mitochondria - Page 2

The Winnowing of the Western Diet: Reconsidering Food Sensitivities

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A few weeks ago, I posted some articles on Facebook regarding the need for protein in one’s diet (here, here). I believe that the lack of protein in the modern diet and the subsequent substitution with processed carbohydrates is one of the leading contributors to metabolic disease. Over the last 50 years or so, we have become increasingly afraid of eating protein and fat. Convinced by industry-sponsored advertising and ill-conceived medical science postulating that only calories matter and that eating fat makes one fat, we avoided the higher calorie foods like meat and shifted our diets towards lab manipulated but lower calorie and lower fat, ultra-processed carbohydrates. This has left much of the population starved for both macro (protein, fats, and plant-based carbohydrates) and micro (vitamins and minerals) nutrients. Ironically, the push to avoid high-calorie foods has resulted in higher calorie intakes in those who regularly consume ‘low-calorie’ foods than those who consume the higher calorie whole foods.

Similarly ironic, a corresponding form of malnutrition develops as a result of the low nutrient content in these industrial foods – this despite nutrient fortification. We have labeled this type of malnutrition as high calorie malnutrition. It is a metabolic starvation of sorts that develops concurrently with obesity, but also, with many disease processes including, I would suspect, food sensitivities. With the choice of highly processed foods, excessive calories must be consumed to meet the minimum nutrient requirements. Sugar is metabolically easy energy. So too is fat. Protein, by comparison, is not. Unfortunately, sugar, though technically energy-rich, is nutrition poor, and therein lies much of the problem. Worse yet, the fats used in most processed foods are hydrogenated, and thus, provide few health benefits but carry many risks.

When I bring up the notion of eating more protein, fat, or simply eating more nutrient-dense foods in general, I am met with resistance, sometimes philosophical, but oftentimes, based upon long-entrenched food sensitivities that develop over time, eventually winnowing the number of non-triggering foods down to almost nothing. Over the last several years, the breadth and depth of individual food sensitivities has exploded. Sensitivities to protein and fats, in particular, seem to be growing, but also to fruits and vegetables and, of course, grains. These are not allergies in the traditional sense, though there may be an altered histamine response involved. Rather, they may represent a complicated response to a lack of particular nutrients that results in the inability to digest or metabolize certain foods.

In response to the aforementioned posts on protein, a reader asked:

Chandler Marrs, what about the inability to absorb protein? …About 17 years prior to my husband’s death, he started eating all kinds of junk food (carbs). Every piece of crap he could pick up at Dollar General…he had never had a sweet tooth or liked junk food till then. Visiting with his neurosurgeon after my husband’s death…on diet and progression of his issues, he told me that when [my husband] went to junk food it was for energy, that he was no longer able to absorb protein. He told me that my husband was doing what his body dictated he do, the only thing he could do for energy…

I don’t know the history behind this gentleman’s illness, nor any of the details beyond what was posted above, but I would not be surprised if cancer were involved, perhaps in the brain, either originally or one that metastasized. The reason behind my suspicions is that cancer involves a switch in energy metabolism, wherein sugars are no longer used effectively in the manufacture of ATP – cellular energy – creating a sense of starvation, particularly when other fuels are absent and/or the machinery used to convert the other fuels to energy is deranged. Even if cancer was not part of this gentleman’s illness, the craving for sugars and the suspected inability to absorb or utilize proteins and fats for energy production points to a common metabolic adaptation to a longstanding nutrient-poor diet. It is a chemical conditioning of sorts, much like a drug addiction, that nets cravings for the foods/fuels that maintain the new normal, whatever that state may be.

What is often missed in the discussions of food sensitivities is that to digest and metabolize foods and convert them into usable and beneficial substrates for health, the machinery responsible requires nutrient co-factors e.g. vitamins and minerals. Absent those co-factors, food cannot be processed into ATP in the mitochondria. And absent ATP, none of the other processes in the body work. Since those co-factors come from the foods themselves, it is a reciprocating process. Nutrient dense foods provide the cofactors to process more micro-and macronutrients while effectively producing the requisite ATP. In contrast, nutrient poor foods provide an excess of sugars – potential energy – that can never fully be converted to actual energy or ATP because the machinery responsible for processing those foods is starving for nutrients, and thus, does not work very well. When one is not able to convert the food to energy nor to derive what few nutrients may come with these foods, cascades of ill-health begin. One of those cascades involves storing the excess as fat. To the extent one is able to store this fat, though unsightly, I imagine is a highly adaptive response, as individuals with similarly poor diets who do not or cannot store fat, risk a comparatively higher rate of all-cause mortality.

Returning to the question of food sensitivities, or more appropriately, the inability to digest and metabolize particular foods, I suspect that longstanding dietary factors, along with genetic and/or environmentally induced epigenetic variables, create and then maintain nutrient deficiencies that inhibit one’s ability to ‘eat’ certain foods. Across time and as those foods are avoided, nutrient availability continues to decline. Mitochondrial function is perturbed but adapts to the new environment, resulting in chemical reactions that induce inflammation and the other patterns so common with metabolic disturbances. This may include intense cravings for certain foods that are metabolically more accessible, like sugars. Admittedly, sugars are exactly what a body in this state does not need, but much like the cravings for drugs in an addiction model, I suspect the body has adapted to having this substance present in high concentrations. It has re-regulated itself accordingly, and because of this, both the absence of the substance and the addition of other, metabolically less well-adapted substances, cause great distress chemically. These changes are then experienced symptomatically.

We know from addiction models, that when a substance is present continuously and in high concentrations, the body adapts so that it can maintain some sort of homeostasis and survive. Receptors, transporters, enzymes, and the like, are reregulated. Some upregulate, others downregulate. As this reregulation occurs, the body becomes chemically conditioned to its new state, seeking to maintain it at whatever cost. When what is in excess carries no nutritional value, as it so often does, we have the bonus of starving the enzymes that make metabolism possible, further imperiling health. At the root of much of this reregulation is nutrition or lack thereof. Every enzyme in the body requires nutrient co-factors to function. Absent these nutrients, metabolism falters; not just the metabolism of foods to energy but the metabolism of drugs, the metabolism of neurotransmitters, hormones, and the like. Absent nutrients, we have widespread changes in the totality of our biochemistry. How those changes manifest is dependent upon the individual’s genetic makeup and environment, but make no mistake, they are occurring.

While it is clear that one can avoid many of these problems by eating a nutrient-dense diet, it is not as clear how one recovers these functions once they are lost. Do we simply feed the offending substance until tolerance develops? Or do we tackle the enzyme issues first, supplying the requisite nutrients in the form of supplements so that they function more effectively and then re-introduce the offending foods? I don’t know the answer, but my instincts tell me that enzyme issues have to be addressed first and the vitamin and mineral deficiencies corrected before the offending foods can be reintroduced. What I do know, however, is that something must be done. Human beings cannot live well or for very long without protein and fat. Those are requisite substrates for health.

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This article was first published on June 20, 2019.

Poor Nutrition Stress: The Enemy of Health

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In previous posts, I have indicated that stress can initiate or exacerbate disease and medication or vaccine adverse reactions. Read that statement, you might think I am attributing the onset of serious disease and adverse reactions to a psychosocial cause. That is not the case. Stress comes in a myriad of forms, some external, some internal, and although much of what we call stress relates to psychosocial responses to perceived threats, I think stress encapsulates so much more. At its most fundamental level, stress represents a physical state where the body is performing less than optimally. Let me explain.

What is Stress?

I define the word “stress” as a physical or mental force that is acting upon you. An example of mental or psychosocial stress might be an insult from a person, meaning that the stress comes from a source outside the body. On the other hand, it might be the realization that a deadline has to be met, a mental source from within. Any form of injury is an obvious source of physical stress. Physical action such as shoveling snow is another form of stress, demanding energy consumption imposed by the individual who wishes to get rid of the snow. Being infected with a virus or by bacteria is a form of stress that demands a defensive reaction. In each of these instances, the body reacts to the inflicting stressor. Sometimes, when the resources are available, it reacts efficiently. Other times, when the resources are not available or when additional factors intercede, the body’s response to the stress is ill-adapted.

