Feb
12
2016

Our Toxic Environment

Dr. Jill Carnahan gave a talk about our toxic environment. Her concern were environmental toxins and that was what she presented at the 23rd Annual World Congress on Anti-Aging Medicine (Dec. 11-13, 2015) in Las Vegas. Her talk was entitled: “Diagnosis and Treatment of Environmental Toxicity”. It was very interesting, but it cannot be summarized here in depth with all of the details. It would take 10 pages or more to do this. Here I am summarizing the key points that she made, as they are not likely general knowledge. Dr. Jill is a functional medicine expert consultant and treats environmental and mold-related illnesses as well.

Toxins around us

The world we live in is full of toxins like industrial toxic chemicals, car exhausts, and housing materials (carpet, drywall, lumber, flooring). The list goes on with clothing bedding and furniture. More chemicals lurk in the bathroom: they can be found in toothpaste, hair shampoo, conditioners, and personal beauty products that we apply to our face and bodies. Cleaning products and laundry chemicals are also on the list.

Why is it important to be aware of that? Because toxic chemicals that enter our bodies through the skin, the gut and the lungs will accumulate over the years in fatty tissue, in breast tissue and breast milk. Over the long term they contribute to the development of cancer, autoimmune disease like Crohn’s disease or thyroiditis and many other chronic diseases, particularly neurodegenerative diseases like Alzheimer’s and Parkinson’s disease.

Environmental history and tests

Dr. Jill (as Dr. Carnahan calls herself) explained in great detail how important it is to take a thorough environmental history, which includes exposure to occupational poisons, home environmental and nutritional exposures, not only for the present time, but also back several decades. One tool Dr. Jill uses consists of several websites that list environmental toxins by zip code. When the physician is informed of of the places where the patient has lived and worked, based on the zip codes a complete exposure picture emerges.

Symptoms are the indicator whether or not toxins may play a role: fatigue, sleep disturbances, memory problems, headaches and the presence of more serious conditions like autoimmune diseases, neurodegenerative diseases and cancer.

In addition, the physician orders refined blood and urine tests that check out toxic levels of common toxins.

There are exotoxins, coming from the outside: phthalates, parabens, heavy metals, solvents, organophosphates and pesticides to just name the more common ones. Toxic molds and heterocyclic amines are also exotoxins. These latter carcinogens (heterocyclic amines) are produced by overheating meat.

Then there are endotoxins, toxins that are produced inside the body: endotoxins in the form of toxic lipopolysaccharides from gram negative bacteria (causing toxic shock syndrome), yeast, chemical additives from food, stress and constant negative emotions leading to an overdose of glucocorticosteroids. All of this leads to the total toxic body burden.

Total toxic body burden

Here what leads to the total toxic body burden: Eating a Standard American Diet is one of the main reasons why people accumulate toxins. Add to that petrochemicals, residues, pesticides, and fertilizers, and exposure to heavy metals, like mercury and lead. Some medications like antifungals can also be toxins. Food allergies, environmental allergies and allergies to molds indicate that the body has accumulated toxins. There are also internal toxins from bacteria, fungi, viruses, and yeast that contribute to the total toxic burden. Hormonal and metabolic toxins that aren’t eliminated properly add to the problem, as do isolation, loneliness, anger, jealousy, and hostility. These negative emotions function like toxins on the immune system. Mental illness can contribute similarly in a negative manner, as the mind and the body work together.

When to expect environmental toxicity

A functional medicine expert like Dr. Jill will suspect environmental toxicity when one or more of the following symptoms are present:

Headaches, joint pain, muscle aches, fatigue, difficulty concentrating, food cravings, gas/bloating, constipation, foul-smelling stools, diarrhea, postnasal drip, sinus congestion, canker sores, heartburn, insomnia, trouble losing weight, water retention, rashes, acne, skin problems, psoriasis, eczema, dark circles under the eyes, bad breath or premenstrual syndrome.

Diseases that are related to environmental toxicity

As already mentioned before Parkinson’s disease and Alzheimer’s disease are among the neurological diseases that have been identified to be linked to environmental toxicity. Some forms of dementia and MS also belong to these. In the very young child autism has been identified as filtering out those who are particularly sensitive to environmental toxicity. Attention deficit disorder also belongs here.

Among adult patients heart disease, chronic fatigue syndrome, fibromyalgia, Crohn’s disease and ulcerative colitis are red flags for possible underlying environmental toxicity. Food allergies, depression, anxiety and insomnia can also be indicators of environmental toxicity. Arthritis, menstrual disorders, autoimmune disease and any form of cancer are also flags for environmental toxicity.

