Don’t let your health go…Up In Smoke!!

You may have noticed that the city of Seattle has been full of smoke!  If you haven’t, we should talk about your work schedule (if you live elsewhere, that is a reasonable excuse!)… The smoke is being generated by wildfires in British Columbia and being carried by the wind to our fair city.  There are many health issues that can be affected by the smoke.

Environmental medicine is the study of how toxins affect the health of a person, and in this field of medicine, smoke is considered particulate matter.  Particulate matter is basically a small piece of charcoal that acts like a tiny airplane that is shuttling chemicals into your lungs and body.  Most of these chemicals are polycyclic aromatic hydrocarbons (PAHs) and other volatile organic compounds.1

Each of these components have different effects on the body with the size of the particulates being the important factor, as the smaller the particle, the more soluble it is in the moisture that lines the mucus membranes.  According to the EPA, wildfire smoke tends to fall in the size range of 0.4 – 0.7 micrometers.2 These particles should be modestly soluble, with less solubility than ultrafine nanoparticles.  They can cause significant oxidative damage to tissues and organs of distribution, reducing the levels of glutathione as well as the function of the enzymes that recycle glutathione, which is the major antioxidant and detoxifier in the body.1

Particulate matter can also damage the mitochondria, impairing cellular energy generation.  Particulate matter of the size of that in the smoke has also been shown to impair cognitive development, with exposures being associated with cognitive deficiencies. 

PAHs are lipophilic molecules that are formed when matter is burnt. These molecules are fat-soluble and easily cross cell membranes.  Because of their fat solubility, they get stuck in your adipose tissue until you are able to detoxify them.  You liver actually metabolizes them into compounds that are more toxic. It then expects these metabolites to be attached to things like glutathione to be excreted.  However, if you don’t have enough glutathione, you may experience further impacts of these toxins. 

What to do?

1.    Minimize contact – There are a number of ways to do this.  Close your windows at home.  Use the recirculation function on the A/C in your car.  If you are out walking around, use a facemask rated at N95 or N100.  In your home, an air filter can help dramatically.  In our clinic, we recommend IQ air or Austin Air.  If you contact the clinic, we can facilitate a discount on either of these of 10%, which is substantial.  If a fancy filter is out of your budget, you can build a DIY filter that will remove the particulates fairly cheaply.  https://www.uofmhealth.org/news/sinus-hepa-0630

2.    Smoke Mix Allersode – When the smoke is thick, many of our patients bodies feel a bit assaulted by it.  It tends to make them feel generally unwell on not only a physical, but also a mental/emotional level.  The smoke mix allersode is a cheap homeopathic remedy that can help shift the body out of this state.

3.    Liposomal Glutathione – We discussed above how the smoke reduces the body’s levels and function of glutathione.  We also discussed how if there is not enough glutathione, then the body makes a bad situation with PAHs even worse by making them more toxic.  If there is adequate glutathione, this is not an issue, so make sure there is enough.  Hold it under the tongue for the best results! 

4.    Electrolytes – Detoxification tends to stress the kidneys, which are in charge of maintaining your electrolyte balance.  This is why people like to consume sports drinks for a hangover!  By increasing your electrolyte intake, it’s like giving your kidneys a break.  Most sports drinks have a lot of “interesting” ingredients like wood rosin, which we are not big fans of.  For an easy over the counter solution, try Nuun Tabs. 

5.    Epsom Salt Baths – If you are really feeling badly, an Epsom salt bath can be really helpful.  It increases both sulfate and magnesium in your body, each of which will help in the processing of the chemicals in the smoke. 

With each of these things, small consistent doses are better than large, infrequent doses.  There are plenty of other considerations that we tend to tailor to each individual’s specific health needs, which we are happy to do in an office visit, but this list is a good starting point.  If you have any questions, feel free to comment or contact the office. 

Good luck out there!

1 Crinnion W and Pizzorno J; Clinical Environmental Medicine; 2019; Elsevier, St Louis, MO.2 https://www3.epa.gov/ttnamti1/files/ambient/smoke/wildgd.pdf - Accessed 8.23.18

Another Publication!