Your Body is Your Fortress, Your Immune System the Soldiers

Perhaps an analogy might help to provide an explanation for the remarks that follow. I imagine the body as being like an old fashioned fortress. The people living within it go into action when the fortress is attacked by an enemy from outside. It would be of little use if the defense soldiers went to the eastern battlements if the attack came from the west and so there had to be a central figure that would coordinate the defensive reaction. The nature of the attack would be spotted by a guard on duty and the central figure informed by messenger.

The body represents the fortress and the lower part of the brain represents the central figure that coordinates the defense. The cells in the blood known as white cells can be thought of as soldiers, armed with the necessary weapons to meet the nature of the enemy. Suppose, for example, a person’s finger is stuck by a splinter carrying a disease bearing germ. The pain, felt in the brain, recognizes its source and interprets it as a signal that an attack has occurred. White cells in the area can be regarded as the “militia under local command” and a “beachhead” is formed to wall off the attack. The white cells sacrifice themselves and as they die, they form what we call pus. If the beachhead is broken and the germs manage to get into the bloodstream, it is then called septicemia and the brain/body goes into a full defensive reaction where high fever is the most obvious result. Such an illness is an attack/defense battle.

The symptoms that develop from such an infection represent the evidence for this defense, feeling ill, pain and developing a fever are excellent examples. Micro-organisms are most efficient at 37° C, the normal body temperature. The rise in body temperature, initiated by the brain, makes the microorganisms less efficient and may kill some of them. One therefore has to question the time honored method of reducing the fever, during illness, as being an example of good treatment. While reducing fever improves the symptoms caused by the infection, it also reduces the efficiency of the immune battle raging within.

The outcome against the stressor is death or recovery; although it is possible sometimes to end up in a kind of stalemate, represented by prolonged symptoms of ill health. Chronic illness may be viewed as the immune system’s inability to eradicate fully the stressor.

Poor Nutrition and Stress

As I have emphasized in previous posts, the autonomic (automatic) nervous and endocrine systems are used to carry the messages between the body and the brain that enable the defense to be coordinated. This demands a colossal amount of cellular energy, no matter the nature of the stress. That energy to fight stress comes from oxidation of the fuel that is provided from nutrition. Of course, the greater the stress the greater the energy demand, but in the end the equation is quite simple. If the energy required to meet the stress is greater than the energy that is supplied, there must be a variable degree of collapse within the defensive system. That collapse presents as intractable symptoms, where the body is unable provide the energy needed to sustain health. This is the secret of the autonomic dysfunction in the vitamin B1 deficiency disease, beriberi. It is also the secret behind the initiation of POTS because both conditions are examples of defective oxidation. You can read more details regarding thiamine deficiency, beriberi, POTS and other health issues from previous posts on this website

High Energy Demands Equal High Nutritional Demands

Nutrient density of diet might appear to be perfectly adequate for a given individual, but inadequate to meet the self-initiated energy demands of a superior brain/body combination in a highly active individual such as an actively engaged student or athlete. Our genetic characteristics, the quality of nutrition and the nature of life stresses each represent a factor that all combine together to give us a profile for understanding health and its potential breakdown.

Epigenetics and Mitochondria: The Stress of Our Parents

Epigenetics, the science of how our genes are influenced by diet and lifestyle, is relatively new. Epigenetics considers the possibility that genes can be activated and deactivated by nutrition and lifestyle. Stress can come in many forms, from psychosocial trauma, poor nutrition, environmental and medical toxin exposures, to infections. Stress impacts how our genes behave. Even though one may inherit a hard-coded genetic mutation from a parent, that mutation may not be activated unless exposed to a particular type of stress. Similarly, an individual who may have no obvious illness-causing genetic abnormalities but stress, in the form of nutritional depletion, exposures or trauma, can turn on or turn off a set of genes that induce illness. What is remarkable about epigenetics is the transgenerational nature of the stressors. The memories of stressors affecting our parents and even our grandparents can affect our health by activating or deactivating gene programs.

We also have to consider the state of our mitochondria, the “engines” in each of our cells that produce the energy for cellular function (to learn more about mitochondria and health, see previous posts on this website). Mitochondria have their own genes that are inherited only from the mother. Damage to the DNA that makes up these genes sometimes explains the similarity of symptoms that affect a given mother and any or all of her children. For example, although this damage may be inherited, we also have scientific evidence that thiamine deficiency, known to be the result of poor diet, can damage mitochondria. A bad gene might be the solitary cause of a given disease, but even where this is known as the cause, the symptoms of the disease are sometimes delayed for many years, suggesting that other variables must play a part. A minor change in cellular genetic DNA might be alright to meet the demands of normal living, but impose a risk factor that could be impacted by prolonged stress or poor nutrition, and disease emerges.

Nutrition is the Only Factor that We can Control

The imposition of stress on any given individual is variable, most of which is accidental and out of our control. Therefore, if we represent these three factors, genetics, stress and nutrition as three interlocking circles, all of which overlap at the center of such a figure, there is actually only one circle over which we have control and that is nutrition. We now know from the science of epigenetics that nutritional inadequacy can affect our genes. By examining the mechanism by which we defend ourselves against stress, we can also see the effect of poor nutrition.

Poor Nutrition Equals a Poor Stress Response

Using these three variables, perhaps we can begin to understand several unanswered questions. Why does a vaccination negatively affect a relatively small percentage of the total population vaccinated? Or why do some medications negatively impact only some individuals? It might be because of a genetic risk factor or because of a collapse of the coordinated stress response related to quality of nutrition or a combination of both. Why does a vaccination tend to “pick off” the higher quality students and athletes? Again, the same kind of answer; high quality machinery demands high quality fuel. Since the limbic system of the brain has a high energy demand and represents the computer that coordinates a stress response we can understand the appearance of beriberi or POTS and cerebellar ataxia, all examples of a deviant response to stress. Nutrition, therefore, should not be looked at as supplement to good health, but as the foundation of health. When disease or medication and vaccine reactions emerge, efforts to identify and then restore nutritional deficiencies must be the first line of immune system health. Without critical nutrients, the body simply cannot mount a successful stress response and the battlefield will expand and eventually fall.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

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This article was published originally on May 6, 2014. 

Beriberi: The Great Imitator

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Because of some unusual clinical experiences as a pediatrician, I have published a number of articles in the medical press on thiamine, also known as vitamin B1. Deficiency of this vitamin is the primary cause of the disease called beriberi. It took many years before the simple explanation for this incredibly complex disease became known. A group of scientists from Japan called the “Vitamin B research committee of Japan” wrote and published the Review of Japanese Literature on Beriberi and Thiamine, in 1965. It was translated into English subsequently to pass the information about beriberi to people in the West who were considered to be ignorant of this disease. A book published in 1965 on a medical subject that few recall may be regarded in the modern world as being out of date and of historical interest only, however, it has been said that “Those who do not learn history are doomed to repeat it”. And repeat it, we are.

Beriberi is one of the nutritional diseases that is regarded as being conquered. It is rarely considered as a cause of disease in any well-developed country, including America. In what follows, are extractions from this book that are pertinent to many of today’s chronic health issues. It appears that thiamine deficiency is making a comeback but it is rarely considered as a possibility.

The History of Beriberi and Thiamine Deficiency

Beriberi has existed in Japan from antiquity and records can be found in documents as early as 808. Between 1603 and 1867, city inhabitants began to eat white rice (polished by a mill). The act of taking the rice to a mill reflected an improved affluence since white rice looked better on the table and people were demonstrating that they could afford the mill. Now we know that thiamine and the other B vitamins are found in the cusp around the rice grain. The grain consists of starch that is metabolized as glucose and the vitamins essential to the process are in the cusp. The number of cases of beriberi in Japan reached its peak in the 1920s, after which the declining incidence was remarkable. This is when the true cause of the disease was found. Epidemics of the disease broke out in the summer months, an important point to be noted later in this article.