Dr. Jill explained that the doctor who specializes in environmental issues would take a detailed history paying attention to chemicals the patient may have ingested or be in contact with. It also includes a dental history, including whether or not the patient has silver amalgam fillings or had them removed without subsequent chelation therapy.

She even showed several slides of known associations with specific toxins for the diseases just indicated. These are subsequently identified as closely as possible by doing toxicity tests.

Markers of reserves

There are several marker substances that get used up when the body starts detoxifying some of the environmental toxins.

  1. Glutathione levels in the blood can be measured and can serve as an indicator as to whether or not the body has been challenged by toxins. Glutathione is synthesized by the liver and is a powerful antioxidant and toxin remover. A low glutathione levels is associated with many chronic illnesses.
  2. A low total antioxidant capacity is an indicator that toxic metal exposure, infection, inflammation, xenobiotic exposures or environmental toxicity in general may be present. There are two metabolic pathways that are important for detoxification to occur: the methylation pathway and the trans-sulfuration pathway. It would be too technical to go into this further, but treatment concentrates on re-establishing these metabolic pathways.
  1. Co-Q-10 (=ubiquinone) can be measured in the plasma and is also a marker of reserve. The patients can also be take it as a supplement at 400 mg per day, which will strengthen mitochondrial function. The mitochondria are the energy packages of each cell.

Organic acids

There are organic acids that are toxic. One of them is methyl-tert-butyl ether (MTBE), which is an additive in use to increase octane ratings in gasoline. Tests found that ground water contains MTBE from leaking gas tanks in filling stations. Inhalation at the gas station can cause dizziness, headaches and mental confusion. In animals it has caused gastrointestinal irritation, liver and kidney damage. Another organic acid, styrene, is widely distributed in rubber, insulation, plastic, fiberglass, food containers and carpet backing. The US-EPA has labeled it as “potential human carcinogen”. Special tests, which the environmental doctor can order can measure the levels of these organic acids in the body.

Epigenetics

Autistic children have taught doctors a lot about epigenetics. After initial 2 or 3 years of normal functioning autistic children suddenly have a variety of severe symptoms like balancing problems, lack of social skills, problems concentrating, tiptoeing etc. The methylation pathway involves one or more of the enzymes. They are are no longer working properly because of epigenetic effects, events that cause their DNA to have a different gene expression. However, with detoxification and nutritional rehabilitation it is possible to turn this around, as the underlying cause is not a fixed genetic defect, but rather an epigenetic malfunctioning. You fix the methylation pathway, and full function returns.

Other research has shown that a similar methylation defect occurs in PTSD and in schizophrenia. Orthomolecular physicians have developed treatment programs for schizophrenics that often work (but not in all cases).

Dr. Jill stated that with genetic disease there is a multitude of characteristic symptoms, which is due to abnormal methylation pathways that is often in combination with a severe oxidative overload, caused by environmental insults. Most cancer and chronic diseases are epigenetic in nature, not caused by genetic causes. Dr. Jill explained that the molecular switches of the epigenetic switch that turns a gene on or off have been unmasked: Acetyl groups promote gene expression, while methyl groups inhibit gene expression. As long as there is a balance in the methyl/acetyl ratio, the patient is healthy; the moment environmental toxins disturb the balance and an epigenetic switch occurs, the patient is heading towards disease. What genes switch on or off determines what disease will develop.

More toxins: alkylphenols, organochlorines and volatile solvents

Alkylphenols

Food and beverage containers, water bottles and plastic dinnerware contain bisphenol (BPA). Many countries have outlawed BPA in baby bottles.

Deodorants, toothpaste and shaving creams contain triclosan.

Organochlorines

Many of these substances have been banned because they are persistent poisons. Because of this they are still in the environment today, particularly in non-organic produce. DDT was in use agriculturally as an insecticide until 1972, but you find it still now in meat, poultry, dairy products and fish. Hexachlorobenzene was in use as a pesticide until 1965 and as fungicide in cereal grains. Mirex was in use as a pesticide for fire ants until 1978.

When you buy non-organic butter, farmed Atlantic salmon, non-organic cheese and non-organic fatty meats (lamb, ground beef) they contain various pesticides.

Dr. Jill’s advice: don’t buy that, but buy organic food!

Sauna therapy and colonic irrigations will remove much of the chlorinated pesticides. Chlorophyll and all chlorophyll containing foods will also help in eliminating persistent organic pollutants. This could be a good reason to consume the occasional homemade green smoothie with leafy organic ingredients like spinach or kale!

