Tuesday, April 28, 2009

Acid Reflux

Acid blocking drugs are some of the most prescribed medications in the country. Aside from those using prescription medications, forty percent of adults self-medicate with antacids and other OTC medications.

But inhibiting stomach acid may not be such a good thing.

Hydrochloric acid (HCl) plays many important physiological roles. Aside from its obvious role and breaking down solid food that can be passed into the small intestine, HCl also assists in protein digestion, facilitates the absorption of minerals and B-vitamins, and stimulates pancreatic enzymes and bile secretion. HCl also protects against orally-ingested pathogens and is the first line defense against infections, helping prevent bacterial and fungal overgrowth of the small intestine.

In short, blocking acid production can set the stage for a variety of maladies related to nutrient deficiencies and bacterial infestations. Yet these drugs are first line therapy for acid reflux and represent the third highest selling category of OTC medications. Thus, exploring alternative methods is paramount.

Understanding Stomach Physiology
When food is present in the stomach, the parietal cells go to work to secrete pepsin and HCl. The stomach then proceeds to gently churn up the mix until the food is pulverized into a soupy consistency that can be passed into the small intestine for extraction of nutrients into the bloodstream. During this process a signal is sent to the esophageal sphincter muscle at the top of the stomach and it closes tight, preventing access of the stomach contents into the esophagus.

The length of time that this process takes will vary depending on the size of the meal, but even with larger meals it usually takes a couple of hours at the most if everything is in order.

When Things Go Awry
A number of different factors play into why stomach function goes awry and people begin to experience acid reflux.

For one, the quality of nutrition is huge. The parietal cells of the stomach are very dependant upon certain nutrients, especially zinc, for their normal function, and when nutrient deficiencies are present the production of stomach acid can be affected.

Stress is also a factor, as chronic stress has been implicated in causing sometimes catastrophic changes in various functions of GI health.

Additionally, sometimes there is literally a structural malfunction of the esophageal sphincter muscle that sometimes requires surgery to repair.

For this post we’ll focus our attention on stomach acid production.

Is the Burning Because of Too Much Acid, or Too Little?
The common medical mindset pertaining to acid reflux is that too much stomach acid causes acid reflux. I suppose sometimes that is true, but more often than not it probably isn’t true. The reason is that if there is a malfunction in the stomach acid secretion process such as a nutrient deficiency, then two things can happen: 1) The mechanism that is supposed to signal the esophageal sphincter to close off after the parietal cells begin secreting acid is weak or sometimes broken altogether since there is too little stomach acid to initiate it. Thus, the sphincter remains relaxed and acid can backwash up into the esophagus, which of course is very uncomfortable. 2) Because of too little stomach acid to break down food properly, food can sit in the stomach for hours and putrefy, thus causing build up of gases in the stomach that pushes the acids to the top of the stomach and causes reflux.

In short, acid reflux can very often – perhaps more often than not – be caused by not enough stomach acid, not too little of it.

An Alternative Solution
A simple solution to the problem of acid reflux is to give MORE acid, not suppress what little you have. HCl and pepsin can be provided in tablet form and can be used to supplement one’s own production of stomach acid so that food is broken down properly, gas and bloating is reduced, and reflux is controlled.

Given the current trends in the reduction of stomach acid production with age, it stands to reason that most people suffer from having too little instead of too much. Research shows that by the time the average person is 40, stomach acid production is reduced by 50% compared to age 20. And by the age of 60 the production is reduced by two thirds as compared to age 20. Timiras PS. Aging of the gastrointestinal tract and liver. In: Timiras PS, ed. Physiological basis of aging and geriatrics. 2nd ed. Boca Raton: CRC Press1994:247-57.

Likewise, the use of a novel agent known as zinc-carnosine has been shown to be remarkably effective in treating acid indigestion and diminishing the presence of a bacteria called, Helicobacter Pylori, which has been implicated in stomach ulcers.

Symptoms of Low Stomach Acid
-Bloating or distention after eating
• Diarrhea or constipation
• Indigestion
• Excessive belching, burping and/or bloating
• Flatulence after eating
• Sense of fullness during and after meals (prolonged)
• Poor appetite, disinterest in food
• Offensive breath
• Bad taste in mouth
• Partial loss of taste or smell
• Difficult bowel movements
• Difficulty swallowing
• Unintentional weight loss
• History of anemia, unresponsive to iron
• Spoon shaped nails
• Sores in corner of mouth
• Smooth tongue

Section 1, Part A of the Health Appraisal Questionnaire is a quick and easy way for practitioners to diagnose possible stomach acid issues.
Related formulas:
Zinlori 75

Monday, April 13, 2009

Stressed and Tired: Adrenal Support part 4

In this final installment of my adrenal stress series, let’s take a look at low cortisol and the end stages of adrenal fatigue.