Early Thiamine Research

Before I go on, I want to mention an extremely important experiment that was carried out in 1936. Sir Rudolf Peters showed that there was no difference in the metabolic responses of thiamine deficient pigeon brain cells, compared with cells that were thiamine sufficient, until glucose (sugar) was added. Peters called the failure of the thiamine deficient cells to respond to the input of glucose the catatorulin effect. The reason I mention this historical experiment is because we now know that the clinical effects of thiamine deficiency can be precipitated by ingesting sugar, although these effects are insidious, usually relatively minor in character and can remain on and off for months. The symptoms, as recorded in experimental thiamine deficiency in human subjects, are often diagnosed as psychosomatic. Treated purely symptomatically and the underlying dietary cause neglected, the clinical course gives rise to much more serious symptoms that are then diagnosed as various types of chronic brain disease.

  • Thiamine Deficiency Related Mortality. The mortality in beriberi is extremely low. In Japan the total number of deaths decreased from 26,797 in 1923 to only 447 in 1959 after the discovery of its true cause.
  • Thiamine Deficiency Related Morbidity. This is another story. It describes the number of people living and suffering with the disease. In spite of the newly acquired knowledge concerning its cause, during August and September 1951, of 375 patients attending a clinic in Tokyo, 29% had at least two of the major beriberi signs. The importance of the summer months will be mentioned later.

Are the Clinical Effects Relevant Today?

The book records a thiamine deficiency experiment in four healthy male adults. Note that this was an experiment, not a natural occurrence of beriberi. The two are different in detail. Deficiency of the other B vitamins is involved in beriberi but thiamine deficiency dominates the picture. In the second week of the experiment, the subjects described general malaise, and a “heavy feeling” in the legs. In the third week of the experiment they complained of palpitations of the heart. Examination revealed either a slow or fast heart rate, a high systolic and low diastolic blood pressure, and an increase in some of the white blood cells. In the fourth week there was a decrease in appetite, nausea, vomiting and weight loss. Symptoms were rapidly abolished with restoration of thiamine. These are common symptoms that confront the modern physician. It is most probable that they would be diagnosed as a simple infection such as a virus and of course, they could be.

Subjective Symptoms of Naturally Occurring Beriberi

The early symptoms include general malaise, loss of strength in knee joints, “pins and needles” in arms and legs, palpitation of the heart, a sense of tightness in the chest and a “full” feeling in the upper abdomen. These are complaints heard by doctors today and are often referred to as psychosomatic, particularly when the laboratory tests are normal. Nausea and vomiting are invariably ascribed to other causes.

General Objective Symptoms of Beriberi

The mental state is not affected in the early stages of beriberi. The patient may look relatively well. The disease in Japan was more likely in a robust manual laborer. Some edema or swelling of the tissues is present also in the early stages but may be only slight and found only on the shin. Tenderness in the calf muscles may be elicited by gripping the calf muscle, but such a test is probably unlikely in a modern clinic.

In later stages, fluid is found in the pleural cavity, surrounding the heart in the pericardium and in the abdomen. Fluid in body cavities is usually ascribed to other “more modern” causes and beriberi is not likely to be considered. There may be low grade fever, usually giving rise to a search for an infection. We are all aware that such symptoms come from other causes, but a diet history might suggest that beriberi is a possibility in the differential diagnosis.

Beriberi and the Cardiovascular System

In the early stages of beriberi the patient will have palpitations of the heart on physical or mental exertion. In later stages, palpitations and breathlessness will occur even at rest. X-ray examination shows the heart to be enlarged and changes in the electrocardiogram are those seen with other heart diseases. Findings like this in the modern world would almost certainly be diagnosed as “viral myocardiopathy”.

Beriberi and the Nervous System

Polyneuritis and paralysis of nerves to the arms and legs occur in the early stages of beriberi and there are major changes in sensation including touch, pain and temperature perception. Loss of sensation in the index finger and thumb dominates the sensory loss and may easily be mistaken for carpal tunnel syndrome. “Pins and needles”, numbness or a burning sensation in the legs and toes may be experienced.

In the modern world, this would be studied by a test known as electromyography and probably attributed to other causes. A 39 year old woman is described in the book. She had lassitude (severe fatigue) and had difficulty in walking because of dizziness and shaking, common symptoms seen today by neurologists.

Beriberi and the Autonomic Nervous System

We have two nervous systems. One is called voluntary and is directed by the thinking brain that enables willpower. The autonomic system is controlled by the non-thinking lower part of the brain and is automatic. This part of the brain is peculiarly sensitive to thiamine deficiency, so dysautonomia (dys meaning abnormal and autonomia referring to the autonomic system) is the major presentation of beriberi in its early stages, interfering with our ability for continuous adaptation to the environment. Since it is automatic, body functions are normally carried out without our having to think about them.

There are two branches to the system: one is called sympathetic and the other one is called parasympathetic. The sympathetic branch is triggered by any form of physical or mental stress and prepares us for action to manage response to the stress. Sensing danger, this system activates the fight-or-flight reflex. The parasympathetic branch organizes the functions of the body at rest. As one branch is activated, the other is withdrawn, representing the Yin and Yang (extreme opposites) of adaptation.

Beriberi is characterized in its early stages by dysautonomia, appearing as postural orthostatic tachycardia syndrome (POTS). This well documented modern disease cannot be distinguished from beriberi except by appropriate laboratory testing for thiamine deficiency. Blood thiamine levels are usually normal in the mild to moderate deficiency state.

Examples of Dysfunction in Beriberi

The calf muscle often cramps with physical exercise. There is loss of the deep tendon reflexes in the legs. There is diminished visual acuity. Part of the eye is known as the papilla and pallor occurs in its lateral half. If this is detected by an eye doctor and the patient has neurological symptoms, a diagnosis of multiple sclerosis would certainly be entertained.

Optic neuritis is common in beriberi. Loss of sensation is greater on the front of the body, follows no specific nerve distribution and is indistinct, suggestive of “neurosis” in the modern world.

Foot and wrist drop, loss of sensation to vibration (commonly tested with a tuning fork) and stumbling on walking are all examples of symptoms that would be most likely ascribed to other causes.

Breathlessness with or without exertion would probably be ascribed to congestive heart failure of unknown cause or perhaps associated with high blood pressure, even though they might have a common cause that goes unrecognized.

The symptoms of this disease can be precipitated for the first time when some form of stress is applied to the body. This can be a simple infection such as a cold, a mild head injury, exposure to sunlight or even an inoculation, important points to consider when unexpected complications arise after a mild incident of this nature. Note the reference to sunlight and the outbreaks of beriberi in the summer months. We now know that ultraviolet light is stressful to the human body. Exposure to sunlight, even though it provides us with vitamin D as part of its beneficence, is for the fit individual. Tanning of the skin is a natural defense mechanism that exhibits the state of health.

Is Thiamine Deficiency Common in America?

My direct answer to this question is that it is indeed extremely common. There is good reason for it because sugar ingestion is so extreme and ubiquitous within the population as a whole. It is the reason that I mentioned the experiment of Rudolph Peters. Ingestion of sugar is causing widespread beriberi, masking as psychosomatic disease and dysautonomia. The symptoms and physical findings vary according to the stage of the disease. For example, a low or a high acid in the stomach can occur at different times as the effects of the disease advance. Both are associated with gastroesophageal reflux and heartburn, suggesting that the acid content is only part of the picture.
A low blood sugar can cause the symptoms of hypoglycemia, a relatively common condition. A high blood sugar can be mistaken for diabetes, both seen in varying stages of the disease.

It is extremely easy to detect thiamine deficiency by doing a test on red blood cells. Unfortunately this test is either incomplete or not performed at all by any laboratory known to me.

The lower part of the human brain that controls the autonomic nervous system is exquisitely sensitive to thiamine deficiency. It produces the same effect as a mild deprivation of oxygen. Because this is dangerous and life-threatening, the control mechanisms become much more reactive, often firing the fight-or-flight reflex that in the modern world is diagnosed as panic attacks. Oxidative stress (a deficiency or an excess of oxygen affecting cells, particularly those of the lower brain) is occurring in children and adults. It is responsible for many common conditions, including jaundice in the newborn, sudden infancy death, recurrent ear infections, tonsillitis, sinusitis, asthma, attention deficit disorder (ADD), hyperactivity, and even autism. Each of these conditions has been reported in the medical literature as related to oxidative stress. So many different diseases occurring from the same common cause is offensive to the present medical model. This model regards each of these phenomena as a separate disease entity with a specific cause for each.

