Constipation – normal but certainly not optimal

The main symptoms of constipation include having to strain to defaecate, the feeling of incomplete bowel evacuation, the passing of hard and lumpy output that is either larger or smaller than it should be and/or having less than 3 outputs per week. Other symptoms that may also be present include bloating, gas, nausea, migraines, headaches, lower back pain, anxiety and fatigue.

The reported prevalence rates of constipation in the UK vary widely between studies, with figures ranging from 4% to 20%. Constipation affects twice as many women as men and older people are five times more likely than younger adults to suffer from constipation (NICE data). Whilst being constipated maybe considered as ‘normal’ it is far from ‘optimal’, as it clearly reflects underlying functional system imbalances in the body.

There are a multitude of potential reasons as to why constipation occurs. These include poor diet, dehydration, lack of appropriate fiber (although increasing fiber with chronic functional idiopathic constipation – long term constipation with no known cause – can in fact make things worse), gluten related disorders and dairy sensitivities, other unidentified food sensitivities (will be unique to the individual), imbalances in the bacterial species of the gut (dysbiosis), small intestinal bacterial overgrowth (SIBO) – typically the production of too much methane, medication use – read the potential side effects of any medications that you are taking and discuss with your GP if required – opioid induced constipation is extremely common, stress, sub optimal magnesium status, thyroid dysfunction, hormonal imbalances, lack of exercise, food poisoning, accidents (damage to the vagus nerve) and even ‘long COVID’.

Often, simply adjusting diet (the general advice is to try increasing fiber), drinking more water and increased levels of exercise will improve/resolve the situation. If however these basic adjustments do not deliver the required benefits, then it is important to engage with your GP to ensure that there are no other significant underlying conditions (in rare cases chronic constipation is correlated with an increased risk of developing conditions such as Parkinson’s disease, multiple sclerosis and even bowel cancer). Please however note that relying long-term on the use of laxatives to achieve the desired output type and frequency, is not addressing ‘why’ you are constipated. By working with a suitably qualified practitioner and thoroughly evaluating the myriad of potential reasons as to why constipation is happening, should lead to answers and an effective solution.

 

We Need An Integrated Approach To Cancer ….

Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018’ (World Health Organisation – September 2020). Unfortunately the current situation is that there are approximately 1,000 new cancer cases every day in the UK (Cancer Research UK – September 2020) and 465,000 every day globally in 2018 (World Health Organisation – September 2020). ‘1 in 2 people in the UK born after 1960 will be diagnosed with some form of cancer during their lifetime’ (Cancer Research UK – September 2020). Is this acceptable? I would suggest not, especially as the current mainstream belief is that up to 40% of cancers could be prevented (Cancer Research UK – September 2020). ‘Obesity, chronic low-grade inflammation, and high blood glucose, insulin and insulin-like growth factor 1 levels have been associated with a higher risk not only of developing but also of dying from various cancers’ (Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality – Physiological Reviews 2015)

Whilst there have undoubtedly been considerable advances in recent years in the ‘standard’ treatment options available and ‘survival rates’ (defined as living for more than 10 years) have doubled in the past 40 years in the UK (Cancer Research UK – September 2020), this disease still continues to inflict an ever increasing and unacceptable economic, social and emotional burden on humanity. This is in spite of unimaginable amounts being spent on research and treatments since the ‘war on cancer’ was declared in 1971. ‘Survival rates’ are not uniform across cancer types, age and sex, ranging from 1% with pancreatic cancer to 98% with testicular cancer (Cancer Research UK – September 2020).

Whilst increasing survival rates are clearly a good thing, is simply ‘surviving’ as opposed to ‘thriving’ good enough? Should we take comfort from the fact that whilst 50% of us are expected to develop cancer at some point in our lives, that we should simply rely on standard modern medical treatments to come to our rescue at the point of crisis, with all their potential negative consequences for the rest of our lives, as opposed to thinking about other options, to not only help reduce the risk of developing cancer in the first place, but also improving outcomes?

