Chronic Fatigue/Fibromyalgia and Energy Production

I regularly see clients presenting with chronic fatigue syndrome (CFS). This is where the client has fatigue that is so debilitating that they are virtually unable to function or undertake normal every day tasks. Often CFS presents as fibromyalgia, which is chronic fatigue with the added burden of widespread pain and stiffness throughout the body.

It is believed that the pain associated with fibromyalgia is caused when the mitochondria (the energy production plants in our cells) desperate to supply appropriate levels of energy to the body, switch from efficient aerobic (using oxygen) to inefficient anaerobic (not using oxygen) metabolism. This anaerobic form of energy production creates large amounts of lactic acid. Lactic acid, as anyone who pushes themselves hard when exercising knows, causes immediate muscle pain, which dissipates after a few minutes of rest. This pain however does not dissipate with fibromyalgia, as the body is unable to break the lactic acid down, due to mitochondrial dysfunction (not working properly). The excess lactic acid can also cause damage to the muscle tissue, presenting as very sensitive areas on the body. This process can feed on itself as the damage to the muscles releases a large number of free radicals (destructive molecules), which can cause additional damage if antioxidant status (the ability to neutralise free radical damage) is low.

Mitochondrial dysfunction is therefore one of the key areas to focus on when it comes to helping move the body back into balance with CFS and fibromyalgia. So what are the key ingredients required for healthy mitochondria? They require a raft of key nutrients for optimal performance, including but not limited to magnesium, B vitamins, essential fats, CoQ10, carnitine and alpha lipoic acid and must not be bathed in toxins.

Whilst clearly mitochondrial dysfunction is one of the key areas to focus on with these conditions, it should be noted that there are often multiple systemic imbalances going on, including but not limited to digestive dysfunction, poor antioxidant status, immune system dysregulation, chronic inflammation, viral infections, food and/or environmental sensitivities/allergies, thyroid and adrenal dysfunction and micronutrient deficiencies. Everything in the body is connected and nothing exists in isolation.

Once again looking at the body from a functional and holistic perspective is key to any potential solution to these devastating conditions.

Migraines

Migraines are debilitating vascular headaches, which usually happen on one side of the head. Migraines are thought to affect around 1 in 7 people with an estimated 190,000 migraine attacks every day in the UK affecting three times as many women as men and accounting for an estimated 25 million days lost from work and school each year.

The typical sequence of events is that an initial spasm happens in the wall of a meningeal artery (one of the arteries in the head); the spasm does not last long (a few minutes) and is followed by a paralysis of the wall of the artery, which can last for days. This paralysis leads to swelling and inflammation of tissues around the artery wall, causing the pain (migraine).

So what causes the spasm in the first place? Many factors are thought to be involved, but one of the key contributors is an over accumulation of toxins in the body. Liver and gut health are fundamental areas to critically evaluate and support due to the crucial role that these two organs play with respect to optimal detoxification.

If an imbalance in the gut bacteria (dysbiosis) is present (a common thread in my articles) then the ‘bad’ bacteria can cause an overproduction of histamine in the gut. Histamine is secreted by specialist immune cells as part of a local immune response to the presence of unwanted bacteria/triggers. It is the excess levels of histamine that causes blood pressure to drop too low and initiate the spasm that starts the sequence of events.

Unidentified food sensitivities (where the immune system is inappropriately responding to specific food proteins) causing elevated levels of inflammation are also potentially a significant trigger for migraines. Research and clinical experience would suggest that gluten related disorders (encompassing wheat sensitivity, coeliac disease and non coeliac gluten sensitivity – another common thread in these articles) are significantly correlated with migraines. Other factors involved would appear to be magnesium status (low magnesium is a significant and independent predictor of migraine risk) and B vitamin deficiencies.

Alzheimer’s a multi-factorial approach

Alzheimer’s disease (AD) is the most prevalent form of dementia and it is estimated that 160 million people globally by 2050 will have this disease.

So far the search for a single ‘silver bullet’ pharmaceutical approach to treating AD has not delivered anything other than a temporary slight improvement in symptoms with no long term impact on disease progression. Recent biochemical research however would suggest that AD is both triggered and perpetuated by a complex interaction of different factors and that a multi-factorial approach to treating this devastating condition may provide better outcomes.

Pioneering work is being undertaken in this area by Dr Bredesen, who describes dementia as being primarily a ‘metabolic problem’. In a small but ground breaking study published in Aging in 2014, a 90% success rate in both arresting and reversing early stage AD was reported. Dr Bredesen uses a combination of personalised dietary and lifestyle interactions (includes supporting digestive function, identifying imbalances in the gut, correcting identified nutrient deficiencies, optimising vitamin D levels, eating food over a particular window of time in the day, assessing metal toxicity, optimising sleep, increasing exercise and movement, reducing inflammation, identifying food sensitivities, supporting mitochondrial function and stimulating the brain) with the client to achieve substantial results over a 3 to 12 month period. Larger clinical trials are currently underway in the UK and USA.