Without the correct balance of glucose, oxygen and thiamine, the mitochondria (the engines of the cell) that are responsible for producing the energy of cellular function, cannot realize their potential. Because the lower brain computes our adaptation, it can be said that people with this kind of dysautonomia are maladapted to the environment. For example they cannot adjust to outside temperature, shivering and going blue when it is hot and sweating when it is cold.

So, yes, beriberi and thiamine deficiency have re-emerged. And yes, we have forgotten history and appear doomed to repeat it. When supplemental thiamine and magnesium can be so therapeutic, it is high time that the situation should be addressed more clearly by the medical profession.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Image: Print ad from 1930; Public Domain.

This article was published originally on November 4, 2015.

Dr. Derrick Lonsdale passed away on May 2, 2024. He will be missed. 

A Question of Responsibility in Health and Disease

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Self-responsibility is much needed in the quixotic culture that surrounds us today. It should begin to be acquired even in infancy as we learn to navigate life. The difficult job of parenthood, perhaps the most important one of all, has to be undertaken without previous experience or training. In former years the wisdom of grandparents was sought avidly when families tended to remain in the same locality. Geographic separation has caused them to be largely discarded.

This post states that there is no more important example of self-responsibility than in maintenance of health. When we are struck down by disease, we have been taught that it is purely an act of nature: that it has nothing to do with our own actions. It is regarded as bad luck or an inevitable effect of genetic predisposition. We have also been taught that when we get sick, whatever the cause may be, that the wonders of modern medicine will take care of it. We accept a prescription as a birthright, often without seeking why it is being prescribed or how it is expected to cure us. Is that really how we want to live?

Self-Responsibility is Critical to Health

When I emphasize dietary indiscretion as the harbinger of ill health, some readers will say, “oh yes, we’ve heard all that stuff before. It is so boring”, not even bothering to read further. So let us use an analogy that I have used before in posts on this website. You have bought a car and the owner’s manual tells you that the engine uses regular gas. However, a friend has told you that high octane gas increases acceleration and makes the car livelier. You have decided that the feel of the car with high octane gas appeals to you, even though you have also been told that it increases the wear-and-tear on the engine, possibly leading to an eventual breakdown. With that knowledge, you are faced with a choice. If your decision is to continue using a fuel for which the engine has not been designed, it might be referred to as indiscretion, or even lack of self-responsibility. When the forecast of breakdown becomes a reality you might even blame the car maker. Cursing the necessary expenditure, you might expect a skilled mechanic to repair the damage, even forgetting that it may have been your own fault. Could this be compared with dietary indiscretion? Of course, you need to have the knowledge of how and why the “wrong choices” do, in fact, result in health breakdown. If you persist in making those “wrong choices”, are you in fact exercising self-responsibility towards your own health?

Natural Sugars versus Sugary Sweets

However we arrived on the face of the earth, we could not have survived if the fuel had not been available to us. Anthropologists tell us that our ancestors were “hunter gatherers”. The food (fuel) was provided by Mother Nature in the form of nuts, seeds, roots, leaves and fruits. In particular, there was no such thing as sugar in a free state. It was locked up in the fruit and leaves. There are at least 40 or more nutrients in natural food that are mandatory to the maintenance of health and many may not even have been discovered yet. None of them are contained in the highly processed, heavily sweetened substances we call food.

Where did we go wrong? Believe it or not, sugar is the villain. We can now go on the Internet and are told repeatedly that it is more addictive than cocaine and yet 80% of the artificial foods on the shelves of a groceries store contain sugar. In fact, these “foods” would not sell unless they were sweet to the taste. People are so bored with hearing this that it is virtually ignored. Because the characteristic symptoms develop slowly and do not produce abnormal conventional laboratory studies, the connection is almost invariably lost. When symptoms do emerge, they are often mistakenly diagnosed as psychosomatic, for which the standard treatment is a prescription for one of the many tranquilizer pills. Self-indulgence as the cause is never considered by patient or physician.

Of Different Fuels

Let’s try to keep it simple by turning once again to analogy. Gasoline in a car engine has to be ignited. The explosion that occurs represents a union of gasoline with oxygen. The resultant energy has to be captured in a cylinder in order to drive a piston. This connects with a flywheel that transmits the energy to the wheels through a transmission. Our bodies have exactly the same problems but the mechanisms are widely different. Glucose, derived from simple sugars, is the primary fuel of our cells, particularly in the brain. It is “ignited” by uniting it with oxygen and this is done by means of an enzyme. In order to function properly, this enzyme requires the presence of vitamin B1 (thiamine) and magnesium. You could say that thiamine and magnesium “ignite the glucose”, releasing energy in the form of electrons. The energy from electrons synthesizes a kind of energy currency known as ATP. This works a little like a battery. Chemical energy derived from “burning” (oxidizing) glucose must be transduced to electric energy for physical or mental function. If those nutrients are not present, the sugars remain unprocessed, free to evoke the host of modern disease processes that fall under the rubric of Type 2 diabetes.

Returning to our engine analogy, many car owners will remember that they had to use a mechanism called a choke when starting the cold engine. This resulted in a temporary high concentration of gas. Perhaps it will be remembered that if and when the choke was not released or discontinued when the engine had warmed up, the engine would run distinctly badly and black smoke would emerge from the exhaust pipe. The black smoke represents inefficient combustion of the gasoline. Therefore, there should be a much lower ratio of gasoline to oxygen when the engine has warmed.

Cellular Engines Need Fuel

Each of all our cells have “engines” called mitochondria that generate energy. They work constantly, do not have to be started like a car engine and are always warm. They do not need a choke. When we take an excess of calories that do not contain the necessary vitamins and minerals, it is exactly like choking our mitochondria, creating inefficiency of energy production. This is particularly true of sugar that overwhelms the ability of vitamin B1 to “ignite” it. Inefficient combustion (oxidation) gives rise to organic acids that are the equivalent of black smoke in the car exhaust and they can be found in the urine. This inefficiency of energy production affects the part of the brain that is responsible for our ability to adjust ourselves (adapt) to the changes that occur in our environment. We develop functional changes such as “brain fog”, palpitations of the heart, unusual or excessive sweating and “goosebumps” may appear on the skin. We may have a drop in blood pressure, associated with a fainting attack. Because the standard laboratory tests are normal, it is concluded that the symptoms are psychosomatic.

I remember the case of an adolescent whose diet contained a lot of “junk foods”. He climbed a rope in the gymnasium, entailing the consumption of energy. When he came down he passed out and was removed to the nearest hospital. Without knowing that he had vitamin B1 deficiency, they gave him intravenous fluids containing glucose. He had eleven bloodstained bowel movements and died. Giving sugar to somebody who is deficient in vitamin B1 is extremely dangerous and the trouble is that ingestion of sugar leads to vitamin B1 deficiency. There is considerable evidence that dietary indiscretion of this nature, continued over years, may eventually give rise to a brain disease that is given a name. Alzheimer’s, senile dementia, Parkinson’s disease and other well-known scourges may well be the legacy in your later years.

What We Eat and Drink Matters

In light of this discussion, who is responsible for the current health crisis? While it is tempting to blame others, and certainly the food and pharmaceutical industries benefit greatly from our incessant need to indulge, the blame ultimately must reside with each of us. We have abdicated our responsibility to manage our own health. Like the car owner who ‘likes the feel’ he gets from his car with high octane gas, we like the feel we get from when we eat sweets and other junk foods. Ultimately though, without the correct fuel, engines clog and sputter. Whether those engines reside in our vehicles or in our bodies, absent the correct fuel, damage accrues. It is a relatively simple equation, but one that requires a modicum of self-awareness and responsibility. Unfortunately, I am afraid self-responsibility seems to have disappeared from modern concepts of health and disease. I suspect that until it is found and embraced again as core human value, diseases of consumption and indulgence will continue to flourish.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

Image by Tumisu from Pixabay.

This article was published originally on December 7, 2016.