Conventional cancer treatments are typically brutal leaving ‘a gruelling physical and mental legacy for many years afterwards….and many of these people are not living well…..living with multiple long term conditions…..including chronic fatigue, sexual difficulties, mental health problems, chronic pain, urinary and gastrointestinal problems and persistent tissue swelling’ (‘Throwing light on the consequences of cancer and its treatments’ – Macmillan Cancer Support, 2013). What are the actual long term social and economic costs associated with just using standard modern medical cancer treatments? What if we could reduce these risks and long term costs by working in a more integrated manner using appropriately constructed and implemented complementary interventions, improving the effectiveness of conventional treatments and reducing their potential long term negative consequences? What if we made this this type of approach available to everyone under NHS care, rather than it being a consideration for those of us that are fortunate enough to be able to consider such options. I would make an educated guess that the return on investment on working this way would be enormous, from both an economic and social perspective.

The other key area to look at in depth is the quality of the dietary advice that is being given on a population wide basis to help reduce the ever increasing number of people that are developing cancer. There is very strong evidence to support the notion that as we have moved further and further away from our ancestral diets, reducing fat intake and dramatically increasing carbohydrate consumption, that cancer frequency has increased (Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects. Oxford, Benediction Classics, 2010). Is it possible that the current dietary guidelines and trajectory are completely incongruent with maximising human heath and well-being? Unfortunately we do not have the space to discuss that thought here!

As a functionally trained practitioner, working with a number of cancer clients at any one point in time, my experience and understanding is that cancer is a complex multifactorial chronic disease. The evidence would strongly suggest that complementary approaches when combined with modern medical treatments can significantly improve patient outcomes. Here are a few examples:

The evidence supporting the use of a ketogenic dietary approach (the very strict control of carbohydrate intake, with moderate protein consumption and the majority of calories coming from high quality fats) improving the effectiveness of radiotherapy is convincing (Fasting, Fats, and Physics: Combining Ketogenic and Radiation Therapy against Cancer – Complementary Medicine Research 2018). A ketogenic state would appear to protect healthy cells, but not cancer cells, from high dose chemotherapy (Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy – PNAS 2008). The effectiveness of a ketogenic approach in combination with hyperbaric oxygen, hyperthermia (increasing temperature in a targeted manner) and chemotherapy in the most aggressive form of breast cancer has been observed (Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer – Cureus 2017). There is very strong evidence to support the notion that the combination of hyperthermia in combination with radiotherapy translates into a 25% improvement in ‘complete resolution’ of head and neck cancers (Hyperthermia and radiotherapy in the management of head and neck cancers: A systematic review and meta-analysis – International Journal of Hyperthermia 2015). High dose medicinal mushroom therapy (Mycotherapy) can be a very powerful complementary approach – ‘there are more than 5,000 publications that indicate the beneficial effect of the extract of certain mushrooms in cancer’ (Dr Pere Gascón (oncologist) for ‘InFocus’ – IHCAN and Nutrition May 2019).

The current standard medical solutions being offered to the cancer patient are not good enough. Why are we not offering complementary approaches that have real evidence of potentially making a difference to their outcomes to all cancer patients? These options may of course not be to everyone’s liking, but at least provide the patient with the choice and run through the potential benefits of doing so. Unfortunately I still hear from the cancer clients that I have the privilege of working with that their doctors/oncologists state that diet has nothing to do with helping treat cancer and improving their outcomes! This is an unbelievable statement and simply does not make any medical or biochemical sense. Why wouldn’t the food that you consume be the cornerstone of any treatment plan? Food is one of the most powerful medicines known to human kind. It can literally switch genes on and off (nutrigenomics).

A ketogenic approach should not be positioned as a diet, but instead as a medicine. It is not always appropriate for everyone to pursue (even if they wish to do so), especially if there are significant imbalances in the microflora/bacteria (dysbiosis) and permeability (leakiness) of the gut present due to an increased risk of moving toxins (LPS – the ‘exhaust’ of bad bacteria) across the gut barrier into systemic circulation. This is why it is important to work with a suitably qualified practitioner who can guide the client through the process of not only evaluating the suitability of using such an approach, but also personalising the intervention in respect of identifying other imbalances that may also be present, covering areas such as unidentified food sensitivities (which if present will contribute to a heightened inflammatory load on the body), lectin/histamine intolerances, micronutrient imbalances and digestive capacity in association with levels of dysbiosis.

