Dear Friends and Patients: 

Earlier this year I attended the ACAM (American College for Advancement of Medicine) conference in South Florida where two and one half days of intensive lectures were centered on mitochondrial dysfunction and related illnesses. The role of mitochondrial disorders in cancer, neurological conditions, environmental exposure to toxicants, autism, and other chronic conditions was explored. It was pointed out that strategies for addressing these conditions from the origin of mitochondrial dysfunction is not currently known to most physicians. Mitochondrial dysfunction can have a genetic etiology and also can be triggered by the environment. 

What Are Mitochondria?


This is a story dating back several billion years ago when bacteria developed a symbiotic relationship with single-celled organisms. These organisms provided a hospitable environment for the bacteria, which, in turn, gave an energy boost back to the organisms. The two later formed a single functional organism. Mitochondria are cellular substructures (organelles within cells) that both produce and store energy and are present in all humans, plants and animals. They also play critical roles in programmed cell death and in calcium storage. 

Mitochondria make up a tenth of your total body weight. Loss of energy is a common sign of aging and disease, and what is happening is either mitochondrial numbers are decreasing and/or their function is impaired. This is because the DNA in mitochondria becomes mutated and they are unable to produce optimal amounts of energy. There are many scientists who believe that free-radical damage (oxidation) to a person’s mitochondria is the basic cause of aging. This is similar to a piece of iron exposed to the air eventually rusting, becoming brittle, and later crumbling apart. Antioxidants such as alpha lipoic acid and glutathione have a major role in blocking these inflammatory pathways. In type I and type II diabetes there is an impaired ability for mitochondria to be stimulated by insulin to produce ATP (adenosine triphosphate). 

When I was in medical school, students were taught the Krebs cycle, where nutrients from the food we eat go through a complex series of chemical reactions and ultimately pass into mitochondria, converting the energy in sugars, fats, and proteins into ATP. ATP can be stored as fuel within the mitochondria or used as an energy source. 

A Perfect Storm for Human Energy Crisis


For most Americans, 50% of their diet now comes from empty calories. People are experiencing hormonal deficiencies from aging, hypothalamic dysfunction, autoimmune illness and toxins. We are exposed to infections due to new viruses and other organisms. Most people are under a lot of emotional stress from the increased speed and stress of modern life as well as many other causes. The average nights sleep in the U.S. has dropped from 9 hours per night 130 years ago (pre-light bulb era) to 6 ¾ hours. 

Symptoms of chronic fatigue syndrome and fibromyalgia all trace back to low energy: exhaustion, achiness, weight gain, “brain fog,” increased thirst, low body temperatures, low libido, disordered sleep and bowel disorders. Significantly lower ATP levels have been observed in platelets and neutrophils of chronic fatigue and fibromyalgia patients. 

Two of the best ways to target mitochondria for improving metabolic health is through exercise and through caloric restriction. Both exercise and dieting increase the number of mitochondria a person’s body has. Nutrients such as coenzyme Q10, lipoic acid (helps recycle glutathione), acetyl L carnitine, D ribose, magnesium, vitamin B complex and creatine all improve mitochondrial function. 

“S.H.I.N.E.”


One of the presenters at the ACAM conference was Jacob Teitelbaum, M.D. He is a well-known integrative physician who has appeared on Good Morning America, CNN, Fox News Channel, the Dr. Oz Show, and Oprah and Friends. He is an author of a number of books and has done studies on patients with both fibromyalgia and chronic fatigue syndrome. What both disorders have in common is dysfunctional mitochondria. His acronym for treating these disorders is “S.H.I.N.E.” 

Sleep 
Hormonal Deficiencies 
Infections 
Nutritional Deficiencies 
Exercise 

Are You Sleeping Well?