Dr. Derrick Lonsdale passed away on May 2, 2024. He will be missed. 

 

Metformin: Medical Marvel or Magical Medicine?

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I am not a big fan of metformin (Glucophage). My disdain for metformin stems not from its efficacy. Metformin is quite adept at lowering blood sugar. In that sense, it is a medical marvel. Consider a pill that will ensure that no matter the individual’s intake of sugar, blood glucose measurements will magically fall within a normal range. What a wonderful invention – to have one’s cake, eat it too, and all the while, maintain normal blood sugar – who wouldn’t want that?

Alas, however, like all magic tricks, when the sleight of hand is revealed, the luster is lost. In the case of metformin, the underlying prestidigitation is not so magical after all. Metformin, like other wonder drugs, treats a symptom of a much greater problem; a symptom that in reality is just a visible sign of a necessary and protective innate process designed for cellular survival. The symptom is insulin resistance, the problem is too much dietary sugar and too few nutrients – an insidious form of high-calorie malnutrition that at once overloads cellular and mitochondrial processing capacities and starves the cells of critical nutrients.

Nutrients – They’re Necessary

A little-appreciated fact in modern medicine, vitamins and minerals power all of the machinery involved in cell function and in mitochondrial energy production. No nutrients, no energy, cellular starvation (even in the face of weight gain), inflammation, dysfunction, and ultimately, death. In the face of too much sugar and not enough nutrition, insulin resistance seems perfectly logical. If cellular fuel is waning, why not keep a little extra floating around, but since the apparatus to process said sugars is crippled, we have to turn down the intake valves. I would argue that it’s not obesity causing insulin resistance, after all not all overweight folks have type 2 diabetes, and not all insulin-resistant diabetics are overweight. It’s the damned sugar and lack of other nutrients initiating insulin resistance. Both the insulin resistance and fat storage are survival mechanisms; ones that ultimately have pathological consequences, but survival mechanisms nevertheless. In fact, folks who are diabetic and overweight have a lower all-cause mortality rate than those who are diabetic and thin.

If the problem is high-calorie malnutrition, which manifests as elevated blood sugar and in many cases, increased fat storage, wouldn’t the more prudent solution be to rectify the problem, to cease sugar intake, and address the nutrient deficiency? Wouldn’t that unwind the damage and heal the body? I think so, but alas, that’s not what we do in modern medicine. No, we don’t correct the problem, we treat the symptom(s) and then we revel in all the cool mechanisms we can interrupt, never considering the bigger picture.

Metformin Usurps Cell Signaling

Metformin bypasses our cells’ innate response to too much of anything – downregulation or desensitization – by overriding the communication systems that control these functions. In this case, metformin becomes the signaling molecule that tells the liver if and when to release glucose into the bloodstream. From an engineering standpoint, it’s a fantastic workaround. No need to address the core problem, just rewire the communication and continue on as if nothing is wrong. The added bonus is that for all intents and purposes, it works. Blood sugar declines, as does some of the pathology associated with elevated blood sugar. A medical marvel, right?

Well, not so fast. It just so happens that we need those pesky nutrients to function and to survive. When we give metformin to individuals who are already in a state of malnutrition, we are effectively ignoring and extending the underlying deficiencies that initiated the insulin resistance in the first place. More importantly, and this is something that is missed almost entirely in western medicine, we are adding to the metabolic mess a chemical that directly leaches a whole bunch of nutrients on its own (which further disables cell function, increases insulin resistance, increases fat storage in the long term and all of the associated pathologies we have come to know and love). Furthermore, we’re disrupting energy metabolism – energy that all cells need to function – and while that may quell some pathologies in the short term, in the long term, we’re all but guaranteeing a progressive decline into ill-health, despite the cheerleading that suggests otherwise.

We Get It. Metformin Treats a Symptom Not the Root Cause. So What?

Why am I blustering on about metformin now, when I have done so on several occasions previously (here, here, and here)? Well, an emerging body of research is showing yet another set of mechanisms by which metformin derails health. It turns out, that in addition to depleting vitamins B12 and B9, which are responsible for 100s of enzymatic reactions and particularly important in central nervous system function including myelination (how many cases of diabetic neuropathy or multiple sclerosis are really vitamin b12 deficiency?) and tanking CoEnzyme Q10 which effectively cripples mitochondrial ATP production in muscles (and likely exercise capabilities) with the resultant loss inducing a whole host of pathological processes (muscle weakness, cognitive decline among a few), metformin also blocks vitamin B1 – thiamine – uptake by multiple mechanisms. And for kicks and giggles, it appears to interfere with the body’s innate toxicant metabolism pathways, the P450 enzymes, rendering those who use this drug less capable of effectively metabolizing a whole host of other medications and environmental toxicants.

Thiamine is Critically Important to Health

For those of you who don’t read our blog and/or are not familiar with thiamine and thiamine deficiency, let’s just say, thiamine is the granddaddy of nutrients, an essential cofactor at the top of the fuel processing pyramid. Without thiamine, food fuel from carbs and, to a lesser extent, fats cannot be converted into ATP. With declining fuel sources, mitochondrial functioning degrades as well and all sorts of diseases processes ensue.

Sit with that for a moment. We’re giving folks who already have an issue with converting foods to energy and who are already very likely nutrient deficient, a medication that blocks the very first step in that conversion process. Since metformin also blocks the lactate pathway and acetyl-coenzyme A carboxylase (an enzyme necessary to process fatty acids into fuels), blocking thiamine effectively shunts the mitochondrial input pathways. Mind you, this is in addition to blocking the critical electron transport functions – via CoQ10 – found at the back of ATP processing. Talk about an induction of energetic stress.

So What If a Few Vitamins Are Depleted?

I bet you’re thinking if these nutrients are so important and metformin is so dangerous, why isn’t metformin more toxic? After all, metformin has been on the market for over 50 years, is considered the first line of treatment for type 2 diabetes, and just about every research article published on this drug begins with a blanket statement that metformin has an excellent safety record.

Why, indeed? Let us consider what constitutes a safe drug?

In modern medicine, the notion of drug safety and toxicology are equated with acute reactions. For decades, we have been operating under the false assumption in medical and environmental toxicology that if something doesn’t kill us immediately it must be safe (and the equally false assumption that toxicological responses are necessarily linear). Many drugs (and environmental toxicants) are much more subtle in their damage. They disrupt systems that, in many cases, have the capacity to compensate, at least for a period of time and until a critical threshold is met. Mitochondrial energetics is one of those systems that is remarkably resilient in the face of a myriad of stressors, sometimes taking years for the damage to be recognized. With nutrient deficiencies, in particular, compensation is aided by continuously changing environmental and lifestyle considerations. Sometimes we eat very well and other times we don’t; sometimes life is good, other times, it is not. Stressors vary.

Nutrient Deficiencies Wax and Wane

With nutrients deficiencies, especially essential nutrients that require dietary intake, there can be waxing and waning of the symptoms that these deficits evoke as diet and other variables change. It’s not until one reaches a critical threshold that the deficiency is recognized if it is recognized at all. With thiamine deficiency, in particular, animal research suggests the threshold for severe symptoms may be as high as 80% depletion. Imagine a system that can maintain life in the face of up to an 80% deficiency. That is remarkable.

Symptoms of severe thiamine deficiency include those associated with a condition called Wernicke’s Encephalopathy, a serious and potentially fatal medical emergency with neurological and cognitive impairments, oculomotor and gait disturbances, and cardiac instability. With milder deficiencies, however, we see things like fatigue, muscle pain, mental fuzziness, GI disturbances, autonomic dysregulation, and a host of symptoms that can easily and incorrectly be attributed to other conditions and/or modern life in general.

Interestingly, once thiamine depletion reaches that critical threshold, it doesn’t take much thiamine to begin seeing improvement in the symptoms. In those same animal studies mentioned above, it took an increase of only 6% of the total thiamine concentration to begin the improvement. So with a change from 20 to 26% of recommended thiamine concentration, symptoms begin to dissipate, at least temporarily. Sit with than one for a moment – what a remarkable bit of resilience. It takes a full 80% reduction in thiamine stores before serious symptoms are recognized but improvement begins with only an additional 6% – when the system is still depleted by 74%.