Finally, whilst the above considerations are important, the approach should not stop there. All lifestyle elements should be thoroughly evaluated including but not limited to stress levels, sleep quality, toxic load, electromagnetic field exposure and movement. The therapeutic use of appropriate breathing and body exercises, meditation and near infra-red saunas in combination with cold water exposure are all therapeutic options to consider. This is all about the power of ‘marginal gains’, which we have written about before.

We need less dogma and more integration if we are to start really getting control of this devastating disease. The pieces of the puzzle are all there, we just need to start putting them together.

 

 

Diverticula Disease (Diverticulosis and Diverticulitis) – Extremely Common Yet Poorly Understood

Diverticula disease includes diverticulosis and diverticulitis. Diverticulosis occurs when small pouches or pockets develop in the colon (the large intestine). This is a very common condition occurring in approximately 1 in 3 over the age of 60 and half of 80 year olds. The majority of individuals will have no symptoms with diverticulosis. Diverticulitis is when these pockets become inflamed. This is when symptoms can manifest, with pain in the lower left side of the abdomen being the most common. Other key symptoms include tenderness of the tummy area, cramping, bloating, constipation/diarrhoea, fever, nausea and vomiting. Approximately 25% of individuals with diverticulitis will go onto develop potentially very serious complications including perforations of the gut wall, obstructions and inflammation of the lining of the abdomen. Medical treatments include antibiotics, pain relief and surgery.

Current mainstream dietary advice to help reduce the risks of diverticula disease is based on limited evidence. Advice includes avoiding nuts and seeds and eating more fibre. So what are the key triggers?

Chronic low-grade inflammation and imbalances in the micro ecology of the gut (dysbiosis) are the most significant triggers of diverticula disease. These are of course connected. For those of you that have been reading this column, this will be of no surprise, as the harmonious balance of bacteria in the gut is a fundamental pillar of well-being.

The evidence base and clinical experience suggest that there is a significant correlation between the presence of Small Intestinal Bacterial Overgrowth (SIBO – a type of dysbiosis) and diverticula disease. SIBO is where the small intestine (the part of the digestive system responsible for absorbing nutrients) is overgrown with bacteria that should not be there. This is a notoriously difficult condition to effectively treat, as unless the key factors that caused SIBO to happen in the first place are resolved, then it will typically return no matter whether Rifaxamin (a special non absorbable antibiotic) or antimicrobials are used.

Imbalances that typically trigger the presence of SIBO include poor digestive capacity (weak stomach acid/bile flow and low digestive enzyme status) and poor motility of the small intestine (the migrating motor complex) due to compromised vagus nerve health (often connected to stress). Probiotic and prebiotic supplementation have both been shown to be beneficial, as has shifting diet towards a whole foods anti-inflammatory approach, reducing stress, exercising, undertaking myofascial therapy and using targeted supplementation.

 

 

Parkinson’s Disease and the Gut

Parkinson’s Disease (PD) was first described over 200 years ago and is one of the most common progressive neurodegenerative conditions. Whilst there are many different symptoms, the main ones are tremor (shaking), slowness of movement and rigidity/muscle stiffness. Symptoms are caused by the brain losing its ability to produce enough dopamine, which is key to co-ordinating movement.

The evidence base suggests that there are a number of potential factors involved in the development of PD including increased exposure to pesticides/herbicides and toxic metals, elevated levels of iron, digestive system imbalances (constipation is now considered to be a key symptom – often present up to 10 years before diagnosis), Small Intestinal Bacterial Overgrowth (SIBO), Helicobacter pylori infections, increased ‘leakiness’ of the gut lining, nutrient deficiencies and associated mitochondrial dysfunction, gluten related disorders and autoimmunity. One key area of research involves the observed accumulation in the brain of a misfolded protein called alpha-synuclein, which has been shown to accumulate in the gut’s own nervous system years before the diagnosis of PD.

Currently there is no cure for PD, with treatments relying on a combination of medications (which aim to increase dopamine levels – often with significant side effects), exercise and complementary therapies.