These results on the face of it look to good to be true, but in reality simply reflect the obvious which is that chronic disease is rooted in the mismatch between our genetics and the modern world that we have created for us to live in. Your environment (diet, toxic load, stress/trauma, and infections) is fundamental to your long-term health and well-being and should be one of the first areas to seriously evaluate when confronted with any chronic condition. What makes you, you is unique to you and this is the premise behind the ‘functional model’ of health. Working with a functionally trained health practitioner on any chronic condition, along with the required work and commitment that these types of interventions require, can provide significant health benefits.

Non Coeliac Gluten Sensitivity – ‘No Man’s Land’

Gluten is the main structural protein complex barley, rye and wheat and wheat is the most widely consumed grain in the world. Gluten related disorders (where there is an inappropriate reaction to gluten) is an umbrella terms that includes coeliac disease (CD), wheat allergy (WA) and non-coeliac gluten sensitivity (NCGS).

CD is an autoimmune condition (please see here and here for previous articles) that develops over time and is officially diagnosed using a combination of blood, genetic and small intestine biopsy test results. Most people are unaware that they have CD. Wheat allergy on the other hand is overt, with symptoms developing in minutes to hours and involves a measurable IgE (allergic) response. Both CD and WA are thought to affect approximately 1% of the population.

NCGS (characterised by feeling better on a gluten free diet) on the other hand is neither allergic nor autoimmune in nature, often involving a mixture of both CD and WA symptoms and is currently diagnosed by exclusion, as there are no current agreed laboratory tests. NCGS frequency is still unclear but might be as high as 6% of the population. Typical symptoms of NCGS include: diarrhoea, abdominal pain, weight loss, gas, bone/joint pain, leg numbness, muscle cramps, foggy head, headaches, dermatitis and anaemia. NCGS is not associated with the existence of other autoimmune conditions and the gut lining typically does not express markers of permeability (as with CD). Our precise understanding of how NCGS evolves as a condition is currently lacking.

A clear connection between IBS and NCGS has been detected. It is therefore likely that a subset of those presenting with IBS who have not got WA or CD may in fact have NCGS and would still benefit from a gluten free diet. This group of individuals are at risk of falling into a ‘no man’s land’ between allergists and gastroenterologists with the explanation of their condition sometimes being connected to psychosomatic triggers, rather than gluten itself. So whether it is IBS or any of the other symptoms listed above, surely it is worth eliminating gluten for a while? You might be surprised at how you feel!

27th April 2017 Event at Arlington Arts (Newbury) – Sensitivities, Chronic Inflammation and Autoimmunity

Sensitivities, Chronic Inflammation and Autoimmunity
How food and environmental choices can impact your long-term health

Thank you to everyone that attended this event. We had 157 people turn up………..

You can view Part 1 of this seminar here: https://www.youtube.com/watch?v=BFOV00Phs7Y

Research shows that unidentified sensitivities (to both food and the environment) are often implicated in the development of and/or perpetuation of a number of chronic health conditions including but not limited to eczema, joint pain, IBS, indigestion, depression, anxiety, headaches, fatigue, weight gain, congestion and heart palpitations.

This seminar provides you with an easy to understand overview of the following key topics:
1) What is the difference between an allergy, sensitivity and intolerance?
2) What impact might unidentified food and environmental sensitivities behaving on your health?
3) Coeliac disease and non coeliac gluten sensitivity – the differences
4) Why simply cutting gluten out of the diet is not enough if you are a diagnosed coeliac
5) Sensitivities and autoimmunity
6) Items to carefully consider when choosing a sensitivity test
7) Personalised dietary and lifestyle interventions and the road to health

 

 

Histamine Intolerance – Are You Reacting to ‘Healthy’ foods?

Occasionally I see clients not reacting as you might expect to a clean healthy nutritional protocol (containing fermented foods, meat/fish, vegetables, fruits and nuts/seeds) and sometimes their original symptoms might even be exacerbated. When this happens I always suspect ‘histamine intolerance’.

Histamine intolerance (too much histamine) can manifest itself as any number of symptoms including but not limited to skin problems, insomnia, light headedness, palpitations, low blood pressure/fainting, muscle pain/cramps, joint pain, tinnitus, depression, unexplained bruising and rosacea.

Histamine is a chemical that is secreted by specialist immune cells as a response to help protect the body against infection. A histamine response is involved in the typical symptoms that are associated with mild allergic reactions (e.g hay fever & hives) and this is why antihistamines are often used to help manage such reactions.