Given the metabolic capacity to maintain survival in the face of all but critical deficiencies, it is easy to see how and why blocking these nutrients would not be considered dangerous or at least obviously so. The decline is so gradual in most cases, and likely waxes and wanes, that it becomes near impossible to attribute symptoms and underlying nutrient deficiencies to the offending medication(s). Unfortunately, just because we don’t recognize those patterns, doesn’t mean that they do not exist.

How Metformin Blocks Thiamine: The Technicals

Backing up just a bit, it is important to understand the mechanisms by which metformin reduces thiamine. When metformin is present, a set of transporters that normally bring thiamine into the cell to perform its task as a cofactor in the machinery that converts carbs to ATP, brings metformin into the cell instead, replacing thiamine altogether. The transporters involved are the SLC22A1, also called the organic cation transporter 1, [OAT1], and the SLC19A3. Conversely, when metformin is not present or at least not overwhelming all of the transporters as it is during the initial phases of absorption post intake, thiamine becomes available for transport. Since these transporters are not completely and continuously blocked (and there are other thiamine transporters), thiamine uptake occurs, just not continuously and just not at full capacity. This may be one reason why metformin is not as acutely damaging as some of the other drugs in its class, but make no mistake, it is still dangerous. Thiamine deficiency is deadly. With the right combination of thiamine blocking variables (other medications/vaccines block thiamine as well), thiamine concentrations can tank and even if the thiamine concentrations hover at a subclinical deficit, the likelihood of chronic illness is high.

Thiamine and Diabetes: Connecting a Few More Dots

A little over a year ago, I stumbled upon some research showing a high rate of thiamine deficiency in individuals with both type 1 and type 2 diabetes (75% and 64%, respectively). I wrote about that research in Diabetes and Thiamine: A Novel Treatment Opportunity. According to several studies, diabetics appear to excrete higher amounts of thiamine than non-diabetics. The research attributes this to either poor kidney reabsorption and/or mutations in the thiamine transporter genes that prevent absorption. None of the research detailed the medication usage of the participants, but one might expect a good percentage of the type 2 diabetics were using metformin. It seems reasonable that if metformin supplants thiamine uptake via the thiamine transporters mentioned above, then the body would excrete the unused thiamine, leading to a higher rate of thiamine excretion than observed in non-diabetics and a higher rate of thiamine deficiency in diabetics versus non-diabetics. Based upon this, additional clinical research has shown that thiamine supplementation normalizes, the aberrant processes activated by sustained hyperglycemia including:

Metformin, in treating a symptom rather than a root cause, is likely exacerbating, and perhaps even initiating, some of the very disease processes that it is intended to prevent. Although metformin is not often acutely toxic, the underlying mechanisms manipulated by this drug suggest that it is likely to induce and not prevent, as is so frequently suggested, chronic illness. From my perspective, that makes metformin a very dangerous drug.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

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This article was published originally on Hormones Matter on February 16, 2016. 

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Mitochondria Need Nutrients

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One of the more common questions I get asked is which nutrients do the mitochondria need to function well? This is really two questions. The first involves which nutrients are involved in the enzymatic processes that allow the mitochondria to convert food to ATP and to manage all of the other tasks that they are responsible for like inflammation, immune function, and steroidogenesis. The second question applies specifically to the individual. It is a question of what he/she needs to be healthy. The answers to both are entirely different. While it is true that there are a set of nutrient co-factors involved in the mitochondrial machinery and these are necessary for mitochondrial function for everyone, which ones and how much of each an individual may need to support his or her health varies significantly. Moreover, although there are baseline minimum nutrient requirements that tell us where insufficiency diseases are likely to develop, what determines an individual’s health or disease is entirely dependent upon genetics, exposures, diet and lifestyle, and even day to day stress. Here, there is no one-size-fits all prescription for nutrient replacement and supplementation or even diet and exercise. This frustrates folks to no end and I think it is one of the reasons both patients and physicians are so reticent to look toward nutrient supplementation seriously as a therapeutic option.

Both the current model of medicine, and to a large degree, the way we approach nutritional therapies, relies very heavily on the silver bullet approach to health. If we’re honest with ourselves, so too do we. It is so much simpler to believe that if we just take X drug or vitamin in Y dose, all of our health issues will disappear and they will disappear at set rate that is linear and predictable. Unfortunately, this is not how the body works. While there is an internal chemistry that requires certain nutrients to function appropriately, that chemistry varies ever so slightly by genetics and is endlessly modified by life itself. There is no one-size-fit-all. There are no magic supplements. There is just your chemistry and your needs.

Since I have written repeatedly on the mitochondria and the reasons why nutrients are required for health, this post will not tackle those topics. Articles on those topics can be found on Hormones Matter with any number of search terms. This information can also be found in the book, Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, that I co-authored with Dr. Lonsdale. Here, since many have requested it, I just would like to present a graphic illustrating mitochondrial nutrient requirements. This is from Chapter 3 of our book. Use this as template to understanding your health.

Figure 1. Nutrient requirements for healthy mitochondria.

mitochondrial nutrientsA few things should be pointed out. First, while these nutrients are required by everyone for proper mitochondrial functioning, not everyone needs to supplement with each one, or even sometimes any of them, although that is becoming increasingly rare with modern dietary patterns. Secondly, notice how many times and where vitamin B1 (thiamine) appears in this chart. It is at the entry points of the entire system and at various junctures throughout. This suggests that among all of the nutrients required for healthy mitochondria, thiamine is particularly important. Unfortunately, it is the one nutrient that is so often ignored or missed in testing. Indeed, that is why we wrote the book. Thirdly, notice how many vitamins are required to process the food we eat into ATP. Contrary to popular opinion, we need more than simply empty calories. For the foods we eat to be converted into ATP, there are multitude of vitamins and minerals required that may or may not be included in sufficient density with the macronutrients we consume daily. Finally, not discussed in this chart, but discussed in great detail in the book, synthetic chemicals, whether in form of pharmaceuticals, industrial, environmental, or food production, damage the mitochondria. Some deplete nutrients directly, while others damage aspects of mitochondrial functioning that necessitate increased nutrient density for the enzyme machinery to work. Of course, underlying all of this, are the genetic variables that each of us brings to the table. These influence how well or poorly we metabolize any of these nutrients from the get-go. All of this combines to make nutrient therapies complicated.

What is not complicated, however, is that we need nutrients to function and so, no matter what else we do to improve health, if we do not address nutrient concentrations, we can never be well. Mitochondrial functioning demands nutrients, and thus, health demands the same. Nutrient deficiencies are not something we can override with a pharmaceutical. That being said, addressing nutrient deficiencies holds great promise for those seeking health. If you or someone you love experiences chronic and complicated illnesses that have been treatment refractory, consider healing the mitochondria by tackling nutrient deficiencies. You might be surprised at well this works.

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was originally published on November 11, 2019.

Understanding Mitochondrial Energy, Health and Nutrition

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I live in a retirement community. In my everyday discussions with fellow residents, I find that the idea of energy metabolism as the “bottom line” of health is almost completely incomprehensible. Since my friends are all well-educated professional people, I came to the conclusion that few people really have an idea about energy. For example, we talk about people who indulge in physical sports being energetic, while people sitting behind a desk are classed as sedentary. What we fail to realize is that mental processes require even more energy than physical processes. Both physically and mentally active people consume energy, so it is obvious that some kind of attempt must be made to talk about energy as it applies to the human body.

Hans Selye and the Stress Response

I will begin by giving an outline of the work that was performed many years ago by a Canadian scientist by the name of Hans Selye. Originally he was a Hungarian medical student. Some of the teaching was done by presenting individual patients to the class of students. The professor would describe the details of the disease for each person. What interested Selye was that the facial expression of each patient appeared to him to be identical. He came to the conclusion that this was the facial expression of suffering, irrespective of the nature of the disease. He referred to this as the patient’s response to what he called “stress”. He decided to study the whole concept of stress. He immigrated to Canada and in Montréal he set up a research unit that came to be called “The Research Institute of Stress”.