Recall that in the first stages of adrenal stress the cortisol is upregulated and the patient presents with anxiety, irritability, nervousness, and an inability to cope with stress. When that condition goes on long enough, the adrenals eventually become very fatigued and cortisol drops off to below normal, and sometimes flat lines altogether. When that happens, severe and prolonged fatigue sets in, and along with it a whole host of other related maladies, such as low libido and reproductive problems, muscle aches and inflammation, low immunity, and allergic reactions, to name just a few.

Nutritionally, these patients need aggressive support in nourishing the adrenal glands directly with adrenal extract, B-vitamins, magnesium, etc, as discussed in previous posts. But the plant kingdom also offers some very powerful options for supporting the entire HPA axis in these patients.

Of note are four herbs in particular: Rhodiola, Cordyceps, ginseng, and Licorice.

Also known as “Arctic Root,” Rhodiola is a flowering plant that grows at high altitudes in regions of Eastern Europe and Asia. In Russia, rhodiola has been used for centuries to cope with the cold Siberian climate and stressful life, where it was valued for its purported ability to promote energy and stamina, enhance mental and physical performance, and prevent fatigue. Russian scientists conducted a great deal of anti-stress research on rhodiola, who categorized is as an adaptogen due to its ability to increase resistance to a variety of chemical, biological, and physical stressors. Based upon the impressive results of this research, rhodiola became widely used by Russian athletes and cosmonauts to help maintain energy levels, promote a healthy mood, and increase attention span and physical performance.

Cordyceps is one of the most valued medicinal plants in Chinese medicine, where it is traditionally used as an adaptogen to support vitality, as a lung and kidney tonic, and to stimulate libido. It has similar properties to those of ginseng, such that it is traditionally used to strengthen the body after exhaustion. The wide spectrum of activities of cordyceps in quite impressive, with observations of beneficial effects on the respiratory, renal, hepatic, cardiovascular, immunological, and nervous systems, as well as glucose and lipid metabolism.

Asian Ginseng
Ginseng root is a highly valued tonic in traditional Chinese medicine, noted for its ability to stimulate mental and physical activity, enhance stamina and prevent fatigue, and increase resistance to stress. According to tradition, the individual who will benefit from ginseng is run down and has exhausted his/her reserves. Although the exact mechanisms have not been determined, animal and human studies suggest that ginseng may influence the activity of the HPA axis in multiple ways. These mechanisms may include 1) promoting the synthesis of corticosterones by increasing levels of cyclic adenosine monophosphate in the adrenal cortex, 2) influencing feedback mechanisms of stress hormone receptors, 3) stimulating adrenocorticotropic hormone (ACTH) in the pituitary gland, 4) increasing HPA sensitivity to glucose corticoids, and 5) inhibiting cortisone-induced adrenal and thymic atrophy. Through these actions, ginseng appears to promote a healthy stress response by helping to balance HPA axis function.

Licorice is an herb with an unparalleled reputation for promoting health and longevity, and it has gained a reputation for strengthening the body during periods of stress. This perennial herb is native to southern Europe, Asia, and the Mediterranean, and was used by ancient Chinese, Egyptian, Greek, and Roman cultures. Currently, licorice is not only one of the most frequently used herbs in traditional Chinese medicine, but it is one of the most popular and widely used herbs in the world. Licorice is well known for its ability to influence adrenal hormone levels. The adrenocorticoid activity of licorice is associated with glycyrrhizic acid and glycyrretinic acid. These activities have ben reported to bind to both glucocorticoid and mineralcorticoid receptors, possibly displacing endogenous steroids and thus contributing to an increase in cortisol availability. Additionally, research suggests that glycyrrhizic acid and glycyrretinic acid increase the half life of cortisol by inhibiting its enzymatic breakdown in the kidneys and liver, thus it is an excellent choice for those with low cortisol production.

Licorice also demonstrates immunosupportive, immunomodulatory, hepatoprotective, and detoxifying qualities. In addition, licorice is traditionally and widely used to promote the health of and soothe mucous membranes of the respiratory and digestive systems.

While the best method of dealing with stress is to get out from under it, that is not always possible in the fast-paced Westernized culture. However, nutritional support of stress defense mechanisms is an excellent way to prevent and treat stress-related conditions.

Related formulas:

Tuesday, April 7, 2009

Managing Stress-Related Disorders, Part 3: Adrenal Extract

The endocrine system is like a house of cards. It is an interwoven system where all the individual components are interdependent. It is therefore difficult to affect one area of it without tripping off the whole thing. That is important in understanding adrenal fatigue, because the stress on the adrenals could actually be caused by another malfunctioning system, such as that of blood sugar metabolism. But that is a discussion for another day.

