Immune System Health and Low Cortisol

7. ALLERGY: is a disorder of the immune system. It is characterized by excessive activation of certain white blood cells called mast cells and basophils by a type of antibody known as IgE, resulting in an extremeINFLAMMATORY response.

10. Immune System Health and Low Cortisol Just as a high cortisol suppresses the immune system, a low cortisol can result in unbridled immune system action. The immune defenses become overly aggressive and not only attack invading organisms, but mount allergic reactions against many environmental agents. "Allergic reactions" can also be directed against endogenous antigens, the components of our own bodies. Autoimmune conditions such as lupus, Rheumatoid arthritis and Sjogrens syndrome can activate during periods when cortisol levels are low. Pauline N. Harding, MD

11. GLUTEN GRAIN INTOLERANCE AND STRESSIn many individuals, the gut becomes inflamed within 30 minutes after consuming gluten-containing grains such as wheat, oats, rye, barley, and spelt. This inflammatory response in the intestinal tract is tantamount to having a "30-foot-long sore throat." In infants we call it colic. We assume the child "outgrows" the food allergy. In fact, the body merely learns to respond to this inflammation by secreting cortisol and, in many cases, an endogenous morphine-like substance to "cover up" the pain and suppress the inflammation. This narcotic substance absorbs into the bloodstream and travels to the brain where it stimulates morphine receptors, and the individual becomes physiologically addicted to the grain or dairy product that induced the inflammation. Observe the symptoms and behavior patterns of individuals consuming grain and dairy products, and note the striking similarities with the "upper" and "downer" phases of drug intake and withdrawal. The similarities with drug addiction become even more striking when the individuals attempt to stop eating dairy and grain products.Pauline N. Harding, MD

12. THE ASSOCIATION OF…IRRITABLE BOWEL SYNDROME AND FIBROMYALGIAIrritable bowel syndrome (IBS) is a very common gastrointestinal condition, which is present in 8-20% of the general population. Several population-based studies have demonstrated IBS symptoms to be more common in women, with prevalence ratios ranging from 2 to 3:1. It has been estimated to affect 14-24% of women and 5-19% of men. The classic gastrointestinal symptoms of IBS are chronic or recurrent abdominal pain and/or discomfort and associated alterations in bowel habits. However, many individuals with IBS also suffer from nongastrointestinal symptoms. Rheumatologic symptoms, such as skin rashes, muscle contraction headache and myalgias, have been reported in two-thirds of IBS patients. Previous studies have found that IBS typically overlaps with fibromyalgia syndrome (FM) in the same patient, suggesting a common cause. FM occurs in up to 60% of patients with irritable bowelLin Chang, MDAssociate Professor of Medicine,Co-Director of the UCLA/CURE Neuroenteric Disease Program,Director of the UCLA Motility Unit FM occurs in up to 60% of patients with IRRITABLE BOWEL

13. FIBROMYALGIA SYMPTOM COMPLEX • Tenderness of specific anatomical sites (at least 11 of 18 points)• Chronic aching• Stiffness• Sleep disturbances• Pain• Headaches• Anxiety• Depression• Chronic fatigue• Intestinal disturbances• Subjective soft tissue swelling• Cardiovascular problems (dizziness, palpitations)• Type II muscle fiber atropy• Mitochondrial abnormalities• Low Levels of ATP

16. Because FM is a multifactorial condition of questionable etiology,treatment that addresses the various bodily systems or processesknown to be defective may be of benefit. While medicationsprescribed for FM complaints may provide temporary relief, theymay not address the underlying factors involved and can causeundesirable side effects such as headache, nausea, drowsiness, orconstipation.National Institute of Arthritis and Musculoskeletal Skin Diseases. National Institutes of Health. Fibromyalgia.Retreived July 2, 2002 from, http://www.niams.nih.gov/hi/topics/fibromyalgia/fibrofs.htm2. Arthritis Foundation Disease Center. Fibromyalgia. Retrieved July 22, 2002 from,http://www.arthritis.org/conditions/DiseaseCenter/fibromyalgia.asp3. Rooks DS, Silverman CB, Kantrowitz FG. The effects of progressive strength training and aerobic exercise onmuscle strength and cardiovascular fitness in women with fibromyalgia: a pilot study. Arthritis Rheum2002;47(1):22-28.4. Jones KD, Burckhardt CS, Clark SR, et al. A randomized controlled trial of muscle strengthening versus flexibilitytraining in fibromyalgia. J Rheumatol 2002;29:1041-48.5. Thorson K. Fibromyalgia syndrome (FMS) political case statement. Retrieved March 6, 2002 from,http://www.fmnetnews.com/pages/case.html6. Smythe HA. “Fibrositis” and Other Diffuse Musculoskeletal Syndromes. In: Kelley WN, et al., eds. Textbookof Rheumatology. 1st ed. Philadelphia: WB Saunders; 1985:481-89. ON THE OTHER HAND, NUTRITION AND DIETARY SUPPLEMENTS THAT SUPPORT THE NERVOUS, ENDOCRINE, AND DIGESTIVE SYSTEMS AND FACILITATE THE REMOVAL OF TOXINS MAY ASSIST THE BODY IN THE HEALING PROCESS.