Last year I spent a considerable amount of time collaborating to create the first clinical textbook of environmental medicine with two icons in this field, Dr. Walter Crinnion and Dr. Joseph Pizzorno.  This tremendous work was recently published and is now available in many outlets, including on Amazon.  My contributions include chapters on the physiologic processes that accomplish the excretion of toxins for different body systems.  The section that I wrote on hair excretion includes a novel interpretation of the literature on heavy metal (hair) analysis in Autism Spectrum Disorder, detailing how there are particular "windows" of increased sensitivity to the molecular environment of the brain.  These windows coincide with changes in the developmental organization of the brain, with the most important factor being an adequate supply of zinc.  Zinc is crucial for proper excitatory balance, and when there is inadequate zinc, the body will up-regulate many processes that can result in increased toxic metal uptake if the zinc continues to be unavailable.  The book is highly referenced and contains a wealth of information!

Chronic Infectious Diseases - Lyme Disease and Co-Infections

I was recently honored with the opportunity to present my perspective on chronic infectious diseases to the graduating class of my alma mater medical school, Bastyr University, at their Grand Rounds.  The lecture consisted of discussions on how to approach patients with chronic infections and how healing takes place in these cases, along with characteristics of the most common microbes as well as treatment options.  The conversation ranged from working with people on the physical, the biochemical, and the psychological levels.  The students were quite engaged, especially considering that it was their last lecture before graduation!  They asked great questions, and I will be hosting a few in my office for continued learning on the topic.  

Adverse Childhood Experiences and Chronic Illness

In terms of societal goals, reducing childhood trauma is something we could probably all agree upon.

One of the ways that researchers have measured childhood trauma is by looking at the number of different types of traumatic events that a child experiences.  These are termed adverse childhood events and given the acronym ACEs.  

One of the things that has been surprising is the shear number of ACEs that many people experience.  In the course of a study conducted at a Kaiser Permanente intake facility in San Diego (generally consisting of people with insurance, so these are mostly people with decent jobs), it was found that 1 in 8 people had experienced 4 or more different ACES in their life and 4 ACES is the point at which the association with health impacts becomes dramatic.

““Things start getting serious around an ACE score of 4. Compared with people with zero ACEs, those with four categories of ACEs had a 240 percent greater risk of hepatitis, were 390 percent more likely to have chronic obstructive pulmonary disease (emphysema or chronic bronchitis), and a 240 percent higher risk of a sexually-transmitted disease.  They were twice as likely to be smokers, 12 times more likely to have attempted suicide, seven times more likely to be alcoholic, and 10 times more likely to have injected street drugs. People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, more auto-immune diseases, and more work absences.””

— https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

This is only looking at the number of different ACEs, and not including the severity or duration of any one of them!

The researcher that developed the idea that lead to the 17,000-person study on the subject was at the helm of an obesity clinic at the time, wondering why so many of his patients who had lost over 100 pounds and were on a good trajectory were dropping out.  He ended up discovering that the majority of the patients in his clinic had been previously abused.  

Overall, we are learning that a huge factor in the predisposition towards chronic disease lies in the mental/emotional realm.  Dr Klinghardt believes that mental/emotional issues create a weakness in the body that allows toxicity to develop and this toxicity provides nourishment for pathogenic microbes (chronic infections, viruses, lyme, etc).  

A large part of my practice is helping people to overcome these mental/emotional hurdles.  This is something that needs to be done very carefully, as some forms of therapy that involve "reliving the trauma" have the potential to re-traumatize the patient that is trying to relieve the problem.  Among other things I utilize craniosacral therapy, which seems to have the power to release what is being held from the body without subjecting the patient to any additional stress.  

Thankfully Washington is leading the nation in promoting this knowledge and using it to shape the approach of staff within the public school system, but this should really be something that is talked about universally.  