Of course, Selye could not study human beings and his experiments were performed on literally thousands of rats. He subjected them to many forms of physical stress and detailed the laboratory and histological results. He found that each animal would begin by mustering the well-researched fight-or-flight reflex. If the stress was continued indefinitely, the metabolic resistance of the animal gradually decayed. He called this ability of the animal to resist stress the “General Adaptation Syndrome” and came to the conclusion that it was driven by some form of energy. If and when the supply of energy was exhausted, he found laboratory changes in blood and tissues that were listed carefully. Although extrapolating this information from animal studies, he ended up by saying that humans were suffering from “diseases of adaptation” and that they were the result of a failure to adapt to the effects of life stresses.

My addition to this is that it would have been better to describe them as “the diseases of maladaptation”, meaning that humans have to have some form of energy to meet life. If there is energy failure, disease will follow. The remarkable thing is that energy production in the human body was virtually unknown in Selye’s time, so his conclusion was a touch of genius. The mechanism by which energy is produced in the cells of the body is now well-known. We know that energy consumption is greatest in the lower part of the brain and the heart, organs that work 24 hours a day throughout life. The lower part of the brain that organizes and controls our adaptive capabilities is particularly energy consuming. So before we begin to think about energy as a driving force, let us consider what we mean by stress and how we adapt to it.

Human Stress: Surviving a Hostile Environment

We all live in an environment that is essentially hostile. We have to adapt to natural changes such as cold, hot, wet and dry. We are surrounded by enemies in the form of microorganisms and when they attack us, we have to set up a complex mechanism of defense. Add to this the possibility of trauma and the complexity of modern civilization, involving business and life decisions. We possess the machinery that enables us to meet these individual stresses, meaning that we are adapting. Health means that we adapt successfully and that is why “diseases of maladaptation” makes a lot of sense. Obviously, the key is that the machinery requires energy.

Energy Metabolism, Physics, and Chemistry

First of all, let us begin by trying to define energy. The dictionary describes it as “a force” and the only way in which we can appreciate its nature is by its effects. It is not a substance that we can see but the effects of light energy enable us to have vision. The old riddle might be mentioned; “Is there a sound in the forest when a tree falls?” The answer is of course that the only way that the resultant energy can be perceived is when it is felt by the human ear. Even that is not the end of the story, because the ear mechanism has to send a message to the brain where the sound is perceived. Thus, there is no sound in the forest when a tree falls. It is the perception of a form of energy, a force that impacts on the ear of any animal endowed with the ability to hear. Energy can be stored electrically in a battery or as heat energy in a hot water bottle, but the inevitable process is that the energy drains away. A hot cup of coffee cools. A battery gives up its stored energy and becomes just “another lump of matter”.

For example, if a stone is rolled up a hill, its natural tendency would be to roll down the hill again. Whatever force is being used to roll the stone up the hill is known as “potential energy”. In other words, there has to be a constant supply of energy as long as the stone is moving up a gradient against gravity. When it reaches the top, we say that the potential energy is being stored in the stone. It is the equivalent of electricity being stored in a battery. The “potential energy”, however, requires an electrical force to “electrify” the battery. The potential energy in the stone can be released by allowing it to roll down the hill and Newton called this kind of energy “kinetic” (the use of a force to produce movement). The force that is being used is of course the effect of gravity and the stone becomes stationary when it gets to the bottom of the hill. The use of gravity as the source of energy is simply wasted, but note that gravity has not changed. It is still available for use. Let us take a simple example of this energy being used for a purpose. Suppose that there is a wall at the bottom of the hill and a farmer wishes to create a gate. In a fanciful way he could use the stone to create a gap in the wall. The gap in the wall is the observable mark of the effect produced by consumption of kinetic energy.

The body consists of between 70 and 100 trillion cells, each of which has a special function. Each is a one-celled organism in its own right and in order to perform their function they need a constant supply of energy. This is developed by complex body chemistry. The “engines” in each cell are called mitochondria and one of their many different functions is to synthesize energy. The energy that is developed is stored in a chemical substance known as adenosine triphosphate (ATP) and in order to understand this a little more, perhaps we should think of the Newtonian analogy for comparison. The Newtonian hill is replaced by an electronic gradient and the stone by the chemical ATP

Of Mitochondria and ATP

Cellular energy is produced in the mitochondria by oxidative metabolism. This simply means that a fuel (glucose) combines with oxygen but, like any fuel, it has to be ignited. The best way to analogize that is to say that thiamine can be compared with a spark plug that ignites gasoline in a car. It “ignites” glucose. The resultant energy is used to add a phosphate molecule to adenosine three times to make ATP (the electronic gradient). We have “rolled an electronic stone up an electronic hill”. As the adenosine donates phosphate molecules, it becomes adenosine monophosphate (AMP) that must be “rolled uphill again”. As it is “rolling down the electronic hill”, it is transferring energy. Therefore, ATP can be thought of as an energy currency. Note that there must be a continuous supply of fuel (food) that must contain the equivalent of a spark plug (thiamine) in order to maintain an energy supply with maximum efficiency.

The loss of any one of a huge number of components in food that work in a team relationship with thiamine, lowers the energy maximum. That is why thiamine deficiency has been earmarked as the major cause of a disease called beriberi that has haunted mankind for thousands of years. Its deficiency particularly affects the lower part of the brain and the heart because of their huge energy demand. Since the lower brain contains the control mechanisms that enable us to adapt to the environment, as depicted above, it is easy to see that we would be maladapted if there is energy deficiency, just as Selye predicted. In fact, one of his students was able to produce a failure of the General Adaptation Syndrome by making his experimental animals thiamine deficient. It also suggests that a lot of heart and brain disease is really nothing more than energy deficiency that could be easily treated in its early stages. If the energy deficiency is allowed to continue indefinitely because of our failure to recognize the implications, it would not be surprising that changes in structure would develop and produce organic disease.

Health and Disease in the Context of Energy

With this concept in view, the present disease model looks antiquated. There are only three factors to be considered. The first one is obviously our genetic inheritance. If it is perfect, all it requires is energy to drive it. However, DNA is probably never perfect in its formation. It may not be imperfect enough to cause disease in its own right, but a slight imperfection would constitute what I call “genetic risk”, causing disease in association with a stressor such as an otherwise mild infection or trauma.

Suppose that a given patient died from an infection (think of the 2018 flu).The present medical model would place the blame on the pathogenic virulence of the virus without considering whether malnutrition played a part by failing to produce sufficient energy for the complex immune response. Therefore, the second factor to be considered is the perfection of the fuel supply and that obviously comes from the quality of nutrition. Stress (the viral attack or non-lethal trauma) becomes the third consideration, since we have shown that an adequate energy supply is required for adapting on a day-to-day basis. There is even a new science called epigenetics in which it has been shown that nutrient components can be used to upgrade genetic mistakes in DNA. A fanciful interpretation of these three factors, genetics, nutrition and stress can be portrayed by the use of Boolean algebra. This is a mathematical representation as interlocking circles. The area of each circle can be easily assessed, marking their relative importance. The interlocking area between any two of the three circles and that of the three circles together completes the picture. It becomes easy to perceive how a prolonged period of stress can impact health. The present flu epidemic may be an example of the Three Circles of Health in operation, explaining why some people have only a mild illness while others die. Could the appalling nutrition in America play a part?

Why Thiamine

The pain produced by a heart attack has always been a mystery in explaining why and how it occurs. The answer of course is that pain is always felt by sensory apparatus in the brain. The brain is able to identify the source of the signal as coming from the heart but cannot interpret the reason. I am suggesting that in some cases, the heart is having difficulties from energy deficiency and notifying the brain. A coronary thrombosis would introduce local energy deficiency, but other methods of producing energy deficiency would apply. It is logical to assume also that brain disease is a manifestation of cellular energy deficiency. That is why I had found that so many children referred to me for various mental conditions responded to megadoses of thiamine. It is also why I had found that so much emotional disease was related to diet and not to poor parenthood.