17. CYTOKINE (INFLAMMATION like signaling hormone) A CAUSE OF:FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME “cytokines regulate the immune system responses and can drive the inflammatory process.” Dr. Lionel Ivashkiv It is thought that highly elevated cytokine levels found in the brains of Alzheimer's patients contribute to their symptoms. Abnormal cytokine activity in rheumatoid arthritis leads to damaged joints. Cytokine disturbances have been implicated, but not always well understood, in other autoimmune disorders as well.

18. According to the latest statistics, new cases of diabetes have increased by 90 percent in the last 10 years, and diabetes or pre-diabetes now strikes one in four Americans. Those are absolutely astounding statistics to say the least. There’s no doubt in my mind that one of the primary fuels for this epidemic is the excess consumption of high fructose corn syrup (HFCS). Several studies over the past few years have also come to this conclusion, including this latest study in Cell Metabolism, in which the researchers note: “Insulin resistance is a common feature of the metabolic syndrome and type 2 diabetes mellitus (T2DM). Both have reached epidemic proportions worldwide with the global adoption of the westernized diet along with increased consumption of fructose, stemming from the wide and increasing use of high-fructose corn syrup sweeteners.   IT IS WELL ESTABLISHED THAT FRUCTOSE IS MORE LIPOGENIC THAN GLUCOSE, AND HIGH-FRUCTOSE DIETS HAVE BEEN LINKED TO HYPERTRIGLYCERIDEMIA, NONALCOHOLIC FATTY LIVER DISEASE (NAFLD), AND INSULIN RESISTANCE.” Nonalcoholic Fatty Liver - Nonalcoholic Steatohepatitis Adiponectin hormone plays a role in the suppression of the metabolic derangements that may result in type 2 diabetes,[4]obesity, atherosclerosis,[3]non-alcoholic fatty liver disease (NAFLD) and an independantrisk factor for metabolic syndrome.[5]

19. Balancing Essential Fats in Foods 3 6 Promotes Health and Prevents Disease

20. 3-eicos make responses long 3 makes 3-eicos Short 3 makes long 3 .

21. 6-eicos make responses long 6 makes 6-eicos Short 6 makes long 6

22. Eicosanoids Differ Anything 3 can do I can do better! 3 6 Good grief! Sometimes 6 is just too much!

23. Eicosanoids Differ Anything 3 can do I can do better! 3 6 Good grief! Sometimes 6 is just too much!

24. Conditions for which you take aspirin, ibuprofen(Motrin), acetominophen(Tylenol), COX-2 blockers, & NSAID’s all have excessive 6-eicosanoids

25. NUTRITION helps in PREVENTION of what gets TREATMENT with DRUGS

26. .

27. Your food choices make the % long 6 in your body

30. One interesting question is whether the change in linoleic acid over the last 100 years correlates with changes in the prevalence rates of major depression in the same time period The next slide describes the correlations between changing cumulative rates of major depression at each age estimated from the ECA data and the linolenic acid (en%) available for consumption in the food supply.

31. Increases in cumulative rates of major depression during the 20th century and increased linoleic acid (en%) in the U.S. food supply. 0.10 Age 35 r = 0.999 F= 268 p<0.00001 Age 45 r = 0.994 F= 286 p<0.0007 0.08 Age 25 r = 0.978 F= 89 p<0.0007 0.06 1985 Cumulative rates of depression 0.04 1975 0.02 1965 1955 0.00 1945 1935 1925 -0.02 2 3 4 5 6 7 8 Linoleic acid, energy % of all foods available for consumption Hibbeln et al 2002, unpublished

34. A great approach to address a number of patient concerns Fully-reacted magnesium glycinate enables therapeutic levels of oral magnesium supplementation without gastrointestinal upset or diarrhea7 • Dosage levels 300 - 600 mg • Fibromyalgia1 - Chronic fatigue2 • Migraine3 - Muscle spasm4 • Tension headache5 -Persistent muscle pain6 • 1.Abraham GE, Flechas JD. Nutr Med1992;3:4959 • Durlach J. Magnes Res1992;5(1):68 • Peikert A, Wilimzig C, Kohne-Volland R.. Cephalalgia. 1996 Jun;16(4):257-63 • Webb WL, Gehi M. Psychosomatics 1981;22:1991-1203 • Altura BM, Altura BT. Med Hypotheses. 2001 Dec;57(6):705-13 • Bilbey DL, Prabhakaran VM. Can Fam Physician. 1996 Jul;42:1348-51 • Schuette SA, et al. JPEN J Parenter Enteral Nutr 1994 Sep-Oct;18(5):430-5

39. CONSIDERATIONS:Calm systemic inflammatory statusSupport antioxidant pathwaysAddress fatty acid profileAssess status of hsCRP and other inflammatory markersAssess general physical symptoms with MSQNUTRITIONAL SUPPORT:Medical food for inflammationAnti-inflammatory diet programRIAA and vitamin D nutraceuticalOmega-3 (high EPA) supplement