Histamine intolerance occurs when the body has too much histamine. This happens when the supply of histamine exceeds the ability of the body to break it down. The effect of histamine on the body is cumulative – visualise a barrel with holes in the bottom being filled up with water. The water represents histamine and the holes the enzymes that break histamine down. If the amount of water entering the barrel exceeds the amount escaping, then the barrel will eventually overflow (this is the point at which the body has too much histamine).

The irony of histamine intolerance is that the foods that you are often told to consume on a healthy plan are the very foods that contribute the greatest histamine load! These include raspberries, avocados, spinach, meat stocks, citrus fruits and fermented foods (including certain strains of probiotics). The key to balancing histamine (stopping the barrel overflowing) is to both reduce intake and support the optimal degradation of histamine. It turns out that some of us are less able to produce the enzymes required to break down histamine. An imbalanced microflora is also significant contributor to elevated histamine levels. Enzyme and histamine levels can be tested for and then an appropriate strategy implemented to help regain control of key symptoms before revisiting the careful reintroduction of healthy higher histamine foods.

Coeliac Disease?

Coeliac disease (CD) is an autoimmune condition where the body’s immune system attacks and damages the villi (the finger like small protrusions in the small intestine) affecting 1% of the global population (circa 70 million people). Originally considered a rare childhood condition it is now recognised as primarily an adult disease. The autoimmune destruction of villi is triggered by eating gluten (found in Barley, Rye, Oats and Wheat) and since this process dramatically reduces the surface area of the small intestine, the body’s ability to absorb nutrients is compromised, potentially leading to a raft of disparate symptoms and disease presentations.

Screening studies show that CD is one of the most common life long disorders in North America and Europe and that currently only 1 in 8 coeliacs are diagnosed and that on average it takes 13 years and 5 doctors for a diagnosis. So why is this?

The classical symptoms of diarrhoea and abdominal cramping are just one clinical manifestation of CD, with research showing that less than 50% of coeliacs currently present with these classical symptoms. Non classical or ‘silent coeliac disease’ presentations can include: iron deficiency anaemia, osteoporosis, arthritis, neurological degradation (ataxia and epilepsy), depression, fertility issues, migraines, blood test abnormalities, chronic kidney disease, raised liver enzymes, mouth ulcers, dental enamel defects and a number of other autoimmune conditions including Hashimoto’s, type 1 diabetes, psoriasis, Addison’s disease, cardiomyopathy and autoimmune hepatitis.

Interestingly the research base would suggest that more people with less severe symptoms (mild anaemia and/or reduction in bone density) are being diagnosed with CD and this often includes irritable bowel syndrome (IBS), with up to 30% of coeliacs having had a previous diagnosis of IBS. It should also be noted that the first-degree relatives (parent/sibling/child) of coeliacs have a significantly elevated risk of developing the same condition and should be tested. Please note that the standard blood tests for CD often provide false negative results (due to the body not being able to produce sufficient amounts of the specific antibodies being measured, or reactions that may be present to other immune stimulating peptides of gluten that are not being measured).

So if your are presenting with an autoimmune and/or chronic condition you might want to seriously consider the impact that gluten might be having on your health.

Thyroid Dysfunction – the ‘Great Pretender’

What might the inability to lose weight, low body temperature (Raynaud’s & cold extremities), lack of energy, depression, chronic constipation, elevated cholesterol, hair loss (eye brow and body hair), sub optimal immune function, varicose veins, skin problems, haemorrhoids, infertility, blood sugar and sex hormone imbalances all have in common? The thyroid…..

The thyroid is a butterfly shaped gland that is located just below the ‘Adam’s apple’ in the neck. Optimal function of this gland is central to well being with its primary role being that of controlling metabolic rate. All cells in the body are influenced by thyroid hormones. This is why thyroid dysfunction has been described as ‘the great pretender’ masquerading as almost any condition that you can imagine.

Low thyroid function is the most common form of dysfunction (10 times more common in women). 90% of low thyroid dysfunction is caused by Hashimoto’s (an autoimmune condition where the body’s immune system attacks the thyroid gland).

The production and balance of thyroid hormones is an intricate process that depends on a multitude of nutritional and environmental factors that need to be in balance. The simplistic version goes like this: The thyroid gland is stimulated to produce its main hormone T4 (thyroxine) by the action of thyroid stimulating hormone (TSH). T4 (the storage hormone) circulates round the body and has to be converted into T3, the ‘active’ hormone. Without T3 the cells would not respond. Here lies the problem. Efficient conversion of T4 to T3 is dependent on the presence of key nutrients and optimal gut health. Nutritional deficiencies (selenium, iodine, iron, copper, magnesium, manganese, zinc, chromium, calcium, vitamins A, B, C, D and E) and the presence of toxic metals (mercury, cadmium, arsenic, aluminium), BPA and certain medications are known to impact thyroid performance. Stress, adrenal health and systemic inflammation also play a significant role. So optimal thyroid health is dependent on a raft of key variables that unsurprisingly include a balanced microflora/ecology in the gut, a low toxic load and a nutrient dense diet.