Article based on and figures taken from the following link: https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

For more info on ACEs:  https://www.cdc.gov/violenceprevention/acestudy/

Viral Issues and Allergies

One of my interests in medicine is the study of inappropriate immune responses.  These responses can manifest as seasonal allergies, food sensitivities, or autoimmunity.  When the immune system is devoting effort to non-infectious causes, this often allows infectious pathogens to exist in the body unaccounted for.  Lately, I have noticed a suspicious coincidence in that many of my patients expressing a sensitivity to foods also seem to have issues with a persistent virus.  After looking at the literature, I found that this is known phenomena. 

A study published in the vaunted journal "Science" discusses just that.  The authors found that the Reovirus, which otherwise causes no other pathology or disease, is able to impact the body's ability to tolerate gluten in celiac disease.  

To quote the authors, "Reovirus is an avirulent pathogen that elicits protective immunity, but we discovered that it can nonetheless disrupt intestinal immune homeostasis at inductive and effector sites of oral tolerance by suppressing peripheral regulatory T cell (pTreg) conversion and promoting TH1 immunity to dietary antigen"  (https://www.ncbi.nlm.nih.gov/pubmed/28386004)

Basically what this is saying is that the reovirus is disruptive to the cells that are responsible for immune tolerance (peripheral regulatory T cells).  

This is a fresh new perspective on the field of allergic sensitivity and more research will surely follow.

Until then we have a number of options:  we can reduce the number of copies of the virus in the body, modulate the chemical messengers responsible for the inflammatory response, and utilize our version of immune desensitization to stimulate new T regulatory cells to replace those that have been suppressed.  These strategies can be helpful for those with seasonal allergies, food sensitivities, or autoimmunity.  

Make an appointment today for a personalized assessment of your immune system.

The 2016 World Parkinson's Congress

I attended this conference composed of 7,000 clinicians, researchers, and patients.  This is a huge number of attendees at a conference!  I learned a lot about the pathophysiology involved in the Parkinson's disease process and am incredibly excited about using this information for the clinical and research opportunities that could come from this.  I traveled to this conference to present my work, in collaboration with Laurie Mischley and Paul Nicolai, on the use of melatonin in Parkinson's Disease patients.  

What we found was that there are a number of papers that describe a neurodegerative effect that happens with the use of melatonin in this condition.  Now, don't go saying that I think that melatonin is bad.  Quite the contrary, the vast majority (by at least 10x) of the papers published on melatonin in PD describe a neuroprotective effect.  This raised the question for us, "Why do we continue to see this discrepancy of effect?"  Our poster was presented as an initiation into a line of research to explore this topic.  Our hypothesis is that the dose of melatonin and the progression of the disease both play roles in the patient response to this hormone.  We are currently conducting a study that is tracking PD patients using surveys to ask how they are doing and what they are doing in terms of lifestyle and treatments.  We have over 1,000 patients enrolled and have at least 2 years of cumulative data on the first 480 of them.  This is a tremendous opportunity to utilize our data to longitudinally track the progress of the patients compared with their treatments.  We hope that this will clarify the issue for the benefit of all of those involved.

Spring Thyme in the Garden

One of my favorite things to do during the week is to spend a few moments working in our garden.  It's an amazing reward to be able to enjoy some time outside nurturing the plants that will nourish my family.  This year we've got lots of greens.  We are coming to the realization that greens provide a tremendous bounty of food, and greens are something that we like to consume continuously.  Plus garden greens as so much more tender and delicious than those you can buy in a store.  They are one of the best sources of minerals and the B vitamin folate, which is all the rage right now.  We have planted lots of collard greens and kale.  There is also broccoli, peas, mustard greens, leaks, tomatoes, strawberries, blueberries, peppers, celery, zucchini, cucumbers, and cabbage.  Herbs in the garden are rosemary, marjoram, thyme, curry, catnip, epazote, skullcap, wintergreen, valerian, wood betony, lemon balm, parsley, spearmint, marshmallow, foxglove, sage, pink yarrow, and peppermint.    I love to see garden pictures.  Feel free to post yours in the comments if you feel inspired.