Monday, September 28, 2009

Vitamin D3 deficiencies, the Flu & Gluten

I’ve written on this topic before but I have some new, updated information that I think warrants some attention. Since this post “jumps off” from the data presented in the last one, you may want to read that one first. Here’s the link:http://glutendoctors.blogspot.com/2008/05/are-you-deficient-in-vitamin-d-odds-are.html

While this blog is dedicated to gluten sensitivity and celiac disease predominantly, this post truly is for everyone so please feel free to share it with friends and family.

There certainly has been a buzz about the importance of Vitamin D3 and getting your levels tested. But what happens once you do? You may remember the chart below where the cut-off for concern seems to be at <30 .="" be="" has="" level="" new="" research="" that="" to="" upped="" well="">60, with 60-100 being the target, especially if there’s any risk of cancer.

Normal or Suboptimal Levels of 25 hydroxy vitamin D
<10 br="" deficiency="" ml="severe" ng="">10-20 ng/ml = deficient
20-30 ng/ml =insufficiency
30-40 ng/ml = possibly insufficiency
>36 ng/ml = decreased incidence of heart disease
>40 ng/ml = decreased incidence of MS
40-50 ng/ml = probably sufficient levels
>50 ng/ml = sufficient or optimum levels
>50 ng/ml = decreased incidence of cancer
80-100 ng/ml = goal for most cancer patients
>125 ng/ml = potentially toxic

So please be pro-active. Realize that many doctors follow the guidelines given to them by the lab. If they're not on the cutting edge of Vitamin D research they may give you the "green light" that your status is fine even if it's only 32! You now know that's not sufficient. It's fine and safe to sensibly take a good quality Vitamin D3 on your own. Just make sure to recheck the level.

The exciting cancer news is that Vitamin D3 is considered the only substance that can reduce 78% of all cancers. Vitamin D affects over 200 genes in our body and is involved in the transcription of genes (how the genes are “read” or “expressed”).

As mentioned in an earlier post, a deficiency in Vitamin D3 is causally related to MS and current research estimates that a patient with MS may need 14,000 IU/day.

What’s too high? A daily dose of 50,000 IU can be immunosuppressive.

With the flu season almost upon us, finding out your Vitamin D3 status and supplementing properly could well assist in avoiding that nasty viral infection. The lower your level the more aggressive you want to be in supplementing. Take between 1,000 - 5,000 IU/day for 1 month and then recheck your level. If it's coming up nicely continue. If the change is very slow, consider doubling the dose you’re taking and recheck again in another month. Barring any other reason for malabsorption (undiagnosed celiac or gluten sensitivity as an example!) you should see a nice change with adequate supplementation.

This is such an easy solution to a deficiency that is affecting us in so many ways.

I hope you find this helpful.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Friday, September 25, 2009

Chronic Fatigue, Chronic Fatigue Syndrome/ME and Gluten Intolerance

My last post on Chronic Fatigue caused some nomenclature discussion to arise that I want to clear up.

The topic of the blog was chronic fatigue and how it can be affected by a gluten sensitivity. It was not meant to include a complex known as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). “Chronic Fatigue Syndrome” is used in the US while the term "Myalgic Encephalomyelopathy" (ME) is used predominantly outside the US.

CFS/ME is a chronic, inflammatory disease primarily affecting the nervous system. It is multisystemic, affecting the central nervous system, immune system cardiovascular system, endocrine system and musculoskeletal system. The disease process can cause a wide variety of symptoms, including changes in sensation, vision, muscle weakness, coordination and speech difficulties, severe fatigue, cognitive impairment, problems with balance, and severe pain. ME will cause some degree of impaired mobility and disability in all cases. The degree of impairment depends upon the amount of brain injury and end organ involvement.

Needless to say this is a very serious debilitating condition and not the one I was referring to in my previous blog. At this writing I have not had any experience with CFS/ME but will pass along any positive treatment options as I come across them.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of "The Gluten Effect"

Wednesday, September 23, 2009

Chronic Fatigue and Gluten Sensitivity

Chronic Fatigue, now known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), affects between 400,000 and 900,000 adults, and is characterized by unexplained fatigue that lasts for at least six months, fails to get better with rest, and interferes with daily activities. It is also accompanied by at least some of the following additional symptoms: extreme fatigue after exertion, memory and concentration problems, poor sleep, headaches, muscle and joint pain, sore throat, or tender lymph nodes.

Chronic fatigue is unfortunately one of those syndromes that seems to “fall through the cracks” of our traditional medical system. Why? Likely because it doesn’t fit into the symptom-drug model. No drug has been created that successfully treats the myriad symptoms associated with CFIDS.