Volatile solvents

Car exhaust fumes contain benzene (gasoline), styrene, toluene and xylenes. Styrofoam contains the toxic compound styrene. Don’t microwave food contained in Styrofoam, as it releases the toxic styrene into the food. Avoid breathing the fumes of gasoline, glues and solvents; use non-toxic cleaners. Vitamin C, selenium and glycine help to detoxify volatile toxins.

After discussing mold and mold toxicity as well as glyphosate toxicity from GMO crops in detail, which would be too long to discuss here, Dr. Jill presented a quick

Clean diet 101

  1. Buy organic food. It should be sugar-free, gluten-free, dairy-free, non-GMO food.
  2. Buy only whole and un-processed foods, a variety of leafy greens and other chlorophyll-rich foods. Add to this a variety of colorful fruits and veggies, but avoid the dirty dozens; buy them organic.
  3. Limit processing of your food.
  4. Get local or homegrown food; avoid refined oils and trans fats.
  5. Limit alcohol and caffeine.
  6. Avoid food allergens; the same is true for the most toxic foods: simply avoid them!
  7. Don’t eat farmed Atlantic salmon, high mercury fish like tuna, orange roughy, Chilean sea bass, shark and swordfish. Here is a detailed guide to low mercury fish. Stick to “very low” and “low mercury fish”.
  8. Avoid non-organic eggs & dairy. Avoid the dirty dozen fruits/veggies mentioned under point above.
Our Toxic Environment

Our Toxic Environment

Conclusion

Here is a quick whirlwind tour through toxins in our environment. The most important step I suggest you take is to review the toxins in your bathroom and around the house. The next important step is to buy and eat the right foods that are toxin free. If you follow Dr. Jill’s “clean diet 101” as described above, you will avoid exposure to toxic substances. Your healthy food intake becomes your maintenance treatment to detoxify at the same time. Only more seriously affected people need to see an expert like Dr. Jill. People with mercury or other heavy metal poisoning may need a series of intravenous chelation treatments as mentioned in this link. The entire process requires a lot of attention and vigilance. Ask questions about products and read labels. It is worth the effort, as this means preventing health problems in the future.

Mar
10
2013

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

I remember how only 40 years ago cancer of the cervix was one of the major killers for women, but with the introduction of the Pap test this has all changed.  For those women who get that screening done, there is no need for fear. The mortality rate from cervical cancer since the 1970’s has steadily decreased as shown in this link.

As far as cancer of the prostate is concerned, a lot of progress with regard to early detection has been made due to the introduction of the PSA blood test, which is used as a method of screening. As a result men are diagnosed earlier with prostate cancer resulting in more cures as the cancer found is at an earlier stage. Here is a link depicting the effect of the PSA test on mortality rates from prostate cancer in time.

March is colorectal cancer awareness month as this article explains.

The key is early detection and treatment as with any type of cancer. Specifically, with rectal and colon cancer there are mostly no symptoms, as blood in stool or any other symptoms occur only late into the disease. What we do know, however, is that there is a long latent phase where precancerous mucous membrane changes lead to polyps and these will degenerate in time into cancer of the colon or rectum.

Not everyone has the same risk of developing colon cancer or rectal cancer.  There are people with a higher rate of colorectal cancer, as they carry a susceptibility gene in their families. A healthy lifestyle can also reduce the risk of colorectal cancer.

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

It is now widely accepted that polyps are the precancerous precursors for colorectal cancer and colonoscopies done on everybody starting at age 50 (those with family risk factors much earlier) have already been shown to have decreased the frequency of the disease as the data from the CDC show. The problem is that the curves over the years shown here should have had a much steeper decline similar to the mortality rates of cervical cancer and prostate cancer shown as links above (not the shallow ones depicted in the CDC link); the incidence of colon cancer should have gone down to almost the zero point. All that has been achieved so far is a reduction of a portion of cases (those who went for colonoscopies early enough before it turned into colon cancer); this is by far not an elimination of colorectal cancer. The reason for this is the fact that in many cases people have colonoscopies too late when the polyp has already turned cancerous, or invasive colon or rectal cancer is already present at the time of the first colonoscopy.

So, designating March as colorectal awareness month makes a lot of sense to me.