I recently came across a patient that I had seen many years ago when he was a child. He had a diagnosis of Tourette’s syndrome, made elsewhere. I treated him with megadoses of thiamine and his symptoms resolved completely. Medical skepticism would answer this by calling it a placebo effect, but since this effect is well-known, it must have a mechanism. For many years I have believed that therapeutic nutrition “turns on” this effect by enhancing cellular energy. A small group of physicians known as “Alternative Medicine Practitioners” use water-soluble vitamins, given intravenously, irrespective of the acceptable clinical diagnosis. For example, I remember a young woman who came to see me with a diagnosis of “Thrombocytopenic Purpura”. This disease is a loss of cellular elements known as platelets and it had resisted orthodox treatment for years. I gave her a series of intravenous injections of water soluble vitamins with complete resolution of the problem. I must end by stating that healing is a function of the body. The only way that a healer can be justifiably recognized is by supplying the body with the ingredients that it requires to carry out the healing process. Perhaps spontaneous healing, as for example initiated by religious belief, is an ability to muster those ingredients that are present, but hitherto unused.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

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This article was published originally on February 14, 2018.

Problems With the Medical Model of Disease

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The use of the word model is supposed to describe the nature of disease as it differs from that of health. Hippocrates was the first person to offer a solution to the preservation of health by saying “Let food be your medicine and let medicine be your food”. Throughout most of history there was no model and treatment was based on largely futile ideas. The present age of medical thinking was ushered in by the discovery of disease producing microorganisms. The model became “kill the microorganism, the bacterium, the virus, the cancer cell”. If no microorganism or cancer cells could be found, the remaining diseases were long considered to be a mystery.

Recent research has advanced the model by discovering that the brain controls inflammation through the vagus nerve by the use of metabolites called cytokines. However, the present medical model still dictates that the various symptoms that signify loss of health are put together in collections. Each is considered to represent a particular disease that has to be named for diagnostic purposes and that a cure for each is to be found from detailed research. So we now have literally thousands of different diseases, often being called after the person who first observed a particular symptom/sign collection, such as Parkinson or Alzheimer. Each of the named diseases is supposedly recognized by a collection of laboratory tests that are “diagnostic”. What is even worse, is that this collection is often called a syndrome and the first observer has his/her name appended. From that time on, this particular collection is known as “Joe Soap’s syndrome”. Fortunately, there is change on the horizon as we gradually realize that the human body is a “machine” whose function is metabolic in nature.

The Stress of Life

When I was in active practice, I discovered that thiamine could be used as a “drug” for many of the situations that I encountered, seemingly irrelevant to the diagnostic category with which I was supposedly dealing. I was thought of by my colleagues as a medical heretic. Since it had long been known that thiamine deficiency was responsible for the disease called beriberi, I studied the history of the early attempts to find its cause. Beriberi had existed for thousands of years and was still largely a mystery at the end of the 19th century. I found how easy it was for the investigators to be misled. In Eastern cultures rice had been a staple for centuries. At that time, factories had been built in China in which buildings had been separated by a corridor. In the summer months the workers would congregate in them to take their lunch. As the sun moved around, it would shine on the congregated workers and several of them would come down simultaneously with the first symptoms of beriberi. The obvious conclusion for the investigators was that this was some kind of infection since several of them had succumbed at the same time. When it was found that thiamine deficiency was responsible, an explanation was required for this simultaneous incidence of the disease.

We now know that ultraviolet light is a source of stress. It can be concluded that the affected workers had been marginally deficient in thiamine. They were either asymptomatic or had mild symptoms attributed to other causes. The stress caused by sunlight had provoked symptoms of the disease simply because the required energy was unavailable to achieve homeostasis. This intriguing discovery caused me to seek the work of Hans Selye, whom I visited in Canada. As I have written in several posts on this website, he had determined from the study of rats that each form of stress had to be resisted and required energy. He called it the General Adaptation Syndrome (GAS) and offered the idea that human disease was a lack of sufficient energy required for adapting to the more severe environmental influences encountered on a daily basis. This included severe trauma and infections. The energy deficiency conclusion of Selye was later backed up by one of his students who was able to produce the GAS experimentally in a thiamine deficient rat without using any form of experimental stress.

It seemed to me to be obvious that I had to study the way energy is produced in the human body if I were to understand the reality of health and disease. In Selye’s time energy metabolism was poorly understood and it was a mark of his genius that enabled him to suggest that it was energy deficiency that caused the collapse of the GAS. The reason that all animals, including humans, are living is because they construct energy from food and this creates a chemical called adenosine triphosphate (ATP). From there, electrical energy has to be created and that is the energy that we use for functional activity. The transition from chemical to electrical energy is not precisely known but there is some evidence that thiamine in the form of thiamine triphosphate (note the parallel with ATP) plays an important part. This triphosphate form is exceptionally high in the electric organ of the electric eel, capable of producing a paralyzing shot of electrostatic electricity to zap its prey. The electric organ is an adaptation of a nerve ending just like ours. It is obviously important to understand that this is an evolutional adaptation and does not mean that we can produce a high energy output from our nerve endings. Indeed, the evidence is strongly in favor of the energy being in microvolts. We are identifying the electrical potential when we perform an electroencephalogram or an electrocardiogram and a recent test has been devised using the electrical potential of a person with Chronic Fatigue Syndrome (Open Medicine Foundation April 2, 2021).

Many of the people reading the information on this website are themselves patients seeking help for their misunderstood disease. The history recorded in their posts is repetitive and in each case their reported symptoms are usually thought to be bizarre by the physicians that have been consulted. In the present medical model a “real” disease is called organic and is marked by a series of abnormal laboratory tests. When these tests are reported to be normal, the conclusion is nearly always the same. The symptoms are considered to be imaginary in a person who is thought to be psychologically abnormal. They are referred to as psychosomatic and the patient is told that “it is all in your head”. It is always surprising to me that the physician seems to have the belief that the bizarre nature of the symptoms is generated in the patient’s brain without consumption of energy, that thought processes or imagination are not the result of energy consumption by brain cells.

Distorted Truth

The real trouble is that the disease model represents a distortion of the truth. To make a diagnosis, it is inherently necessary that some of the presently used laboratory tests must be abnormal. No thought is given to the possibility that energy deficiency in the brain might be the cause of the symptoms. Therefore no effort is made to obtain the right laboratory tests. It demands a totally different way of thinking about health and disease. People affected by this kind of brain energy deficiency disease are often working and living ostensibly normal lives but suffering greatly. They are in fact experiencing early beriberi, a disease that has a long morbidity and a low mortality. They can go on experiencing these symptoms for years, but if they are completely ignored as psychological misfits, one can easily imagine that permanent damage will develop. Perhaps Alzheimer’s and Parkinson’s disease are really reflections of this permanent damage and that there will never be a “cure” for them. Attention to relatively simple symptoms, usually diagnosed and treated as variable named conditions such as “allergy” may be the only way in which these named diseases can be prevented.

To give an example of this kind of thinking, I was confronted by a 12-year-old African-American girl with extremely severe asthma occurring in individual attacks. Physical examination revealed that her body was covered with “goose bumps”. Because of this I came to the conclusion that her autonomic nervous system was dysfunctional and the cause of her asthma. I had already come to the conclusion that thiamine deficiency caused the energy failure that resulted in dysautonomia and that sympathetic/parasympathetic imbalance could affect the bronchial tubes. Without further testing, I gave her thiamine in pharmacological doses. It resulted in a complete disappearance of the asthma. This patient, at the age of 30 years, contacted me to let me know that she had only experienced two mild attacks of asthma in her 20s.

Health Requires Energy

What is important to remember is that any situation involving physical or prolonged mental stress requires energy in the brain, used to organize the complex defenses of the body. The recent discovery by Dr. Marrs and myself that thiamine deficiency in America is common, suggests that brain energy is insufficient in many people. If and when they are attacked by a microorganism such as Covid-19 it is possible their symptoms and their continuation reflect brain energy deficiency. Consequently perhaps they are unable to adapt and overcome the stress of the viral attack. It also suggests that symptoms expressed by so called Longhaulers might be helped by the administration of pharmacological doses of thiamine.

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This article was published originally on April 7, 2021.

Image by Joshua Nicholas Vanhaltren from Pixabay.