Not being a particular fan of masking symptoms with drugs, I don’t find the lack of “effective” drug treatment a negative. But what I would like to address is the success we’ve had here treating Chronic Fatigue and the interrelated causative factors.

Research studies have associated the development of chronic fatigue with patients exposed to traumatic events and chronic stress, with stress increasing an individual’s risk by 500%!

If you evaluate the symptoms associated with adrenal gland exhaustion and compare them to those of chronic fatigue, you will see a common thread between the two.

The adrenal glands are your stress gland and when they aren’t functioning adequately you can expect to experience such symptoms as fatigue, immune system weakness, joint pains, muscle aches, depression, anxiety, insomnia and headaches. Basically the symptoms of adrenal fatigue are identical to those of chronic fatigue.

Our philosophy is to address the underlying root cause and upon evaluating a chronic fatigue patient it is most common to find the following:
Weakened adrenal glands
Food sensitivities
Digestive malfunction
Infections of the digestive tract
Hormonal imbalance.

While the list may seem a bit extensive, a program can embrace most all of those issues simultaneously resulting in a patient feeling substantially better in 2 or 3 months.

Many researchers are putting chronic fatigue and fibromyalgia in the same category and I too see similar features in both disorders.

But more important than the label is to truly normalize body function such that the unrelenting fatigue and other debilitating symptoms are no longer an issue. When addressing root cause one needs to get to that undercut of malfunction that, when resolved, results in regained health. While this can prove challenging it truly isn’t difficult when one understands how the body functions.

We reviewed that adrenal malfunction and chronic fatigue have similar symptoms. So the next question is, how do we resolve adrenal fatigue? It’s a natural therapy but it doesn’t tend to be the bottom line root cause. Rather it’s often a secondary effect of the root cause. The primary problem is often digestive in nature and involves food sensitivities (think gluten and dairy as the biggest culprits), infections in the small intestine and a resultant weakened immune system.

Diagnosing and treating the above is not difficult and it’s completely natural (excepting an occasional antibiotic to treat a particularly stubborn infection). But the program must be done as an orchestrated whole utilizing strong enough remedies to affect the necessary change. Simply going to your local health food store and picking up some vitamins or probiotics is likely not going to be sufficient.

We have treated many patients with chronic fatigue successfully. The worst of which was a woman in her 30s that was disabled because of it. I’ll never forget speaking to her on the phone and her relating to me that she would lift her forearm off the bed just to see if she still could. That was the extent of effort she could perform. We not only got her back to work but it has been over a decade and she continues to do well and has a very productive life.

If you know someone suffering please forward this to them and let me know how I may be of further assistance. I truly believe that the treatment protocol that I’ve laid out above can be successful for most.

Until next time, I wish you good health.

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Wednesday, September 09, 2009

Depression and Gluten; Is a Dietary Change Just Too Easy?

FUNCTIONAL MEDICINE UPDATE
-->
If you ever watch TV you’ve probably seen ads for a new drug called Abilify. I found several aspects of the commercial interesting, not the least of which was the opening statement that: “2 out of 3 patients taking antidepressants were still depressed”. The commercial goes on to “explain” that the reason for this is that a patient needs more drugs. Abilify is an add-on to an anti-depressant, supposedly making it more effective.

Really? Could it be that the actual problem is that antidepressants don’t work and are factually very dangerous? There have certainly been enough studies to validate my opinion.

But no, this ad campaign asks you to suspend such logical thinking. Well keep it suspended so that you won’t hear all the side effects they then list out. Such things as suicidal thoughts, large weight gain, diabetes symptoms, restlessness or jitteriness and last but not least, abnormal muscle movements (these movements can become permanent if Abilify is not stopped quickly)!!

Wow, sounds terrific! (Sorry, I’m becoming sarcastic).

What about this approach? Why don’t we get to the underlying root cause of the depressive symptoms and address that? And in 25 years that root cause has never been a deficiency of an antidepressant drug?

But there has certainly been a strong cause and effect association between gluten and depression. Am I suggesting that all depression is caused by a reaction to gluten? Of course not. However it is definitely an issue that should be ruled out.

Can I support these statements? You bet!
The American Journal of Medicine in 2004 studied how well brains of celiacs were perfused with blood. They found a strong association between celiacs eating gluten and brains starved for bloodflow. And the area of the brain most affected was the frontal lobe, most associated with depression.