I happen to come from a family where my mother died in 1980 from colon cancer at the age of 59. Because of this my doctor told me that I have a risk of about 3-fold higher than the population at large to also develop colon cancer. I have had colonoscopies since the age of 40 every 3 years. Ironically a few days ago right during the colorectal awareness month, I was getting my 9th colonoscopy. On three occasions polyps were removed, which tells me that the cancer-screening program works!

So why is it important to screen in regular intervals? One reason is that we are now exposed to more toxic chemicals in our environment and food than 100 years ago. So all cancers, but especially colorectal cancer rates have increased. We know the pathophysiology, which is the science that studies how an illness develops. We know that it takes several years between the occurrence of the first precancerous cells that form in the lining of the gut (called “mucosa”) and the formation of polyps. It takes another few years before polyps turn cancerous. This means that there is enough of a time interval to do screening. If we are not aware of this and ignore it (as unfortunately many people do), the process will run down the conveyor belt on an automatic program, which ends up in end stage colorectal cancer. The stages of colon cancer are depicted in this link.

As the table of my chapter on colon cancer staging shows, the invasive end stage colon cancer (stage IV or Duke D) has a 5-year survival rate of only 6%. Even when the cancer is limited to stage II (also called Duke stage B) there would be a 5-year survival of only 80% (see table in link).

What does screening really achieve?

On an individual basis the gastroenterologist who does the colonoscopy can screen the whole colon for premalignant polyps and remove them during the procedure.

This moves the potential cancer staging backwards to beyond any detectable cancer, as all of the potential early cancer cells would have been inside the polyp (called local “in situ” disease) and were removed by cauterizing the stalk (see above link). There is another potential factor that can help to reduce colorectal cancer incidence: Recently a connection was made between Helicobacter pylori (H. pylori) infection of the stomach and polyps in the colon as well as colon cancer. In the past several smaller studies failed to show this correlation. It took 156,269 patients in this study to show that there was a correlation. As H. pylori is being tested for and treated more and more, this will also have a positive effect on lowering the frequency of colorectal cancer.

On a population basis with mass colonoscopy screening the incidence of colorectal cancer would be reduced much faster and eventually would turn into a disease similar to cancer of the cervix, where it still matters whether you screen or not, but very few people would have to suffer from it. Here is an image from a paper (look for Fig. 2, halfway down the page) that shows that survival benefits (longer lives) are registered only after 10 years or more following colonoscopy. Every polyp that is removed  in a particular patient will ad up to the colon and rectum health of the nation at large when you sum up all of the colonoscopies done around the country year after year.  But we need a nationwide and worldwide awareness that this is something worthwhile doing for a cancer that is the third most frequent cancer in many parts of the world.

I am grateful that colonoscopy screening works, as I had polyps removed three times over a 29 year span and I did not have to go through all the surgical procedures that my mother had to endure. Had I lived 50 years earlier I may not have lived long enough to tell you how important colonoscopy screening is.

Here are the recommendations:

  1. No risk of colorectal cancer in your family : Screen once at age 50, just to make sure you are not one of the spontaneous colorectal polyp producers. If OK, screen every 10 years, if the colonoscopy is always negative.
  2. Family history of direct bloodline relative (mother, father, brother, sister had cancer of the colon or cancer of the rectum): do colonoscopies every 3 years. There may be up to 15% of missed polyps during a colonoscopy so that with the next colonoscopy there is a high likelihood that these missed polyps would still be diagnosed early enough (before they turn cancerous) and removed during this subsequent screening.
  3. There are special cases, families with genetic syndromes like the familial polyposis of the colon. In these families children need to be screened for polyps when they are young adults (from age 20 to 25 years onwards).

Don’t complain, if you belong to category 1 or 2 as it could be much worse (category 3). Cancer is serious business. Remember, March is colorectal cancer awareness month.

More information about colon cancer: http://nethealthbook.com/cancer-overview/colon-cancer/

Last updated Dec. 18, 2014

Dec
17
2012

Lessons from the 2012 Anti-Aging Conference in Las Vegas…From Wheat to Autoimmune Disease and Obesity.

It is not possible to summarize all the multitude of lectures from a three day conference on one page. However, what was striking was that several topics such as autoimmunity, obesity, diabetes, hormone disbalances and more did develop into a common thread. Dr. William Davis, the author of the book “Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health” explained how the BASF, a major chemical company from Germany was able to chemically modify the genes of wheat in the 1960’s and 1970’s. The farmers liked that the new wheat (called Clearfield wheat) grew with stronger roots, shorter final stems and much larger grains so the yield per acre was higher. This type of wheat was patented under the name of Clearfield wheat and sold all around the world. What was not publicized at the time was that the gliadin content increased manifold from the composition of wheat strains used for thousands of years before. Gliadin gets rid of the glue like substance between the gut cells and causes leaky gut syndrome, something that was mentioned at many other lectures throughout the conference. This leads to exposure of immune cells to foreign proteins from the gut, which causes the immune system to hyper react with autoimmune antibodies.