Dr. Teitelbaum noted in order to eliminate pain and restore energy production, it is critical to get eight to nine hours of deep sleep each night. Natural sleep aids such as Valerian, Passion Flower, Hops, Theanine, Melatonin, or magnesium can be used. 5-HTP may be of benefit to boost serotonin levels. Serotonin is an inhibitory neurotransmitter that calms the body and also improves bowel function, with 95% of the body’s serotonin residing in the intestines rather than the brain. Taking a hot bath and keeping your bedroom cool is another suggestion. Low doses of prescription sleep medications may be needed for limited periods. Sleep apnea should also be evaluated if patients fall asleep during the day, have hypertension, or snore loudly and stop breathing while sleeping. 

At the Center, some of the natural sleep aids we carry are VHP, a Biotic’s product which contains a combination of Valerian, Hops, and Passion Flower. We also carry Theanine, MG Zyme (magnesium citrate), Serene (contains 5-HTP with cofactors for serotonin production}. A new product we carry is Cerenity which supports both GABA and serotonin production. GABA is another inhibitory/calming neurotransmitter. We also have a homeopathic sleep aid, Neurexan, for people whose minds “race” when trying to fall sleep. 

Hormonal Imbalance Can Cause Fatigue and “Brain Fog”


Dr. Teitelbaum pointed out that even mild under-production of hormones can be associated with many health problems and leave the patient sick, “brain fogged,” and tired. Hormones are produced by glands which are controlled by the hypothalamus in the brain. Hormonal imbalance is a subject books have been written on and is too involved to discuss in this Newsletter. I would just point out that in interpreting lab tests that “normal” lab values do not necessarily equal “healthy.” Lab ranges are very wide, often 2 standard deviations from the mean, and are adjusted for age. For example, I frequently see hypothyroid patients who have a “within the normal range” TSH that are on thyroid medication and have been told everything is fine, but they still have symptoms of fatigue, weight gain, cold intolerance, low body temperatures, low libido and hair loss. Obviously, something is not right. The whole idea of correcting hypothyroidism or other hormonal imbalances is to make a person feel well. 

Infections Can Play a Role in Chronic Fatigue


Chronic infections with Ebstein-Barr virus, Cytomegalovirus and others as well as fungal, parasitic and bacterial infections can be found. One caveat is that most people with chronic Lyme disease have post-Lyme chronic fatigue syndrome due to candida infections from all the antibiotics that person had taken. Improving immune function through detoxification and improved nutrition in addition to antibiotic/antifungal therapy is often beneficial. 

You Are What You Eat


Nutritional deficiencies may be present for a variety of reasons. The obesity epidemic in the U.S.A. and its associated increased risk of heart disease and diabetes is well-known. The average annual per capita sugar consumption in the U.S.A. is 140 pounds! The average calories per day from white flour is 18%. We encourage our patients to avoid high sugar/processed foods in general and eat a variety of fresh fruits and vegetables, wild line-caught low mercury fish, or free range, antibiotic and hormone-free poultry. Some people are intolerant of wheat and gluten products and should try alternative grains such as Quinoa or Amaranth. More detailed dietary recommendations are provided in each new patient’s comprehensive evaluation report and on our website www.prevent-doc.com. 

Even when a person is eating healthy foods, they can still have deficiencies of vitamins and minerals. This is because of soil depletion where modern intensive agricultural methods have stripped away increasing amounts of nutrients from the soils in which the food we eat grows. In an April 2011 Scientific American article entitled “Dirt Poor: Have Fruits and Vegetables Become Less Nutritious?” a Kushi Institute analysis of nutrient data from 1975 to 1997 found the average calcium levels in 12 fresh vegetables dropped 27%; iron levels 37%; vitamin A levels 21% and vitamin C levels 30%. A similar study of British nutrient data from 1930 to 1980 published in the British Food Journal found that in 20 vegetables, a similar decline in nutrient value took place. Yet another study concluded that one would have to eat 8 oranges today to derive the same amount of vitamin A as our grandparents would have gotten from one orange. 