The evidence base now strongly suggests that gut health is a key factor in the development of PD. The gut/brain axis is irrefutable with the central nervous system being directly affected by the balance of bacterial species in the gut itself. Multiple studies have shown there to be significant alterations in the bacterial species (dysbiosis) of individuals with PD compared to healthy controls and it has been shown that the use of specific strains of probiotics can provide a marked reduction in key symptoms of PD when compared to placebo.

So the chain of events leading to PD might look something like this: dysbiosis (caused by poor diet/lifestyle/toxic load/stress/parasites) causes an increase in ‘leakiness’ of the gut and the expression and accumulation of misfolded alpha-synuclein, which is then transported from the gut to the brain directly via the vagus nerve. Chronic inflammation and ‘leakiness’ of the gut lining promote body wide inflammation, which in combination with the accumulation of misfolded alpha-synuclein in the brain causes damage to the dopamine producing cells of the brain and hence PD – (NPJ Parkinson’s Disease (2017)).

Maybe the gut holds the keys in respect of unlocking effective preventative and therapeutic interventions for this devastating condition?

COVID-19, Vitamin D and Saving Lives

Vitamin D is called the ‘sunshine vitamin’ as it is produced in large quantities by the action of sunlight on the skin. The science clearly shows that ‘optimal’ levels of vitamin D (circa 150 nmol/L – UK units) are associated with a significant reduction in the risk of developing a number of chronic diseases (other than osteoporosis) including, but not limited to cancer, diabetes, Alzheimer’s, depression, high blood pressure, autoimmunity, asthma, eczema, multiple sclerosis, cardiovascular disease and respiratory diseases.

There has been a flurry of research/reviews appearing in the literature over the past 6 months discussing/analyzing/questioning the potential role that optimising vitamin D levels might have on reducing the severity of COVID-19. One particular recent preliminary study titled ‘Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study – (Prabowo Raharusuna et al, April 26, 2020)   analysed the outcomes of 780 hospitalised COVID-19 patients and concluded that ‘when compared to cases with normal vitamin D status, death was approximately 10.12 times more likely for vitamin D deficient cases’.

The chart below (taken from the above study) clearly shows that when vitamin D levels are above 32 ng/ml (US measurement) which equates to 80 nmol/L in UK numbers, the risk of death is reduced 10 fold. This very strongly suggests that one of the most effective strategies that you can do, to stay as well as possible, should you ever get COVID-19 is to have optimal levels of vitamin D, which is circa 150 nmol/L.

This is an extraordinary observation that has enormous potential therapeutic and prophylactic implications, especially as supplementing with vitamin D is cheap and easy to do. Another recent review paper titled ‘Point of view: Should COVID-19 patients be supplemented with vitamin D?’ (C Annweiler et al – Maturitas, 2020), analyses the available evidence base according to the ‘Hills Criteria of Causation’ (used to assess evidence of a ‘causal relationship’) and concludes that ‘vitamin D may be considered a biological determinant of COVID-19 outcomes’. This paper then goes on to say that ‘given the lack of specific treatment for COVID-19, the urgency of the pandemic, and the safety of vitamin D supplementation, these observations provide an argument for testing vitamin D as an adjuvant treatment to improve the clinical presentation of COVID-19 and its prognosis’.

A number of randomised controlled trials are now thankfully underway. In the meantime, given the significant evidence base linking ‘optimal’ levels of vitamin D to improved COVID-19 outcomes, why would one not measure current levels (can be done at home using a finger prick test – https://www.revital.co.uk/revital-nhs-vitamin-d-test-kit-kit and  https://medichecks.com/products/vitamin-d-25-oh-blood-test are good options)    supplement accordingly (a safe dosage to take per day to improve levels would be 5,000 IU) to achieve/maintain optimal levels, especially as there is a great deal of concern about a second wave of COVD-19 in the coming winter? Whilst clearly this will not prevent COVID-19 being contracted, the current data does strongly suggest that it will reduce the risk of potentially fatal complications – thereby protecting the NHS and saving lives.