The Journal of Neurology, Neurosurgery and Psychiatry in 1997 stated:
“The immune response triggered by sensitivity to gluten may find expression in organs other than the gut; and the central and peripheral nervous systems are particularly susceptible.”
Digestive Disorders in 2008 had an article entitled: “Affective and Psychiatric Disorders in Celiac Disease” where the association was clearly delineated.

And lastly, Practical Neurology in 2004 stated: “Neurological manifestations of gluten sensitivity are a scientific fact, not a theological issue. Whilst the debate continues, we owe it to our patients to screen them effectively for gluten sensitivity with the simple, widely available antigliadin antibody test so that we do not in the meantime deprive them of a harmless but potentially effective treatment in the form of a gluten-free diet.”

I couldn’t say it better myself!

To your good health,

Dr Vikki Petersen
Co-author of “The Gluten Effect

Friday, September 04, 2009

Gluten, The Cold, Hard Facts

Recently I’ve been hearing the expression “soft science” and a possible relationship to gluten sensitivity. These same individuals conclude that the only “hard science” applies to celiac disease. They maintain that suggesting a benefit may be achieved from a gluten-free diet for anyone who is not diagnosed as a celiac is not only dangerous, but misleading and downright cruel!

So let’s take a look at these claims and accusations and see if they have any merit.

I believe that new ideas and new findings, be they in the field of health or anywhere else, are frequently not embraced. We are critical and cautious of change. Is the “soft science” of today the “hard science” of tomorrow? I think we have seen this on many occasions. It brings to mind the bacterium Helicobacter pylori. This bacterium can infect the stomach and cause not only ulcers but cancer. My clinic has been looking for and addressing H. pylori infections for many years. But we, and other clinics like us, were accused of treating a “normal constituent” of the stomach and it was claimed that the bacterium was definitely not a danger. Fast forward about 5 years from that point and “every” GI doc is currently testing for it. Why? Because it can be dangerous.

Getting back to gluten sensitivity vs celiac disease, if the information regarding celiac is so clear cut, why do we as a nation only diagnose 5% of those suffering? And why does it take about a decade to get properly diagnosed?

The presence of “hard science” does not equate to efficient diagnosis nor effective treatment.

I try to stay abreast of all the most current research as regards celiac and gluten sensitivity. Dr Harris out of the University of Maryland Medical School works with Dr Fassano, a long time researcher in the area.

Dr Harris stated that gluten sensitivity was a condition where the combination of genes for it and celiac disease may very well be the same but other insults hit the celiac creating that disease and autoimmunity.

She feels that gluten is initiating an innate immune response but that it somehow gets regulated such that the intestinal epithelium remains more intact than in the celiac. But she continued to say that they did see infiltration of lymphocytes in the epithelium. (Note: some researchers states that infiltration of the epithelium by lymphocytes is the precursor to villous atrophy.)

Dr. Harris has already published several articles about her work. Specifically a 2008 article published in The Journal of Immunology was co-authored by Dr. Fasano. Shall we accuse Dr Harris, one of the leading researchers in the field, of practicing “soft science” because she believes that gluten sensitivity is a real thing?

One of the problems we encounter with celiac is diagnosis. While intestinal biopsy has long stood as the gold standard of diagnosis, it currently is considered antiquated. Why? It’s too gross a measurement of such a large and complex structure. In a biopsy one is taking a few snips of small intestine that has the surface area of a tennis court. What is the likelihood of missing an affected area and giving a false negative diagnosis? Quite high obviously since we only effectively diagnose 5% of those affected with the disease.

Everything happens on a continuum. Does villous atrophy happen suddenly or slowly? It’s a slow erosion as inflammatory factors affect the small intestine. Is it correct or “kind” to wait until someone’s intestinal lining is completely eroded before diagnosing them? Talk about cruel and unusual!

What’s wrong with an early diagnosis? What’s wrong with trying to prevent autoimmune disease, the third leading cause of death? I say nothing.

While I appreciate the role of a researcher needing “proof” and hard evidence before going forward with a statement of fact, as a clinician I have a duty to help my patients to enjoy better health. Should I put all my patients “on hold” because there is still some discrepancy in the research? Should I ignore the miraculous results patients have experienced going gluten-free because they don’t have a definitive celiac diagnosis?

What’s right? I think if you’re a researcher waiting for more support of your hypothesis is acceptable. But if you’re a clinician and the benefits so vastly outweigh the liabilities (there is absolutely no proof that a gluten-free diet can in any way be dangerous) then I think the answer is obvious.

I’m a clinician and I will continue to utilize gluten-free diets for those patients whom have positive laboratory tests identifying an immune system reaction to gluten and those patients who, upon elimination and provocation, have a positive reaction to gluten. And if you want to call that “soft science” so be it.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect