CAN YOU TRUST TODAY'S "SCIENTIFIC" GUIDELINES FOR THE TREATMENT OF CARDIOVASCULAR DISEASE?
The title of today's post raises a pertinent question; can the current medical guidelines for treating cardiovascular disease be trusted? Sure they can. If you are big pharma or big medicine you can trust them to be your continual cash cow --- a revenue stream that's definitely more raging river than gentle brook.
I've written extensively about MEDICAL GUIDELINES in general, but a brand new study on cardiovascular guidelines was published in today's issue of JAMA Network (Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018) concerning two organizations that I have, upon several occasions, said were as corrupt as any within the academic medical community --- the American Heart Association (AHA) and American College of Cardiology (ACC).
After looking at over 6,300 recommendations by the world's three most prestigious cardiovascular societies --- two from America and one from Europe (at an average of 125 recommendations per guideline) --- these authors, from Duke, Stanford, and the University of Bern in Switzerland, concluded that on average, less than 10% have rigorous evidence behind them. This is even worse than what Duke's David Eddy told us nearly three decades ago in his landmark study published in a 1991 issue of the British Journal of Medicine --- Where is the Wisdom? The Poverty in Medical Evidence (he said less than 15% of all treatments / recommendations are backed by solid evidence). As far as today's study from JAMA Network is concerned, take a peek at these, cough cough ahem, conclusions.
"Among recommendations in major cardiovascular society guidelines, only a small percentage were supported by evidence from multiple RCTs (randomized controlled trials) or a single, large RCT. This pattern does not appear to have meaningfully improved from 2008 to 2018."
The real question is why? Why are the American recommendations from the ACC and AHA, when added together, only supported by real evidence 8.5% of the time (the European recommendations were a whopping 14%)? Look no further than the recent avalanche of fake news concerning the new fish oil "drug," VASCEPA, that the AHA and ACC have been fawning over for two years. Or you could look at some cardiovascular guidelines that came out just yesterday.
The US Preventative Services Task Force issued an official "recommendation" (their equivalent of a Papal Bull) titled Final Recommendation Statement: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication.
"The USPSTF used a CVD microsimulation model to estimate cardiovascular event rates based on baseline risk factors and aspirin use. It used the AHA/ACC risk calculator to stratify findings of benefits and harms by 10-year CVD risk. The USPSTF also calculated estimates of CRC incidence and harms of bleeding to determine the net balance of benefits and harms across individuals with varying baseline CVD risk.... Nearly 40% of U.S. adults older than 50 years use aspirin for the primary or secondary prevention of CVD."
Aspirin use is no small thing. As time has progressed it's become increasingly clear that just like NSAIDS, aspirin is not nearly as safe as people have been led to believe (HERE). According to a 2014 study from Clinical Medicine and Research (The Role of Aspirin in the Prevention of Cardiovascular Disease), not only is aspirin "the most widely used drug in medicine, with nearly 20% of adults in the United States reported taking aspirin daily or every other day, increasing to nearly 50% in those aged 65 and older," but these recommendations have been in place since the 1980's. What should also be noted is that the authors re-crunched the data from history's nine largest aspirin trials, coming to some interesting conclusions of their own.
"In the last 30 years, nine major trials have examined the benefit of aspirin for primary CVD prevention.... When cardiovascular and all-cause mortality was assessed, no statistically significant effect on all-cause mortality was observed."
Folks; that means that not only did the proverbial "aspirin-a-day" mantra prove ineffective at preventing death in those with cardiovascular disease, it did noting to slow down death rates from everything else either, including the myriad of diseases caused by INFLAMMATION. Despite this, just last September the ACC (New Data on Aspirin Use in the Era of More Widespread Statin Use) was still recommending aspirin for most adults, age 40 to 70. Sort of makes you wonder when the new recommendations are going to come out on STATIN DRUGS? No, I'm not holding my breath.
As I've shown you in my posts on EVIDENCE-BASED MEDICINE, there is really only one reason these sorts of recommendations are produced and followed for decades, despite significant evidence to the contrary. Money. With the people writing guidelines often having their fingers in a wide array of financial and pharmaceutical pies, it's no surprise that we can trust neither the recommendations from private entities like those of the ACC or AHA nor the recommendations from governmental watchdog agencies such as the FDA (HERE). What should people be doing instead?
Instead of continuing to live an inflammation-producing / inflammation-saturated life and then trying to mop up the effects of excess SYSTEMIC INFLAMMATION with an array of drugs, why not simply turn off the faucet that's perpetually flooding your body with inflammation in the first place? Fortunately for you I am giving you a way to start the process (HERE), completely free, as in no charge to you. While not a panacea or cure-all, the simple fact is that if you can reduce your body's systemic inflammatory load, good things tend to happen, body and soul! If you appreciate what goes into creating these posts, be sure and spread the wealth by liking, sharing, or following on FACEBOOK, since it's still an effective way of reaching those you love and value most.
COLORADO CHRONIC NECK PAIN RELIEF
"Instead of the roof of the subacromial space (the AC joint) coming down and pressing on the structures, I really think that most of it is that the floor (the glenoid ball of the shoulder) is coming up." This means that inferior glide of the humeral head is a must!
Watch as these same two physical therapists demonstrate four different orthopedic tests used to determine the likelihood that your shoulder problem is an impingement or something else (HERE).
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IS IT EVEN POSSIBLE FOR AUTHORS OF STUDIES OPPOSING MAINSTREAM MEDICAL THOUGHT TO BE HEARD IN THE PEER-REVIEWED LITERATURE?Read Now
IS IT POSSIBLE FOR ACADEMICS WITH "CONTRARIAN VIEWS" TO GET A FAIR SHAKE IN THE MEDICAL JOURNALS?
"Earlier this month, Dr Nicola Luigi Bragazzi --- a medical doctor with a Ph.D in nanochemistry and nanobiotechnology --- of Italy's University of Genoa, along with a group of researchers from the Zabludowicz Center for Autoimmune Diseases at Israel's Tel-Aviv University, published a study in the journal Vaccine called Debate on Vaccines and Autoimmunity: Do Not Attack the Author, Yet Discuss it Methodologically. As you might imagine from the study's title, Bragazzi and company are tired of taking it on the chin for publishing legitimate research findings that are not in lockstep with standard vaccine propaganda."
Taking it on the chin. Believe me when I tell you that many (many) researchers have taken and continue to "take it on the chin" for their views concerning any number of controversial topics (HERE and HERE are a couple of these individuals). Mind you, we are not talking about opinions here, but about research findings that don't necessarily jibe with current medial dogma (my post titled "MUZZLED" is another good example). For instance, in the comment section of Dr. Packer's article, Sydney Singer (author of a book I read years ago; DRESSED TO KILL) talked about the manner in which research showing health problems associated with bras (including BREAST CANCER) continues to be suppressed. As is typically the case, if you want to see real-time, real-life examples of this phenomenon in action, simply read the article's comment section.
Dr. Packer began his article by revealing something that many people are unaware of unless they regularly follow my EVIDENCE-BASED MEDICINE COLUMN; the fact that when it comes to medical research and the journals charged with both publishing it and getting it out to the medical community and the public at large, the problems run so deep that nothing, and I do mean nothing, can be trusted without first looking at numerous factors, including who paid for the study or HOW THE RESEARCH WAS DONE. After discussing what modern editorials in today's medical journals have become, Packer asked the question "Who loses?" Below is his CHERRY-PICKED response to this ETHICAL QUAGMIRE.
"All too often, it is the reader who loses. If readers were expecting enlightenment, a different perspective, or a contrary opinion from the editorial, more likely than not, they will be disappointed. What if the study is terribly flawed and the editorialist does not take notice? Can readers submit criticisms or an alternative viewpoint? They can certainly try, and I wish them luck. If you want to raise concerns about a published article, you could write a letter to the editor. But you need to work fast. Most editors will not accept letters that are submitted more than 3-6 weeks following publication. And they decide what letters get published. Many are reluctant to acknowledge errors. If you want to write a longer piece (i.e., an editorial) that is poised to disagree with a published article, you could send a request to the editors. But do not expect a positive reply. Even if you have valid criticism and points to make, the editors may not be receptive. Why would they publish an editorial that challenges their decision to have published the original work in the first place? Of course, you could decide to write a critical editorial and send it to a different journal. But often that will not work. Many journals have a standing policy that they will not consider editorials that are critical of work published in other journals. (Disclosure: I hold editorial positions at Circulation and the European Heart Jour"
Packer went on to discuss numerous other issues with the process, including the fact that the very people who will review your letter-to-the-editor are usually THE VERY PEOPLE WHO REVIEWED THE RESEARCH in the first place. Are they ready to "take it on the chin"? Doubtful. I don't know many people who like like getting punched in the face, including Packer himself. Not to pick on Dr. P because he is undoubtedly a guy I would enjoy shooting the breeze with on the CURRENT RIVER. But as an editor of the prestigious journal of the American Heart Association, Circulation, some would argue that Dr. Packer is doing the very same thing. Just remember not to ask Dr. Vasquez his opinion.
Although in certain circumstances he would fulfill the definition of a "contrarian" (something I've been accused of at times myself); as a person holding naturopathic, chiropractic and medical degrees as well as a post-doctorate fellowship in nutrition (not to mention the several areas of research he is actively involved in), Dr. Alex Vasquez is a sharp guy and formidable debate opponent. It makes me wonder whether at least one of his recent 'disagreements' with both the American College of Cardiology and the AHA (see below) ran through Packer's office. What am I talking about? Using some of Dr. Alex's recent articles, allow me to show you exactly how big journals are squelching "contrarian" opinions that might --- in these cases, "are" would be a better word --- upsetting the medical fruit basket.
- The ASCEND Study on Fish Oil from the New England Journal of Medicine (and touted by the ACC in their article, ASCEND: Use of Aspirin and Fish Oil Supplements in Diabetic Patients) fraudulently and unethically showed fish oil in a bad light for the sole purpose of promoting a new-fangled patented and medicalized version of fish oil (HERE and HERE). In fact, when I Googled "ASCEND Study Fish Oil", the first thing that came up was an ad for --- you guessed it --- the drug Vascepa
- Another study by the ACC, this one concerning nutritional supplements for heart disease, was challenged by Dr. Vasquez on his website. Why on his website? Because their journal refused to publish a rebuttal (HERE).
- Other research that Dr. Vasquez likewise weighed in on heavily was the AHA's 2017 study showing that coconut oil , as well as saturated fats in general, are harmful (HERE). For the record, I should note that my earlier "quagmire" link connects you with Dr. Alex's version of the "echo chamber" mentioned by Dr. Packer in his quote at the top of the page.
The point is this. Be careful who you believe, myself included. Double check everything and assume that online personalities are simply trying to sell you something until proven otherwise. As far as helping yourself with the root of most modern diseases, heart disease included, be sure and learn what it takes to start addressing systemic inflammation in your life (HERE). And if you appreciate what you are finding on our site, be sure and help spread the wealth by liking, sharing, or following on FACEBOOK since it's a viable way to reach the people you love and value most.
OAKLAND RAIDERS ARE PROFESSIONAL FOOTBALL'S GREATEST TEAM
SO SAYS MEDICAL RESEARCH
"So it is with much that you read and hear. Averages and relationships and trends and graphs are not always what they seem. There may be more in them than meets the eye, and there may be a good deal less." Darrell Huff from his famous 1954 book, How to Lie With Statistics
Even though the Raiders have the NFL's classiest receiver, Kansas State's Jordy Nelson, the truth is, they stink. Bad. As in get out the Lysol and spray the whole can. Playing in a division that was arguably the cream of this past season's crop --- the AFC West --- the Raiders finished a lowly 4-12. Like I said, they were terrible. But in the same way that REVISIONIST HISTORY has become the new norm in politics, so it has in medical research as well.
Although I have spoken of all of the research community's tricks-of-the-trade at various times in my EVIDENCE-BASED MEDICINE column; commenting on Dr. Keller's article was too good to pass up. Today you're going to see that TOM BRADY really does have nothing on Derek Carr!
"The Raiders can quickly and easily turn their season around by using the tried-and-true techniques of medical research. If a pharmaceutical company did 16 clinical trials of their new potential blockbuster, Drug X, they would never let a 4-12 outcome get them down. When published, I guarantee those trial results would look a lot better than 4-12. The Oakland Raiders can use the same techniques to improve their season record."
Of course Keller mentioned INVISIBLE & ABANDONED studies, which I have dealt with extensively on my site. This is the ultra-common practice (50% of all medical studies) of simply not finishing or not publishing research that's not conducive to selling your company's products to the public. He also talked about changing primary endpoints midstream. Changing your study's primary endpoint is roughly the equivalent of throwing darts at a dart board, missing the target every time, and then taking the dart board off the wall and painting an extra-large target of your own to make it appear like you are ready for the English Pub-League Championships.
"The Raiders lost 12 games in the 2018 season using the primary outcome of final score. But if we look closely at each of these 12 games, we might be able to find, by chance, another potential outcome we could switch to. Take, for example, when Oakland played the Indianapolis Colts on October 28th. The Raiders lost that game 42-28. But if we were to switch the outcome to the score at the end of three quarters, the Raiders win 28-21! We'll publish that as a victory without saying that we changed the primary outcome. Similarly, in their second game of the season, the Raiders lost to the Denver Broncos 28-20. But if we change the outcome to the score at halftime, we can publish this as a win, 12-0! We can do the same thing for their first game against the Los Angeles Rams."
A similar trick is using composite endpoints. Instead of limiting your study to one premise or hypothesis, you could have dozens (although you would never mention this in the final draft). The result is that if you throw enough darts, you will probably hit upon something. Especially if I add a little twist. If I have 25 dartboards on my wall instead of just one, I can throw my darts and pick the board(s) that the most land on, later claiming that my results were targeted and significant. Using similar tricks, the Raiders would have beat the Patrick Mahome's-led Chiefs --- twice.
"Take, for example, the third game of the season against the Miami Dolphins. Oakland lost that game 28-20, but Oakland had more total yards, more first downs, and a longer time of possession than Miami. Clearly, we can publish this as a victory for Oakland using our composite endpoints. Applying our composite endpoints, we can similarly change five other losses to victories. Oakland's record now is 13-3."
Next is a little trick that is exactly the opposite of the invisible and abandoned studies mentioned earlier --- publish your team's positive findings multiple times in multiple ways. With so many journals, and so many of these many journals desperately vying for what amounts to "breaking news," make sure that the data for each individual (positive) endpoint or hypothesis is published as it's own stand-alone study. Even better if you can mix it up a bit and publish the same findings in a different journal.
"Let's apply this principle to the Oakland Raiders. Their most impressive victory of the entire season was when they upset a very good Pittsburgh Steelers team -- on the road, no less -- on December 9th. We certainly want to publish that twice! Let's also duplicate-publish the Raiders' victories over the Denver Broncos and the Cleveland Browns. The Oakland Raiders' final record after applying the principles of medical research is an undefeated 16-0."
Lest you think that this is an over-hyped absurdity, simply spend some time skimming through titles of my EBM column (see earlier link) and realize that in many cases ---- particularly cases where there is a lot of money at stake ---- this is a perfect description of a few of the ways you are being swindled. Even JOHN Q AVERAGE DOCTOR knows this (Keller is an ER doc with 25 years of experience who works in prisons).
It all goes to prove what I have been telling patients for nearly three decades --- your health is up to you. HERE is a post that might provide some ideas for starting the process of taking your health back. And if you appreciate what you are seeing on our site, be sure and like, share, or follow on FACEBOOK as it's still a good way to reach the people you love and value most.
BRAIN INFECTIONS IMPLICATED IN NUMEROUS DISEASE PROCESSES
"Multiple sclerosis is a serious chronic neurological disorder in which demyelination and inflammation occur in the white matter of the central nervous system. The most likely cause is a virus because more than 90% of patients with MS have high concentrations of IgG in the brain and cerebrospinal fluid. Most chronic inflammatory central nervous system disorders are infectious." Cherry-picked from the March 2005 issue of Lancet Neurology (Infectious Causes of Multiple Sclerosis)
"Multiple sclerosis is a chronic neuroinflammatory disease that is characterized by progressive, inflammatory, and multifocal demyelination of the brain and spinal cord. MS affects approximately 2.5 million people worldwide, with women being afflicted twice as frequently as men. Importantly, young adults are the primary groups afflicted with MS: the average age of diseases onset is 30 years, with half of these patients requiring a wheelchair within 25 years of their diagnosis. Currently, there are three prevalent theories on the pathogenic mechanisms for MS: autoimmune, degenerative, and infectious. These pathogenic mechanisms are not mutually exclusive." From the October 2016 issue of the Journal of Neurology and Neurophysiology (A Review of Multiple Sclerosis as an Infectious Syndrome)
I want to start by addressing something that everyone is already thinking --- just vaccinate people so they don't become infected. No infection, no disease --- right? While vaccines MIGHT prevent overt diseases (emphasis on the word 'might'), because they contain germs, germ parts or germ proteins; thanks to MOLECULAR MIMICRY, one's immune system can begin attacking self if it perceives that the germ-based proteins it's been attacking has a close enough molecular shape to myelin or other human proteins or structures (it's similar to the concept of GLUTEN CROSS-REACTIVITY). This would help explain why even though the number of vaccines has increased exponentially over the past several decades (HERE), we are seeing more autoimmunity than at any time in human history (HERE or HERE).
"The immune siege appears to be a result of something called "molecular mimicry." Normally the body's immune system attacks foreign invaders like viruses and bacteria. If a molecule that's part of the body happens to closely resemble a portion of an intruding microbe, then both molecules can be targeted. Put another way, say a particular protein on the surface of a virus is similar in structure to a protein found in myelin. The immune system ramps up to clear the virus but also attacks the myelin. It's a case of mistaken identity, of collateral damage. The idea of molecular mimicry is one of the most important ones in MS. We and others have shown that mimicry between myelin peptides and viral and bacterial peptides indeed exists."
Here's what's even crazier. When quizzed about which germ was believed to be the culprit, just as you saw in the links provided in the first paragraph, the answer was that it could be just about any of them. In other words, there are large numbers of germs, antigens and other "factors" that can lead to autoimmunity. I've actually spoken of some of those 'factors' HERE. And when asked about what the scientific community is doing to address this, the answer was that rather than relying on the IMMUNO-SUPPRESSING drugs which are almost universally used today, a new form of treatment (immuno-tolerance therapy) is supposed to REDUCE IMMUNE SYSTEM ACTIVITY by acting as (and I quote) "a sort of negative vaccine." A negative vaccine? Huh?
In light of everything we've discussedin this post, coupled with THESE POSTS (not to mention THIS POST), we can't be surprised that constantly amping up immune systems --- especially young and immature immune systems --- with large and constantly-increasing numbers of shots has led to HUGE CONTROVERSY concerning what sorts of SIDE EFFECTS we may be heaping on future generations. If you appreciate what you are finding on our site, be sure to like, share or follow on FACEBOOK. And if you are looking for ways to control systemic inflammation (the root of most chronic illnesses and chronic pain), THIS FREE MOSTLY-DIY POST might provide you with a few ideas.
VIRAL INFECTIONS AND THEIR
RELATIONSHIP TO CHRONIC ILLNESS
"As far back as 1385, doctors in Europe recorded connections between influenza infection and psychosis. That link between the flu and the brain became much more apparent during and after the 1918 Spanish flu epidemic. More direct evidence for the virus-brain link came in the 1970s, when researchers found viral antigens in the brains of deceased people who had been afflicted with a condition known as encephalitis lethargica. One of the earliest links between influenza and neural dysfunction was a correlation between the 1918 Spanish flu, caused by a subtype called H1N1, and an epidemic of Parkinson’s a few decades later. In the 1940s and early 1950s, diagnoses of the neurodegenerative disease appeared to increase abruptly, from 1–2 percent of the US population to 2.5–3 percent, then fell back down to 1–2 percent. 'Basically, 50 percent more people in those years got Parkinson’s.'"
The authors spoke of two different mechanisms whereby this happens. The first involves something we have discussed many times previously; a disruption of the blood-brain barrier. Metabolically and physiologically this is quite similar to what happens in leaky gut syndrome, which is probably why it has a similar name ---- LEAKY BRAIN SYNDROME. The second had to do with an "over-activation" of a type of neurological / immune system cell known as GLIAL CELLS. The end result? "Two different flus, two different mechanisms, but the same effect in a sense. They were both inducing inflammation and death in the parts of the brain that degenerate in Parkinson’s disease." What's doubly interesting is how GUT HEALTH came into play.
The authors went on to talk about a "widely accepted hypothesis" that's been around for nearly two decades. "Parkinson’s disease starts in the gut, manifesting as digestive issues, and then moves into the brain. The progression of the disease from the gut to the forebrain, that takes place over maybe 25 or 30 years in a human." From there the discussion moved on to several other chronic neurological diseases that have can have roots in chronic infections. MULTIPLE SCLEROSIS, more on PARKINSON'S, and HIV. If you follow my site you already know how common this phenomenon really is (HERE).
What's their recommended solution? You already know the answer. "Vaccination for the flu—or at the very least, taking Tamiflu if a person gets infected—might help prevent neurological complications of influenza infection." Key word here is 'might'. What other issues 'might' their approach lead to? Unfortunately, numerous studies have shown that not only do consecutive years of flu vax make it increasingly ineffective at preventing flu (HERE), but that those same consecutive years of shots can actually lead to significantly increased chances of developing Alzheimer's (HERE). And as for Tamiflu; if there's been a bigger hoax perpetrated on the American people through the concerted efforts of big pharma and the medical community (HERE), I'm not sure what it might be other than possibly STATIN DRUGS.
Although it's impossible to cut your risk of chronic disease to zero; because this short article mentioned the word INFLAMMATION nine times, it would behoove us all to both understand what it really is, and have a plan for diminishing it systemically. My plan is free of charge (HERE), and is in no ways to be considered a "cure" for neurodegenerative diseases. But as far as helping reduce the factor that seems to be the common denominator in virtually all health problems (inflammation) it's a start. Fortunately there are doctors out there (Karim Dhani in Toronto is one of them) who specialize in tracking down and helping chronically ill people with occult infections. Oh, and if you like what you are seeing on our site, be sure to like, share, or follow on FACEBOOK.
GUT BUGS ARE CRITICAL FOR OVERALL HEALTH & AUTOIMMUNITY PREVENTION
(BUT DON'T FORGET THE VITAMIN D!)
As long as there is balance in the microbiome, the immune system idles softly, ready for immediate response if called upon. However, when there is a disruption in gross numbers or ratios of these organisms (DYSBIOSIS), the end result is sickness and disease of numerous kinds --- diseases that are linked in more ways than the average doctor realizes or typically cares to understand (HERE). When AUTOIMMUNE DISEASES RESULT (click for a list of some of the more common ones), it's critical to realize that most of these have nothing overtly to do with the gut. In other words, the self-immune system attack and subsequent symptoms can occur anywhere, which is why, regardless of symptoms, natural healers have been preaching "heal the gut, heal the body" since well before THE ADVENT OF MODERN MEDICINE. Today we will look at a few brand new studies that spell this out.
Next month's issue of Current Opinions in Rheumatology (The Microbiome in Systemic Autoimmune Disease: Mechanistic Insights From Recent Studies) tells us exactly why this is happening. "Recent changes in modern societies have disrupted homeostasis and contributed to a rise in immune-mediated conditions." First, to call what's going on a 'rise' is like me calling the Grand Canyon a ditch (HERE). The truth is, thanks to modern, Westernized lifestyles, we have been facing an EXPLODING INCIDENCE OF AUTOIMMUNITY for decades. Secondly, we see today's first mention of compromised epithelial barriers ('THE LEAKIES'). "Recent studies highlight that a breach of the gut barrier and translocation of commensal bacteria to non-gut organs can trigger several autoimmune pathways that can be prevented by commensal vaccination or dietary interventions."
While it's quite true that vaccinations can cause autoimmunity via the dysbiosis pathway (HERE), this is not the sort of "vaccination" these authors are speaking of. They are talking about "vaccinating" (their word, not mine) using entities such as PROBIOTICS, FECAL MICROBIOTA TRANSPLANTS, VAGINAL SWABBING (SEEDING) for babies born via C-section, or maybe even plain old GARDENING OR HAVING AN INDOOR / OUTDOOR PET. It could be as simple as feeding your microbiota with plenty of NON-DIGESTIBLE FIBER. The object is to get people exposed to diverse microorganisms, and lots of them, while feeding them what they need to colonize the Gut. As the authors reveal, this diminishes inflammation and helps shore up the "leaks" that allow these organisms into the general circulation. Let's move on to another concept that is starting to gain traction in the current research on GUT HEALTH --- molecular mimicry as a cause of autoimmunity (as seen in the same study).
"Recent findings suggest that autoimmune manifestations in genetically susceptible individuals can arise through cross-reactivity with commensal orthologs of autoantigens or commensal-mediated posttranslational modification of autoantigens. Physiologic responses to gut, oral, or skin commensal bacteria can thus be misdirected toward such autoantigens in susceptible hosts."
Two things to talk about here. First is that in most cases, the majority of those who are "genetically susceptible" do not get sick. Why not? Because as I've shown you HERE and HERE, epigenetic factors (bad habits and exposure to bad things like THIRD-HAND SMOKE, TOXIC CHEMICALS, SUGAR, or XENOESTROGENS) are, at least in the vast majority of cases, much more important than raw genetics and whether or not you carry a particular gene. This is why I have said repeatedly that you are not controlled by your genes nearly as much as you have been led to believe (HERE). Secondly, in many ways this phenomenon is similar to GLUTEN CROSS-REACTIVITY.
Because there are many foods with proteins that have a similar molecular structure to GLUTEN (wheat protein), in certain individuals, these proteins can trigger serious gluten sensitivity-like reactions (EVEN IN NON-CELIACS). The highlighted paragraphs simply show that some "commensal organisms" (bacteria, fungi, etc that we live with every day) are "orthologs of autoantigens". This is a fancy way of saying that some of these microorganisms contain or secrete compounds with a similar enough molecular architecture to a tissue, enzyme, or protein in your own body that given the right conditions, your immune system may actually start attacking said tissue, enzyme or protein in the case of autoimmunity.
We just saw an example of this in a study on a common autoimmune issue, ECZEMA, that was published earlier this week in Science Translational Medicine (The Nonlesional Skin Surface Distinguishes Atopic Dermatitis with Food Allergy as a Unique Endotype). Bottom line, while it's always possible for the immune system to go haywire without any outside help, these sorts of dysfunctions are mostly related to epigenetic issues --- issues that if understood, can be somewhat controlled or at least managed.
Now, back to the leakies. Last month's issue of the International Journal of Molecular Sciences (Recent Advances on Microbiota Involvement in the Pathogenesis of Autoimmunity) had this to say about LEAKY GUT SYNDROME (which in the scientific medical community is known as increased intestinal permeability or similar).....
"The impact of an imbalanced gut microbiome in the pathogenesis of autoimmunity has been suggested by an increasing amount of experimental evidence, both in animal models and humans. Several physiological mechanisms, including the establishment of immune homeostasis, are influenced by commensal microbiota in the gut. An altered microbiota composition produces effects in the gut immune system, including defective tolerance to food antigens, intestinal inflammation, and enhanced gut permeability. In particular, early findings reported differences in the intestinal microbiome of subjects affected by several autoimmune conditions, including prediabetes or overt disease compared to healthy individuals."
Not only do we see "enhanced gut permeability" here, which allows an array of particles to get into places they shouldn't, we see the authors talking about both "food antigens and intestinal inflammation". Let's see how these work in concert with a leaky Gut to cause autoimmunity. If you are consuming foods that your body is sensitive to, whatever those might be and for any number of reasons (GRAINS, DAIRY, NIGHTSHADES, LECTINS, etc, etc) your body will react by creating INFLAMMATION. This inflammation causes the cellular 'tight junctions' that separate the contents of your intestines from your blood stream to actually get bigger (looser). The end result is that particles of undigested food, PARASITES, toxins and other "stuff" are allowed to leak through, winding up in systemic circulation, where the body mounts increasingly intense immune system responses against them. What's interesting is that for nearly a century, science has shown that once the immune system starts attacking gluten, it's much more prone to start attacking self --- it's own cells, tissues, enzymes, proteins, etc (HERE) via autoimmune reactions.
Just so you are aware, the importance of GUT HEALTH encompasses both autoimmunity and a wide array of inflammatory diseases (see earlier link on inflammation) as seen in this three month old issue of Clinical Science (Impact of the Gut Microbiome in Cardiovascular and Autoimmune Diseases).
"The gut microbiome functions like an endocrine organ, generating enzymes and bioactive metabolites, which affect host physiology. Alterations in intestinal microbial and metabolic composition play an important role in human health and disease, including cardiovascular and autoimmune diseases. Changes in the composition of gut microbiota (dysbiosis) are linked to chronic inflammation, thrombosis, atherogenesis, chronic kidney disease, obesity, and type 2 diabetes. Moreover, significant evidence exists to implicate the role of microbiota in blood pressure regulation and heart failure. Microbiota interacts with the host through multiple pathways....."
The GUT BACTERIA AS AN ENDOCRINE ORGAN? Of course! It's why none of this should be shocking if you understand some of the larger "pathways" indicated in the last sentence. For instance, we've known for a long time (HERE) that cardiovascular disease is not so much caused by consuming fat (HERE) as it is caused by consuming sugar and high glycemic processed carbs. I would take that a step further, saying that virtually every modern health problem has roots in BLOOD SUGAR DYSREGULATION. And the cherry on the sundae is that sugar feeds infection, dysbiosis included (HERE). This is why I have written so many articles on doing whatever it takes to BREAK YOUR SUGAR ADDICTION.
Now that we've established that your microbiome is critical for your health, the most important question to ascertain is what you might be doing to foul it. Although most drugs have anti-microbial properties (HERE), the one class of drug that will absolutely throw your microbiome into dissaray is ANTIBIOTICS. Nothing, and I mean nothing screws people up faster, longer, and often times earlier in life than antibiotics (the most dangerous offender of being the family of antibiotics known as FLUOROQUINOLONES such as cipro). THIS ARTICLE shows the numerous ways in which antibiotics are screwing up people's health. A brand new study, takes it a step further, showing that prescribing babies antibiotics messes up their brains. From last month's issue of Science Reports (Oral Neonatal Antibiotic Treatment Perturbs Gut Microbiota and Aggravates Central Nervous System Autoimmunity).....
"Gut microbiota dysbiosis has been considered the essential element in the pathogenesis of multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis (EAE). Antibiotics were administered orally to Dark Agouti (DA) rats early in their life with the aim of perturbing gut microbiota and investigating the effects of such intervention on the course of EAE. As a result, the diversity of the gut microbiota was reduced under the influence of antibiotics. Consequently, aggravation of EAE, paralleled with stronger immune response in lymph nodes draining the site of immunization, and increased inflammation within the CNS, were observed in antibiotic-treated DA rats. Thus, the alteration of gut microbiota leads to an escalation of CNS-directed autoimmunity in DA rats. The results of this study indicate that antibiotic use in early life may have subsequent unfavourable effects on the regulation of the immune system."
The last link above proves that while this might be scary, it cannot in any ways be considered new information. How scared should you be as a parent or grandparent of young children if you are taking them to the doctor for antibiotics for anything less than life-threatening situations?
"There is an increasing awareness of serious consequences of antibiotic use on gut microbiota. Indeed, a rising number of observational, clinical, and epidemiologic studies focused on children and antibiotics use show that antibiotic exposure-related dysbiosis of intestinal microbiota increases the risks for various diseases such as obesity, diabetes, inflammatory bowel diseases, celiac disease, allergies and asthma. Antibiotics are the most commonly prescribed pediatric drugs, taking a share of more than 30% of all drugs prescribed to children younger than two years."
If this doesn't wake you up, this next study might. Thanks in part to antibiotics, "rare" diseases are becoming increasingly less rare. January's issue of the Journal of Autoimmunity (The Microbiome and Immunodeficiencies: Lessons From Rare Diseases) described a few of the pathways whereby this increase in previously rare disease is occurring. The study started by describing PID's (Primary Immune Deficiencies) as "inherited disorders," leaving those individuals more prone to "malignancy, inflammation and autoimmunity".
Next, the authors suggested that a DIMINISHED HOMEOSTASIS of the gut bacteria (dysbiosis) leads to "altered intestinal permeability and bacterial translocation". In other words, bacteria and their metabolites gain access to the systemic circulation, where the immune system either attacks these bugs outright or via the 'molecular mimicry' pathways we spoke of earlier. This leads to "immune system dysregulation," which results in "enhanced pathobionts colonization" (can anyone say BIOFILMS?), "increased disease susceptibility and secondary infections in these patients".
Here's where things really start to get dicey. Not only do the factors discussed by the authors (increased inflammation, increased autoimmunity, increased malignancy) occur directly, they can occur indirectly as well. We are seeing this in the numbers of studies relating chronic latent infections to these sorts of problems. Although I spoke of this relationship recently in a post linking still another infection to Alzheimer's (HERE), in my post titled SECOND THOUGHTS ON THE GERM THEORY, I wrote......
"Despite our best efforts to "cure" infectious disease, why are rapidly growing numbers of people plagued with illnesses that are increasingly believed to be the result of what Dubos referred to as "latent infections" (ALZHEIMER'S DISEASE, DISC HERNIATIONS, EBV, PANDAS/PANS, IBS, FLACCID PARALYSIS, DISEASES FROM ROOT CANALS OR OTHER ORAL INFECTIONS, and on and on and on)?"
More importantly, how do these authors --- MD / Ph.D research types from prestigious institutions and universities in both Italy and the United States --- propose we solve this issue? Pay close attention. "Finally, we provide evidence, in preclinical models of PIDs, for the efficacy of microbiota manipulation to ameliorate disease complications, and suggest that the potential use of dietary intervention to correct dysbiotic flora in PID patients may hold promise." There are essentially four ways to deal with underlying dysbiosis, with doctors (especially doctors with a 'natural' bent) trying them in various combinations.
- You can try to kill the dysbiosis off with either natural or chemical antibiotics (which often means you kill everything and have to start completely over or almost so from scratch).
- You can do FMT, which is quite amazing and effective if YOU CAN FIND THE RIGHT DONOR (it's all about your donor).
- You can take prebiotics, probiotics, and various bacterial metabolites marketed as nutritional supplements (the problem is, at least with probiotics, they don't do a very good job of matching your gut's natural microbiome --- HERE).
- You can change your diet, because there is abundant evidence that what you feed your "Gut Bugs" is either driving or squelching your health (i.e., antibiotics usually precipitate dybiosis, but sugar and high glycemic carbs feed it). See earlier link on fiber.
How can information like this help you solve your chronic health issues? For starters, simply by better understand and deciphering the current scientific literature. For instance, the issue of Autoimmune Reviews that came out about six weeks ago published a study titled Autoimmunity in Celiac Disease: Extra-Intestinal Manifestations that dealt with all the "extra-intestinal" (non-gut) ways that CD can affect people (something I've shown you previously in my posts on gluten's association to neurological disease --- HERE, HERE or HERE). Here are the mechanisms, exactly as we have previously discussed today....
"Nutrients, dysbiosis, dysbiotic components and their mobilome, post-translational modification of naive proteins, inter-enterocyte's tight junction dysfunction resulting in a leaky gut, microbial lateral genetic transfer of virulent genes, the sensing network of the enteric nervous systems and the ensuing pro-inflammatory messengers are mutually orchestrating the autoimmune interplay. Genetic-environmental-luminal events-mucosal changes are driving centrifugally the remote organs autoimmunity, establishing extra-intestinal multi organ injury."
Super technical sounding, but what is this really saying? That certain nutrients (gluten, for instance, is a protein) can team up with dysbiosis and the molecular byproducts created by these 'bad' organisms, causing the tight junctions to become loose or leaky, which can lead to bacteria transferring "virulent genes" to their buddies. The result is an "interplay" (a vicious cycle that can feed itself while spinning either direction) between inflammation and autoimmunity. Once the necessary factors are in play to actually turn these 'bad' genes on (the very definition of epigenetics), the problems they cause are not constrained to the Gut, but can travel to the farthest (remotest) reaches of the body, leading to even more "autoimmunity and multi-organ injury".
Although we could play "pick a disease, any disease" and watch this phenomenon in action, let's take a look at arthritis. In December's issue of Arthritis and Rheumatology (Microbiome Analytics of the Gut Microbiota in Juvenile Idiopathic Arthritis Patients...) we see something that we already knew or at least suspected; that the guts of children with inflammatory autoimmune arthritis are different than the guts of children without. "We found evidence for dysbiosis in JIA patients." Why is this important to both know and understand? The same month's issue of Cell Immunology revealed via its title (Modulation of Autoimmune Arthritis by Environmental 'Hygiene' and Commensal Microbiota) that there are steps that people can be taking to help themselves, without relying on DANGEROUS DRUGS for everything.
"Specific commensal organisms are associated with enhanced severity of arthritis in susceptible individuals, while exposure to certain microbes or helminths can afford protection against this disease. In addition, the role of metabolites (e.g., short-chain fatty acids, tryptophan catabolites), produced either by the microbes themselves or from their action on dietary products, in modulation of arthritis is increasingly being realized. In this context, re-setting of the microbial dysbiosis in RA using prebiotics, probiotics, or fecal microbial transplant is emerging as a promising approach for the prevention and treatment of arthritis."
Interesting because this is exactly what I was talking about in my earlier bullet points (although I fialed to mention the part about purposefully creating HELMINTH INFESTATIONS). It's all about the HYGIENE HYPOTHESIS folks. And although VITAMIN D is mentioned in my GENERIC AUTOIMMUNE PROTOCOL (not to mention several of these studies), let's take a bit deeper look at why it's doubly critical to understand for those of you with AUTOIMMUNITY. Just remember as you read this next (short) section that the reason that Vitamin D gets so much publicity in relation to other vitamins is because it's not really a vitamin at all, but an immuno-modulating hormone precursor.
GUT HEALTH, AUTOIMMUNITY AND
THE CONNECTION TO VITAMIN D
Under a header titled Vitamin D and the Innate Immune System: Antimicrobial Activity, we start to learn how necessary Vitamin D really is if you want to stay healthy. We'll get there, but first let's talk about the innate immune response (as opposed to acquired immunity). The innate response pertains to the aspects of immunity that you are born with, namely white blood cell function (except for lymphocytes) and inflammation as well as the cellular barriers that I already showed can become "leaky". Also under innate immunity you'll find numerous types of enzymes and other proteins that have varying degrees of antimicrobial properties. Acquired immunity pertains mostly to the antigen / antibody reactions, which we will cover momentarily.
Citing studies from the 1940's, the authors wrote that "Vitamin D is a well-known regulator of innate immunity.... D3 increases chemotaxis, autophagy, and phagolysosomal fusion of innate immune cells.... and up-regulates CAMP in cells participating in the innate immune system as first-barrier defenses" In essence this means that with Vitamin D the body can get the proper cells or metabolites to where they need to go quicker (chemotaxis), that the body is better adapted to a form of detoxification that involves deconstructing and recycling old and worn out cells in an orderly fashion (autophagy), that the cells that engulf and dissolve harmful invaders in "BLOB-LIKE" fashion are working at full capacity (phagocytosis / phagolysosomal fusion), as well as aiding in cellular signaling / messaging (up-regulating cyclic AMP). What did the authors conclude after looking at these factors in detail?
"Taken together these data point to a role of vitamin D in defending the organism against pathogens, suggesting that vitamin D sufficiency has to be granted in patients affected by acute or chronic infection."
In other words, if a person is dealing with an infection (overt, occult as we spoke of above, or some form of dysbiosis), decades worth of studies mean it's a given that Vitamin D levels will be compromised / depleted. What this really means is that if you have an infection (dysbiosis included), there is an entire cascade of harmful effects to the immune system that will follow. The authors discussed why "THE LEAKIES" (hyperpermeable epithelial barrier membranes) are a factor in Vitamin D deficiency as well.
"Vitamin D is responsible for the barrier function of the intestinal epithelium and for the modulation of the bowel immune system, hence, low levels may be associated with greater gut permeability and, consequently, with Gut-induced metabolic endotoxemia that induces a low-grade inflammation. Moreover, vitamin D administration may influence Gut composition. In animals with vitamin D depletion and the knockout of the Vitamin D Receptors, Gut dysbiosis favors metabolic disorders. Other studies in mice demonstrated that Vitamin D Receptor [dysfunction] reduces the response to infection of the intestinal epithelium."
Metabolic endotoxemia implies that lipopolysaccharides (LPS) is present in the blood stream or organ that these epithelial barriers are trying to protect (lungs, brain, spinal cord, nerves, etc). LPS are byproducts of certain kinds of bacteria and are not only heavily associated with low grade inflammation, but with the sort of immune system hyper-reactivity that can lead the body to start attacking itself (although they are also associated with T2D, LOW T (or HIGH T), high levels of IL-6 and TNFA, DEPRESSION, FATTY LIVER, PARKINSON'S, OBESITY, and for those who regularly follow my site, CHRONIC PAIN).
The authors went on to mention Vitamin D's relationship to something I've already touched on, cellular apoptosis. "Over-expression of VDR in the intestinal epithelium induces resistance to colitis and decreases mucosal inflammation suppressing epithelial cell apoptosis, boosting tight junction function." In other words, having lots of (an "over-expression of") receptors for Vitamin D suppresses epithelial apoptosis. Activated by the TH-17 part of the immune system mentioned earlier, apoptosis is cellular death that is programed to occur when one of several things happen. Of course AGE can be a factor, and so can STRESS (metabolic stress, physical stress, psychological stress, etc).
Another factor, kind of like falling dominoes, is the fact that if I'm a cell and the cell next me undergoes apoptosis, I'm very likely to undergo apoptosis as well. Not to freak you out, but the average adult loses 50 to 70 billion cells a day to apoptosis, while children lose about half that many. Thus, it's easy to see why slowing this process down by addressing the factors that speed it up (vitamin D deficiency being one of many) could have some very beneficial results. Furthermore, research that was published just last week shows that making the correct changes to the cellular environment can slow down and in some cases, actually REVERSE cellular apoptosis.
Adaptive / acquired immunity is the opposite of innate immunity and deals with a type of white blood cell (lymphocytes) that will differentiate into either T-cells or B-cells (to see the difference, you can read THIS POST on the relationship between overactive immune systems and autoimmunity) or Natural Killer cells.
"D3 suppresses adaptive immunity. In experimental models it down-regulates the immune responses mediated by T helper (Th) 1 cells, thus inhibiting the production of pro-inflammatory cytokines, such as Interferon-y, IFN-y, IL-6, IL-2, and TNFA....... It has been suggested that Vitamin D3 acts as an immunomodulatory not only by suppressing Th1 cells activation, but also modulating Th2 cells, T regulatory (Tregs) cells activity, and Th17 cells."
We just discussed the TH-17 system, but TREGS are interesting because you want them activated in cases of autoimmunity. Why? They slow down or "regulate" an immune system that's galloping out of control.
After suggesting that there is strong data for the role of Vitamin D's ability to act as a modulator of the immune system to better fight pathogens, the authors revealed that there are no medical recommendations for Vitamin D supplementation in those specifically coping with autoimmune issues --- issues that by official counts affect almost 25 million Americans. Once, however, you start factoring in the dozens (maybe hundreds) of diseases that are believed to be autoimmune but not proven because the specific auto-antigen ---- the entity that's being attacked --- has yet to be discovered), many experts put this number at at least double or even triple this. Not surprisingly and for many reasons that are no fault of their own, the author's Vitamin D "recommendations" fall short.
"Thanks to the evidences of immunomodulatory effect of vitamin D the role of vitamin D deficiency and supplementation in autoimmune diseases has long been studied. Animal studies showed an important role of D3 supplementation in the control of autoimmune diseases...." [However], "There is no current indication for vitamin D3 supplementation in patients with infections and/or autoimmune diseases."
What we can do is read between the lines a bit. Even though, depending on one's age (older people are supposed to take a higher dose), the RDA for Vitamin D ranges from 400 to 800 international units (IU) per day, every FUNCTIONAL MEDICINE expert I know (including many who are MD's) laughs at this. While I am not going to make any recommendations of my own, suffice it to say that the authors of this study talked about certain conditions and studies where the participants received as much as 50,000 IU a week, or (gulp) 300,000 IU in a one-time "bolus". One of the more brilliant functional medicine MD's I know has told me that for certain patients in certain situations, he sometimes recommends as much as 80,000 IU's a day, short term (do not do any of this without first consulting your physician).
If you are interested in seeing some more information on Vitamin D as it pertains to natural light (HERE and HERE) or how it plays a part in my generic health protocol (HERE), as well as what the profile of the average autoimmune sufferer tends to look like (HERE), just follow the links. And as always, if you like what you are seeing, be sure and like, share, or follow on FACEBOOK as it's still a great way to reach the people you love and care about most.
CHRONIC PAIN RELIEF
UPPER BACK AND NECK
Probably due to the physical demands of LOGGING, Anthony had developed FASCIAL ADHESIONS that had literally "TETHERED" the musculature on the right side of his spine from the top part of his THORACOLUMBAR FASCIA clear into his NECK. I quickly figured out what was going on, broke the adhesions, adjusted him, and did not see him again for three years. In fact, this has been his pattern.
I've seen him once every three years since that time, with the latest coming sometime last week. Although I had forgotten how severe this problem was for Anthony when I first saw him, he reminded me. When I asked if he would be interested in sharing his story via a video, he agreed. And while it's short and to the point, it's quite clear not only how severe he was, but how much the care in our office changed his life.
MINNESOTA CHRONIC PAIN RELIEF
IN MOUNTAIN VIEW, MISSOURI
There was no rhyme or reason for Tedd's pain. He simply woke up with it one morning and has been struggling for two and a half decades --- all while continuing to work a physically demanding job. What has he done to try and solve this problem? He tried all the usual; CHIROPRACTIC ADJUSTMENTS, THERAPY, massage, ACUPUNCTURE, INJECTIONS, and even SURGERY. And that's just for starters (the list he gave me is to long to print here, but those of you who have been down the same road could guess most of it).
And of course he had had every imaging test under the sun (HERE, HERE and HERE), all to no avail, with everyone seemingly trying to explain his pain away with brilliant diagnostic statements like "Gee Tedd, you just aren't as young as you used to be" --- unfortunate and ridiculous for a person significantly younger than I AM. When I hear a history like his --- the only thing that brings any real relief is chiropractic adjustments, but they just don't hold (LIKE THIS) --- my first thought is always SCAR TISSUE / FIBROSIS. Rather than me talk about it, I am going to let Tedd spill the beans in an unsolicited email I received yesterday.
Good Morning Russell,
I just wanted to send you quick note on my progress. It was three weeks ago yesterday that I had my first treatment done in your office. I have been following the guidelines on the stretching and implemented the exercises that we discussed. The days after the treatment it’s almost like I had a flare up and my symptoms worsened.
Since then things have vastly improved. Before the treatment I had been seeing a chiropractor on average twice a week for over 20 years. I can happily (ecstatically) say that I haven’t felt the need to get adjusted since leaving your office. My mobility has improved along with a massive reduction in pain. In one treatment my back and neck went from weak and fragile to strong and durable.
Thank you so much for treating me! I almost forgot to tell you I shoveled approximately 6,000 pounds of snow off my roof yesterday. I couldn’t even do one shovel full a month ago.
All I can say Tedd is fantastic! I never get tired of hearing stories like these. Ever! And let's all be honest with each other for a moment; who else tells their patients that they will know after a single treatment if their treatment will prove helpful (HERE, HERE or HERE)? By the way Tedd, if you and your wife are ever in Missouri when the weather is good, hit me up and we'll head to CURRENT RIVER and continue the great conversations we had during our two hours together! For my readers, especially those struggling with chronic conditions, be sure and check out THIS POST. And if you appreciate what you are finding on our site, be sure and spread the wealth by liking, sharing, or following on FACEBOOK.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).
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