Please do not simply supplement with vitamin D without testing levels, as it is a fat-soluble vitamin, and can therefore become toxic at high levels. It is also important that you monitor progress (retest every few months) if supplementing with vitamin D, so that the dosage can be adjusted accordingly to achieve/maintain optimal levels. You cannot guess your levels – you have to test. Vitamin D supplementation should always be discussed further with your doctor if you have parathyroid issues, elevated calcium levels, kidney disease or sarcoidosis.

Another key point to consider is that it is generally accepted that Black Asian and Minority Ethnic (BAME) groups living in the West have significantly lower levels of vitamin D compared to their white counterparts. This is due to the fact that the sun is not strong enough to generate sufficient levels of vitamin D due to the sunlight protective effect of increased melanin pigment in the skin. Maybe, just maybe this is one of the most significant reasons as to why a disproportionate number of this group are dying of COVID-19?

It should also be noted that as a nation the UK has one of the highest levels of vitamin D deficiency in Europe, with average levels at 47.4 nmol/L and that it is perfectly possible that this fact is contributing to the high COVID-19 death rate (105 per million) that we are experiencing compared to other countries (on the other end of the scale Slovakia has an average vitamin D level of 81.5 nmol/L and a death rate of 0.4 per million) – ‘The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality’ – Petre Cristian Ilie et al – Aging Clinical and Experimental Research.

So in summary, the evidence base would very strongly suggest that one of the simplest things that you can do to reduce the risk of developing serious complications if you contract COVID-19, is to optimise your vitamin D levels – aiming for circa 150 nmol/L, by testing, supplementing and monitoring your progress.

 

‘All disease begins in the gut’ – (Hippocrates 460-370 BC)

Hippocrates the father of modern medicine famously stated 2,400 years ago that ‘all disease begins in the gut’. The gut is the 25 feet of tubing that runs from the mouth to the anus and contains on average 100 trillion bacteria (the microflora/microbiome) weighing approximately 2 kg and over 3 million genes. The explosion in scientific research over the past 10 to 15 years into the fundamental role that optimal gut health plays in respect of our overall health and well being, is starting to enable us to understand just how true these wise words are, yet to date modern medicine has yet to embrace this paradigm.

Clinically, no matter what chronic disease the client is presenting with, we always start with supporting gut health. Optimal gut health is the foundation upon which your house of health is built. Optimal health requires optimal gut health.

Any form of diarrhoea/constipation, excess mucous, light/excessively dark coloured and/or foul smelling output are all clear signs of gut imbalances being present. You do not however have to be presenting with any overt signs of dysfunction to still have gut imbalances. This is an oversimplification, but gut health is dependent on three key areas of the system working as well as possible: digestive capacity (includes stomach acid strength, bile flow and digestive enzyme status), the balance of the individual bacterial/yeast/fungi/parasite and viral inhabitants and the ‘leakiness’ of the gut lining (the gut lining regulates what is let in and kept out). All of these areas are intricately interconnected. If there are imbalances/issues with any of these key areas, then it is almost inevitable that your health will be negatively impacted in some way. The evidence base continues to uncover real connections between overall gut health and an ever increasing number of chronic conditions that are becoming a significant issue for society, including but not limited to anxiety, depression, IBS, inflammatory bowel disease, arthritis, Parkinson’s/MS/ALS/neurodegenerative conditions, dementia, cancer, cardio vascular disease, diabetes and metabolic dysfunction.

Thanks to modern testing, we can now comprehensively measure how well each of these key areas of gut health are performing and then subsequently create personalised interventions to help support/correct any identified imbalances, often with impressive results. Why then, after 2,400 years, is this approach not yet a cornerstone of modern medicine and chronic disease management?

Coeliac Disease – new diagnoses increasing at over 7% per year

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/gut). Originally considered a rare childhood condition it is now recognised as primarily an adult disease. CD is essentially a disease of malabsorption. If the cells are not getting the micronutrients from the food that we eat, then logically a number of significant health problems can eventually manifest anywhere in the body.

A recent meta analysis in The American Journal of Gastroenterology concludes that – ‘the incidence of coeliac disease is significantly rising (7.5% every year for the past few decades)’.

Incidence is the number of new cases expressed as proportion of the population being studied and provides a better understanding of what is really going on, compared to measuring prevalence, which is a measure of existing cases in a particular population.