Dr Broda Barnes (an eminent endocrinologist who dedicated most of his professional career to thyroid dysfunction) noticed that average body temperature is significantly lower if you are presenting with low thyroid function (as metabolic rate (which controls temperature) is controlled by thyroid hormones). He devised a simple test that effectively measures the cellular response to thyroid hormones and not simply levels of thyroid hormones in the blood. The Barnes Basal Temperature test can be done in the comfort of your own home with the only requirement being the ownership of a mercury or modern day analogue thermometer (digital thermometers are not accurate enough). I often suggest this test with clients that I feel maybe presenting with thyroid dysfunction and use the results to support a request for further comprehensive evaluation (not just levels of TSH – but the full array of thyroid hormones and antibodies) via their GPs. If the GP does not oblige, then there are a number of comprehensive thyroid panels that can be run privately.

Unfortunately the modern medical general practice approach to thyroid dysfunction is too simplistic. Research suggests that measurement of TSH levels alone is not always sufficient to diagnose dysfunction (you can have normal TSH levels and still have thyroid dysfunction) and the prescription and monitoring of only T4 (for those taking prescribed medication to help manage low thyroid function) may well work for some, but as I see regularly in my clinic, it often does not work for others.

Thyroid Health – A Functional Perspective – Seminar – 22nd September 2016

Thyroid dysfunction has been described as ‘the great pretender’ masquerading as almost any condition that you can imagine. Common symptoms associated with thyroid dysfunction include: weight gain, low body temperature, lack of energy, chronic constipation, elevated cholesterol, hair loss, sub optimal immune function, infertility and sex hormone imbalances.

This seminar is being held at Natures Corner in Newbury on Thursday 22nd September 2016 starting at 19:00 (expected end time 20:30). During this seminar we will discuss how the thyroid works, signs and symptoms, the adrenal connection, the role of systemic inflammation, basic tests that you can do at home to evaluate your thyroid function and the impact that diet, lifestyle and supplementation can play in supporting overall thyroid health.

There will be a Questions and Answers session at the end.

Ticket cost £5 (redeemable against any in store purchases).

The Gut and Its Role in Human Health

What might joint pain, asthma, fatigue, high blood pressure, diabetes, skin problems, heart disease, depression, IBS and autoimmunity all have in common? Answer: The digestive system.

The health of the digestive system is fundamental to overall well-being. Hippocrates stated nearly 2,500 years ago that ‘death sits in the bowels’ and ‘bad digestion is the root of all evil’. Scientists are now just beginning to realise the truth associated with these statements. Study after study links imbalances in the digestive system to the development of long-term disease. So why might this be the case?

The 25 feet of tubing that runs from the mouth to the anus, is populated with a huge number of bacteria. It is estimated that we have on average 100 trillion bacteria in our digestive system (that’s equivalent to the number of footsteps required to walk from Earth to Pluto and back again over 7 times!), effectively making us more ‘bacteria’ than ‘human’. These bacteria weigh in total around 2kg and consist of an estimated 35,000 different bacterial species, typically being referred to as the microflora or microbiota.

The microflora is made up of both good and bad bacteria. In a healthy gut, good bacteria dominate and keep control of the bad ones (using them for important tasks). Some of the key roles undertaken by a balanced microflora include: weight management, energy production, genetic expression, balancing mood, efficient digestion and absorption of nutrients, manufacture of certain vitamins and maintaining both a strong and tolerant immune system.

Problems can start to occur when the bad bacteria become too dominant (dysbiosis), contributing to inflammation of and damage to the gut lining. This can lead to the manifestation of any number of disparate and seemingly disconnected symptoms. The science now recognizes multiple ‘gut–organ axes’. What happens in the gut does not stay in the gut and we ignore the impact that the microflora has on our health at our own peril.

What causes dysbiosis? Modern life! Specifically: caesarian birth, poor dietary choices, food sensitivities, low stomach acid, antibiotics, medications, chronic stress, toxins/pollution, infectious diseases and alcohol/drug abuse.

Thankfully the body is regenerative and it is possible, working with a skilled practitioner, to both identify and rectify imbalances in the microflora, using specific functional diagnostic testing in combination with targeted nutritional and lifestyle protocols. Remember, ‘you’re in control’ far more than you might at first ever believe.