Dr. Aristo Vojdani explained in his lecture that there are three stages of autoimmune disease. First, there is the silent stage where there are no symptoms, but the immune system is starting to react. Next there is autoimmune reactivity, which is the second stage. The third stage is autoimmune disease where there are signs of loss of body function. Autoimmunity develops in about 1/3 of identical twins in families who are prone to this. When non-identical twins were examined as a control group, only 2% to 5% of twins developed it. This tells us that genetics are responsible for only about 1/3 of the cases of autoimmunity. The other 2/3 come from the environment such as genetically modified foods, toxic chemicals, and chronic infections and also from substances excreted by fat cells. Dr. Vojdani emphasized that gliadin in our foods has become one of the major factors of driving autoimmune diseases up in the last few decades. It is the immune cells, called T cells that will determine whether our own cells are considered “self” or whether they are considered “foreign” and are attacked as they are in autoimmune diseases such as Celiac’s disease, ulcerative colitis, lupus, rheumatoid arthritis, MS and others.

Las Vegas December 15, 2012v

Las Vegas, December 15, 2012

There are regulatory T cells, which are good and T cells whose genetic material has been changed to become Th17 cells, a kind of “Pac Man” cell that attacks cells inside the body. Altered gut flora (called gut dysbiosis) in connection with a leaky gut syndrome contributes to the formation of these aggressive Th17 cells. It is the combination of gliadin with bowel dysbiosis that drives the development of autoimmune diseases. Behind this is the fact that the gut plays a major role in the normal functioning of the immune system. Normally there is a tight connection between the gut cells that form the lining of the gut so that there is no exposure of immune cells from the blood to the contents of the gut flora. We are fortunate that researchers have developed antibody titer tests for the major food groups and these can be valuable pointers that can be used as a tool during the first two stages of autoimmunity before autoimmune disease causes permanent damage. Using these tests on large population groups researchers have found that common food allergies develop against wheat, dairy products, soy and eggs (as Dr. Pamela Smith remarked and Dr. Thomas Alexander explained in detail).  IG-G, IG-A and IG-E antibody tests can be run from a few blood drops and tested against a whole battery of common foods. This helps the physician to monitor the development and treatment of autoimmune diseases.

Back to the leaky gut and obesity. The obesity wave in North America and the rest of the world started when the newly patented Clearfield wheat was introduced. With the higher gliadin in wheat products the balance in the gut was changed, more gliadin entered the body, it bound to the opiate receptors of the appetite center (although it is structurally differently from opium) and caused a hunger for more of the same product. The excess calories –in this case from wheat products- are stored as fat. Fat cells by themselves have their own hormones and inflammatory substances causing diabetes, high blood pressure, heart disease, strokes and even cancer. Add to this that with obesity the enzyme aromatase from fat cells causes elevated estrogen production, which causes estrogen dominance and results in heart disease and breast cancer in females and heart disease and prostate cancer in males.

So, this is the story of the A4M conference 2012 in a nutshell: Wheat products with the increased gliadin (gluten) content have caused increased leaky gut syndrome in the population since the 1970’s. This is the cause of the wheat addiction, which was further fueled by the obsession of the regulatory bodies to recommend strongly eating according to the food pyramid (a splendid marketing pyramid for wheat consumption, as one of the recommended  products are cereals and wheat).With these findings  the cause of the obesity wave can be clearly seen. Along with obesity comes the flood of autoimmune diseases, which have developed from the action of the Pac Man type TH17 immune cells that attack various tissues in the body. The common denominator in the body is a low grade chronic inflammation that Dr. Aristo Vojdani explained in more detail. This causes blood vessel diseases culminating in high blood pressure, heart attacks, strokes and cancer.

There were many other lectures that I attended. Some dealt with bio-identical hormone replacement, some with telomere health, and others with the effect of fitness on an ongoing basis to achieve longevity. Like a red thread lifestyle issues were discussed in almost every lecture. Nutrition is not the only factor in longevity. Exercise on a regular basis can be instrumental in preventing about 50% of disease, especially the main killers like heart attacks, strokes and cancer.

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/

Last updated Nov. 6, 2014