Poor absorption is another reason that a person may experience nutritional deficiencies and this can be due to bowel infections such as candida, enzyme deficiencies, bowel inflammation/colitis and can also occur with the use of acid blockers. Processed foods do not contain the natural plant enzymes which help digestion. This can lead to poor digestion and eventually to leaky gut syndrome, food allergies and immune problems. So the next time you drink a glass of orange juice that wasn’t freshly squeezed from a whole orange, the stomach irritation you feel could be due to the destruction of the natural plant enzymes during pasteurization. At the Center we use traditional lab tests, dietary history, intracellular vitamin analysis (Spectracell) and hair analysis of essential minerals and toxic metals to gain a picture of a person’s nutritional status. 

Nutritional Supplements May be Helpful in Boosting Energy Production


Nutritional supplements can be of benefit. D-Ribose is a promising supplement for chronic fatigue and fibromyalgia sufferers as well as cardiac patients. Ribose availability is rate-limiting in energy production, especially in people having an “energy crisis.” Ribose is also a key component of DNA and RNA, ATP, and other components of the Krebs energy cycle. We carry the Corvalen brand of D-Ribose at the Center which has been used in a number of scientific studies due to the high quality of this product. 

A multicenter study where 53 health care practitioners enrolled 257 patients with fibromyalgia and/or chronic fatigue syndrome was presented at the ACAM conference. Patients were given the Corvalen brand of D-Ribose using 5 grams of the product three times daily for 3 weeks. A Visual Analog Scale of 1-7 points rated energy, sleep, cognitive function, pain and overall well being. The results of the study were quite dramatic and the composite averages were reported as follows: 

Energy 61% increase 
Sleep quality 29% increase 
Mental clarity 30% increase 
Pain 16% decrease 
Overall well being 37% increase 

Other nutrients that are also very important for energy production include Acetyl-L-Carnitine and either Coenzyme Q10 or Ubiquinol (we carry a brand of both that does not use a benzene extraction in the production of these supplements. Benzene is a cancer-causing chemical). 

If you are chronically fatigued, consider taking 1 scoop of Corvalen twice daily, Acetyl-L-Carnitine 1-2 capsules daily, and Ubiquinol 50mg daily for a month to see if you experience improvement in any of the symptoms listed in this study. 

Get Off The Couch


Exercise is also important. Too little exercise causes deconditioning. Too much exercise will cause post exertion fatigue. I suggest a person starts with a walking program and to walk as long as is comfortable. After 10 – 12 weeks a person can increase walking by 1 minute a day as able, up to a total of 60 minutes. At 60 minutes, the intensity of the walking may be increased – as able. The 60 minutes do not need to be consecutive if time is an issue, and can be divided into two 30 minute blocks. Exercise activates a process known as mitochondrial biogenesis, where new mitochondrial growth takes place. Mitochondrial biogenesis also takes place with caloric restriction. Animal studies have proven that caloric restriction extends lifespan, and this may hold true for humans as well. Cut down on portion sizes and leave deserts for those special occasions. 

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Another Reason to Avoid Corn Syrup


In 2004 an environmental researcher at the Food and Drug Administration (FDA) by the name of Renee Dufault, discovered some chemical companies make lye by pumping salt through large vats of mercury. Lye is used to separate corn starch from the corn kernel in the manufacture of high fructose corn syrup. Ms. Dufault wondered if mercury might be getting into the corn syrup itself and she sent samples from three different manufacturers that used lye to the labs at the University of California-Davis and also to the National Institute of Standards and Technology. The labs found mercury in nearly half the samples. So she went and presented her findings in 2005 to the Food and Drug Administration’s center for food safety, but the agency decided against further investigation because it wasn’t convinced there was evidence of a risk, according to an article written by Melinda Wenner. Dufault along with eight other scientists went ahead and published their findings in a peer-reviewed journal Environmental Health. In the Wenner article, she states the corn-syrup industry claims no high fructose corn syrup manufacturers currently use mercury-grade lye and that its own tests found no traces of mercury. But hundreds of foreign plants still use mercury to make lye which, in turn, can be used to make foods for export. “Already, 11 percent of the sweeteners and candy on the US market are imported.” 

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Patient Success Story – Panic Attacks Treated with Methylcobalamine and TAAT


Mr. D is a 17 year old male study who had been under stress from the death of family members. There was also a history of emotional issues with his mother. While eating dinner at home he had the sudden onset of tightness in the chest, a sensation that he couldn’t breathe, whole body shaking, nausea, vomiting and dizziness. He later couldn’t move his hands or feet. 911 was called and Mr. D was taken to the emergency room where he was given Ativan, which relieved his symptoms. He later had a few more anxiety attacks and his family did not want him taking prescription psychotropic drugs, so they consulted me. 

Mr. D’s physical exam was normal. Routine lab including a blood count, thyroid panel, and vitamin D levels were all normal. Spectracell testing analyzing intracellular vitamin and mineral levels documented a vitamin B12 deficiency and Neuroscience urinary transmitter testing showed a neurotransmitter imbalance with low GABA, a calming/inhibitory neurotransmitter. 

Mr. D was started on TAAT (targeted amino acid therapy) to support GABA and adrenal function. He was also started on both oral B vitamins, sublingual Methyl-B12/folate and weekly Methylcobalamine shots. Shortly following initiation of this therapy this patient had no further anxiety issues and state “I feel good.” At his 2 month recheck he stated he could definitely tell a difference in how he felt after receiving a Methylcobalamine shot. He left the Center on low dose maintenance therapy and the frequency of his Methylcobalamine shots was reduced to twice monthly. 

One of the symptoms of a genetic defect in the methylation pathways of B12 or folic acid can be emotional issues such as anxiety and depression. 

Patient Success Story – Arthritis and Foods That Cripple


Mrs. V is a very pleasant lady who was suspected to have rheumatoid arthritis by her rheumatologist, but her lab testing did not confirm this. When she saw me I placed her on Meriva SR, which is a patented sustained release curcumin product used to reduce inflammation and/or boost immune function. She was pain-free on this product and did not require prescription drugs. Months later she suddenly developed severe joint pains in her elbows, knees, and hands and had to take a prescription arthritis drug her rheumatologist previously gave her. Examination did not show active tenosynovitis (inflammation around the tendons) or joint swelling or redness. I questioned her about her diet and activities. Several days prior to the onset of her symptoms she had eaten in a Latin restaurant and then ate leftovers on succeeding days. I suspected exposure to nightshade vegetables or spices (these include potatoes, tomatoes, peppers, eggplant, tobacco, and certain spices) in her food. Mrs. V was given information on nightshade avoidance. 

Norman Childers, Ph.D. while teaching at Rutgers University discovered animals that had grazed in pastures containing the Solanaceae family of plants (nightshades), would be found crippled and sometimes dead. Dr. Childers later expanded his studies to include humans and found over ¾ of the people who had aches and pains, regardless of their type of arthritis, or if they had fibromyalgia or degenerative disc disease — had a sensitivity to nightshades. He found that ¾ of these people when put on a nightshade-free diet for 3 months were totally out of pain. 

One of the worst offenders in the nightshade food group is the potato category, which is the number one vegetable in the U.S. The baked potato or French fries are obvious. But hidden potato sources include soups, breads made with potato water, certain processed foods including yogurt, modified food starch, modified vegetable starch or hydrolyzed vegetable protein. Potato starch can be in gluten-free baking powders or in artificial crab meat where it is used as a binder. Potato starch is also used as a common filler in medications (ask your pharmacist). Sweet potatoes and yams are fine. 

Nightshade spices include cayenne, paprika, chili, and ground red pepper. Non-nightshade spices that are safe to eat include black or white pepper, allspice, ginger, turmeric and garlic. Hidden sources of nightshade spices include Thai sauces, prepared mustards, salad dressings, mayonnaise, Worcestershire and tobasco sauce. If the food is “pink” or “red” in color, find out why. If the food is spicy, most likely it has nightshades in it. Always read the labels on your food purchases.