Osteoclasts, you are in good shape. This test is considered the Gold Standard because its accuracy far outweighs the standard Dual-Energy X-ray Absorptionmetry  most doctors use for osteoporosis determination.

NOTE: Osteoporosis has nothing to do with calcium.  One of the best products I have ever recommended for Osteoporosis is Magnifical and although the last three letters are “cal” there is no calcium in this product.

NOTE: As written above, hormones play a vital role in the prevention of Osteoporosis. Women past menopause or heading into menopause usually display a very weak Progesterone signal and men usually have no signal at all.  For this I recommend the Saliva Test for Hormones because it measures both RNA and DNA and as such is a more accurate marker than conventional blood test which can only measure one point in time.

NOTE: Drugs like Fosamax and Prolia interfere with the breakdown of dead cells (Osteoclast) and as such, dead bone cells are not being eliminated to make room for new fresh bone cells ((Osteoblasts)) to replace them. This causes “spontaneous fractures” which is when you are sitting down watching TV and your arm or leg suddenly breaks.  This has been well documented and was shown in a i hour piece on ABC News a while back.

NOTE: You do not fall and break your hip–your hip broke and you fall as a result!!

For more information:

http://www.ncbi.nlm.nih.gov/pubmed/25202834

http://www.ncbi.nlm.nih.gov/pubmed/24385015

http://www.ncbi.nlm.nih.gov/pubmed/21815190

http://www.ncbi.nlm.nih.gov/pubmed/21149714

http://www.ncbi.nlm.nih.gov/pubmed/20162450

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Vitamin E & the Brain

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Vitamin E & the Brain

Among fat-soluble vitamins, vitamin E often gets sidelined in favor of compounds with better-known functions. People automatically associate vitamin A with vision and eye health, vitamin D with calcium homeostasis and bone health, and vitamin K with proper blood clotting. When vitamin E makes a rare appearance in discussions about health and nutrition, it’s often in the context of infertility, since deficiency of this nutrient is associated with reproductive difficulties  in animals and humans. But with advances in technology, scientists continue to uncover previously unknown and under-appreciated roles for vitamins and minerals. In the case of vitamin E, this nutrient might have a significant role to play in brain health and neurological function.

Results of a recent animal study support a requirement for sufficient vitamin E in order to deliver and maintain adequate levels of DHA and DHA-dependent phospholipids in the brain. Neuronal cell membranes are rich in cholesterol and polyunsaturated fats, which are highly susceptible to oxidation. With vitamin E having an antioxidant function, a deficiency can have dangerous consequences for brain health. In fact, severe vitamin E deficiency can manifest as cerebellar ataxia, demonstrating the importance of this nutrient for proper functioning of the central nervous system. Vitamin E deficiency also results in reduced myelination of spinal cord fibers, and leads to neuropathic and myopathic lesions all of which may have disastrous consequences for cognition and neuromuscular coordination.

A small, double-blind, placebo-controlled crossover study demonstrated that vitamin E supplementation led to improved scores on the Abnormal Involuntary Movement Scale (AIMS) in tardive dyskinesia patients who had had the condition for less than five years. The vitamin intervention was less effective in subjects with more longstanding disease.

The cerebrospinal fluid (CSF) of Alzheimer’s disease patients has been shown to be low in Vitamin E.While this specific finding may play a direct role in disease pathology, it might also simply be a reflection of overall poor nutrient status resulting, in part, from the modern diet, which is high in refined carbohydrates and low in micronutrients. However, considering the important role of vitamin E in the central nervous system, a lower level of this nutrient in CSF may expose neurons to profound free radical damage, leading to memory loss and declining cognitive function. Compared to placebo, patients with moderately advanced Alzheimer’s given 2000 IU of vitamin E per day experienced delayed deterioration of cognitive function. . Other studies indicate vitamin E is more effective in combination with another important antioxidant, vitamin C.

Reviews and meta-analyses of studies involving the use of supplemental vitamin E show mixed results, leading researchers to stress using caution regarding high doses of vitamin E. Some study authors suggest emphasizing food sources of vitamin E, or a multivitamin with around 30 IU of alpha-tocopherol, rather than isolated vitamin E supplements that deliver a higher dose. As is true for the use of any nutritional compound in a healthcare setting, caution should, of course, be practiced when dosing vitamin E. However, the mixed outcomes of studies employing vitamin E may be the result of confounding from the makeup of the supplements themselves. For example, a high alpha-tocopherol preparation may result in different effects than one with a higher fraction of gamma-tocopherol.

While frank vitamin E deficiency is rare, it is not unheard of. Vitamin E Deficiency can result from inborn errors of tocopherol transfer proteins, as well as disorders of lipid absorption, transport, and assimilation. Conditions that affect digestive efficiency, such as celiac disease and Crohn’s  disease, may interfere with proper absorption of fat-soluble nutrients. Biliary insufficiency resulting from compromised liver or gallbladder function may also contribute. An additional cause of vitamin E deficiency (as well as deficiency of many other nutrients) is bariatric surgery. While this can be a lifesaving procedure for many people, altering the anatomy of the digestive tract can have severe consequences for nutrient absorption, and extra care should be given to ensuring sufficient nutrient uptake in the body.

The foods richest in vitamin E are nuts and seeds, whole grains, and vegetable oils, such as corn, soybean, and safflower oils. However, overly large intake of these oils is not recommended, due to the potential for skewing the dietary omega-6/omega-3 fatty acid ratio toward the generally pro-inflammatory omega-6 pathways.

NOTE: GCEL (Glutathione) is 5000 times stronger than Vitamins C & E,

  • Vitamin C has 5 extra electrons to donate
  • Vitamin E has 3 extra electrons to donate
  • GSH has 1 million extra electrons to donate