So what is going on? A number of factors are certainly at play here including, access to improved blood tests since the 1990s; the change in guidelines in respect of being able to diagnose CD in certain children without the requirement of a biopsy and the increased awareness amongst clinicians/doctors that the classical symptoms of abdominal pain and diarrhoea occur in less than 50% of coeliacs. Other common symptoms including migraines, skin problems, depression, fertility issues, chronic fatigue, joint pain, liver and cardio vascular disease, osteoporosis, other autoimmune conditions (especially type 1 diabetes and autoimmune thyroiditis) and neurological problems. This is of course all welcome progress, but is not the full picture.

Environmental factors are also more than likely playing a significant role here. These factors include, the hybridisation of wheat to create dwarf wheat – which has a significantly higher gluten content compared to ancient varieties, the timing and amount of gluten introduced into the diet of infants, the amount of antibiotic exposure within the first year of life and the presence of childhood infections. Add into the equation the explosion in the use of glyphosate/Roundup since the early 1990s due to the practice of ‘crop desiccation’, where glyphosate (a patented antibiotic) is sprayed on wheat (and other staples) just before harvest to improve yields and one can start to understand why we are seeing the continued rise in one of the most common lifelong disorders in North America and Europe.

COVID-19 – beyond washing hands and social distancing…

Thoroughly washing hands and social distancing are clearly good advice, but these actions are just the start of what we can all do to make a difference. We all have an obligation to look after ourselves and our loved ones, to not only reduce the chances of contracting the virus but also the severity of the disease, should we get it, so that those of us that require critical care can access it.

So what else can we do? This is not about ‘boosting’ immune function by the way; it is about immune system ‘modulation’. The immune system’s purpose is not to overreact to the world, but instead to tolerate it (foods, pollen, dust, animal hair etc) only reacting when required, at an appropriate level, to pathogens – viruses/bacteria.

From clinical experience, clients that regularly catch infections – coughs/colds/flu/viruses, become more immunologically robust by working on their health from a multifactorial perspective. They achieve this by:
• Eating organic (if possible), nutrient dense, unprocessed, natural whole foods – grass fed meats/ wild fish/vegetables/nuts/seeds/fruit and water, cutting out all added sugars/trans fats/alcohol/processed foods/gluten grains and dairy. Each and every one of our 36 trillion cells require optimal amounts of over 250 different micronutrients in order to function properly. We get these micronutrients from our food, so you not only have to consume these nutrients, you also need to be able to absorb them. Gut health is key here. Use a food state multi vitamin and mineral supplement.
• Optimising vitamin D levels (check levels via finger prick testing – aim for 150 nmol/L) and take a few grams of vitamin C per day – not appropriate with certain medical conditions and always check for any adverse interactions with prescribed medications. Now that spring has sprung, aim for regular sensible sun exposure if at all possible.
• Focusing on getting good sleep – this is when we repair.
• Regularly exercising – at a level that is appropriate to you.
• Breathing properly – an excellent way to not only oxygenate the body but also to manage stress.
• Reducing exposure to Electromagnetic Fields (EMFs) – the science is becoming clear, EMF exposure damages cellular biochemistry and therefore health. Recommendations include switching off your WIFI at night, swap out any DECT/mobile landline phones for corded phones, make your bedroom a technology free zone, reduce mobile phone use and do not carry/place a mobile close to your body/head.
• Managing stress levels – stress increases the body’s production of corticosteroids, which are medically prescribed to suppress the immune system! Reduce exposure to the media and consider meditation/mindfulness and breath work.

Stay safe and well….

 

Osteoarthritis is not a ‘wear and tear disease’

Osteoarthritis (OA) is an ‘age related low-grade inflammatory disease of the joints’ which causes the protective cartilage cushion between the bones to wear down, allowing the bones to rub together, creating a great deal of pain and discomfort. In the UK, OA affects 8.75 million people contributing to a significant burden on our health and social care systems. Modern medical treatments involve the use of paracetamol, non-steroidal anti-inflammatory drugs (e.g. ibuprofen), opioids, steroid injections, joint replacement/fusing and osteotomies. The use of drugs will provide pain relief, masking the symptoms but will not get to the root cause of the problem. Taken for long periods of time, these drugs can cause significant long-term health issues in themselves.