In the last post I talked about hypercortisolemia, where the cortisol is in a chronic state of elevation and the patient manifests with anxiety, restless sleep, irritability, etc. When that state goes on long enough, soon the adrenal glands begin to fatigue and the cortisol drops off. Since we need a certain amount of cortisol for normal function, a lack of it can cause terrible fatigue, low libido, a loss of drive and motivation, and eventually inflammation.

For this post, let’s focus on treating low cortisol with the use of adrenal glandulars.

Glandular Therapy for Adrenal Support
The concept of using animal tissues in treatment of disease and support of health is a controversial one in medicine, with opinions ranging from useless to miraculous. On the one hand, we have thyroid hormones, insulin, and estrogens, for example, which are used routinely. On the other hand, we have extracts of tissues from glands such as adrenal, pancreas, pituitary, thyroid, etc, which can be taken orally to help support those same tissues in humans.

The argument against using glandulars as supplements is that it is simplistic to think that eating an animal’s glands would help strengthen one’s own like glands. From a medical perspective, one should be able to measure the hormone activity of any substances used and monitor their effects in the body. Glandulars, however, are usually measured by the amount of the actual glands present, but we do not really know what they do. Further, since these glands are broken down into their basic nutrients in the digestive tract, many believe that they would not necessarily go directly to improve one’s own glands.

The pro argument is that it is likely that the basic components of those gland tissues may offer the precursor substances that our own bodies and glands can use to enhance their functions. And there may be hidden factors that may offer some benefit. The glands, like foods, supply basic nutrients, such as amino acids, fatty acids, vitamins, other active substances, and a potential "life force," for lack of a better term, where a drug will not. Some evidence from radioisotope studies suggests that glands, when eaten, do in fact influence the function of the human glands.

In modern medicine, glandular therapy began in the late nineteenth century when physicians suggested that their patients eat the animal parts, usually from cows, that corresponded to the weak areas of their own bodies. So people began eating brains, hearts, kidneys, and so on as part of their medical treatment.

Actually, glandular therapy began much earlier than this, as the ancient Greeks and Egyptians used it following their basic premise that "like heals like." Technology and medical endocrinology evolved this therapy by isolating specific hormones at the source of the glands’ activities (just as we extracted the active pharmaceutical drugs from whole plants). These new drugs are more potent, but they also have more potential for dangerous side effects than the whole glands.

For example, desiccated thyroid gland was first utilized in the late 1800s to help people with goiter and low thyroid function. Then thyroxine (T4) was isolated and used, but many doctors still preferred the whole gland as it was felt to be better absorbed and utilized by the body. Later, the other thyroid hormones, triiodothyronine (T3) and calcitonin were discovered, but these were always part of the whole gland. Today, both individual synthetic hormones and measured active thyroid tissue are used to support or replace thyroid activity.

In the early 1920s, insulin was isolated by Sir Frederick Banting and Charles H. Best, who received the Nobel Prize for their discovery. Insulin has been a lifesaver for many diabetics, but it is also a potentially dangerous drug because it has such a narrow range of safe uses. Overdoses can cause very low blood sugar and shock. Insulin is destroyed in the gut, so it must be injected. It is possible that when extracts of pancreatic tissue are used as supplements, as with other glands, certain molecules protect the active hormones from the digestive juices, and some of these substances actually get into the body. The whole pancreas gland, which had previously been used, is certainly safer than insulin, but pancreas itself is not thought to be strong enough to treat diabetes once it is established.

In the case of treating conditions associated with adrenal fatigue, adrenal glandulars are often suggested for people who experience fatigue, stress, environmental sensitivities or allergies, infections, and hypoglycemia. The symptoms that come from low blood sugar are probably more related to adrenal than to pancreas, and supporting the adrenals with freeze-dried adrenal at 50–100 mg twice daily, along with other stress-supporting nutrients, such as the B vitamins, may be helpful. For extremely low cortisol, some physicians find it useful to super-dose with as much as a gram of adrenal glandular with B-vitamins for a period of a few days to kick start the adrenals back to optimal function. This approach would not be recommended for someone who has elevated cortisol, but could be very helpful for those who are experiencing the overwhelming symptoms of low cortisol.

In my 15+ years in this industry, I have come to rely heavily upon third party data, but have also learned to not rule out clinical experience even when research is lacking. And the clinical experience of hundreds of physicians points to the fact that adrenal extracts works extremely well in treating adrenal fatigue and the associated maladies.

In the next post I’ll introduce you to some other very powerful options from the plant kingdom in supporting the HPA axis and sluggish adrenals.