OA is often described as a ‘wear and tear disease’ that is caused by getting older. There is now very compelling evidence to suggest otherwise. Obesity is the strongest risk factor for OA onset in the knees, but the fact that being overweight/obese also increases the risk of developing OA in non-weight bearing joints, such as the hands/wrists, suggests that physical weight/wear and tear of the joints are not the only factors at play. In 2017 researchers at the University of Surrey identified a significant link between the body’s metabolism (the chemical processes that occur within us to maintain life) and OA – The role of metabolism in the pathogenesis of osteoarthritis – Nature Reviews Rheumatology, 2017.

In this review a comprehensive explanation is made on how poor dietary choices and lack of exercise can trigger the reprogramming of cells in the joints (and indeed the rest of the body) from a balanced resting state to one that is highly active, creating a number of cellular by-products that both inhibit the repair of/and destroy tissue, as well as fuelling inflammation. We know that regular moderate exercise confers significant benefits to overall joint health, as it strengthens muscles, prevents further cartilage breakdown and builds bone.

Lead author, Professor Ali Mobasheri summarises: ‘It is important never to underestimate the significance of a healthy diet and lifestyle as not only does it impact upon our general wellbeing but can alter the metabolic behaviour of our cells, tissues and organs leading to serious illnesses’. The big question of course is what exactly does that ‘healthy diet’ look like for the individual, as healthful foods for one can literally be a slow poison for another.

 

Depression – one size does not fit all

In a previous post (available here), we explored the gut-brain axis and the significant and sustainable improvements that are often achieved in respect of anxiety and depression, by simply removing from the diet the foods that typically cause the greatest harm, focusing on the consumption of nutrient dense wholefoods, implementing targeted lifestyle choices and even consuming therapeutic dosages of turmeric.

There are however times when this approach on its own does not deliver the desired outcomes, suggesting the presence of a more complicated picture.

Dr William Walsh has spent the past 30 years collecting data across tens of thousands of patients presenting with a range of mental disorders (including ADHD, autism, depression, schizophrenia and Alzheimer’s disease) and has created a comprehensive database of nutrient imbalances that can fuel these conditions. Dr Walsh’s work is based on the premise that we are all biochemically individual and that nutrient imbalances and/or the presence of toxins that can cause significant disruption in brain biochemistry. Interestingly Dr Walsh in his book ‘Nutrient Power – Heal Your Biochemistry and Heal Your Brain’ describes a surprising finding that ‘nutrient overloads usually cause more mischief than deficiencies’. Dr Walsh goes onto to describe 5 ‘depression biotypes’, which have very specific symptoms and traits: These are:

  • ‘Undermethylation’ – very sensitive to the methyl/folate levels in the brain and must avoid folate/folic acid, choline, manganese and copper supplementation. Usually respond well to antidepressant medications and improve with magnesium, vitamin D, B6, tryptophan, A, C and E.
  • ‘Folate deficiency’ – typically intolerant to antidepressants. Must avoid tryptophan, copper and inositol. Respond well to folate, B12, B3, choline, manganese, zinc, B6, C and E.
  • ‘Copper overload’ – 96% female – mixed reaction to antidepressants. Must avoid copper. Improve with zinc, manganese, glutathione, B6, C and E.
  • ‘Pyrrole disorder’ – significant zinc and B6 deficiencies which are often genetically driven (family history of depression). Require high doses of zinc and B6.
  • ‘Toxics’ – typically caused by excess levels of lead, mercury, arsenic and cadmium. This type is difficult to diagnose – typically diagnosed by exclusion of the other types.

Clearly treating depression with a ‘one size fits all’ SSRI (selective serotonin reuptake inhibitor) drugs and/or random supplementation is too simplistic and may in certain situations actually do harm. Tailored nutritional therapy interventions, under the guidance of a suitably qualified healthcare practitioner, can be an extremely powerful tool when it comes to implementing a comprehensive strategy to help optimally manage depression.