Chronic stress and inflammation will take you right over the edge of the cliff as far as disease is concerned—especially if you're already standing on the rim of it. They increase your risk of developing certain neurodegenerative diseases, such as multiple sclerosis, as well as a host of other inflammation-based diseases.
Also, they can elevate the severity of the disease process. Using mice, researchers simulated a chronic-stress situation by placing three young males together for a few weeks. Once the mice had become situated and comfortable living together in this environment, establishing their own natural hierarchy, the researchers then upset the applecart. An aggressive male mouse was introduced into the mix for a couple of hours each night for three consecutive nights. To throw the mice off a bit, they got the next night off from the aggressor before an entirely new aggressor was introduced. This guaranteed that the young mice never knew what to count on next and were in a state of chronic stress. To add to their environmental stress, the mice were given Theiler's murine encephalomyelitis (TMEV)—an infection of the central nervous system that is similar to multiple sclerosis in humans.
The result was an increase in their cytokines (particularly interleukin-6), which is a pro- inflammatory protein that helps the inflammation process along. This cytokine regulates the infection-fighting portion of the immune system. And an increase in this cytokine was found to increase the severity of their infection from the TMEV. This was enough to spur on inflammation, resulting in a weakened early immune response to that infection.
Once the early immune response is affected adversely, the stage has been set for later immune response—which means it will continue to be weak. What this means for you is that whether you are currently dealing with a disease or are simply at risk for one, chronic stress will tip you over the edge. Not only will it make current conditions worse, it can actually fire up the disease process to take hold faster.
I recommend that you master a stress-fighting strategy that works for you. Many community hospitals and colleges offer courses in stress-management techniques, whether they are based on ancient Eastern practices like tai chi and meditation or on a modern-day alternative like biofeedback. Make it a priority to get stress under new management.
Dr. Alan Inglis House Calls
Tuesday, September 11, 2007
Certain Foods can Help or Hinder Arthritis Symptoms
For arthritis patients – especially those with rheumatoid arthritis (RA) – certain foods can help or hinder arthritis symptoms. But many patients aren't aware of the effects these foods produce.
Tomatoes contain solanine, an alkaloid known for its toxicity. Potatoes, eggplants and peppers are also members of the Solanum family. These plants are known as nightshade plants, and the solanine in their leaves and roots provide natural protection against insects. For most of us non-insects, solanine is neutralized in the intestine. But because solanine foods often trigger joint pain, some researchers believe that arthritis patients may lack the intestinal mechanism that undoes solanine's toxicity.
One report noted that a solanine-free diet won't reduce joint pain right away, and for some patients it may have no effect at all. Meanwhile, a study from Europe shows that rheumatoid arthritis patients may require an entirely different dietary change in order to find relief.
Meat of the matter - Scientists at university research facilities in Norway and Sweden conducted a study to investigate reports that certain foods may increase RA severity. Their plan: Measure antibody response. Antibodies are proteins produced by the body as an immune response to the presence of antigens; substances the body perceives as toxic.
STUDY ABSTRACT
Researchers recruited 14 patients with RA, and 20 healthy control subjects
Blood samples and intestinal fluids were examined for antibody activity
Irregular antibody response was significant among many of the RA patients, but not among the healthy subjects
In particular, high levels of antibodies were detected in the intestines
Researchers concluded that milk, pork, cod, eggs and cereal triggered antibody activity In recent years, we've seen reports that a high intake of red meat might be linked to RA risk. This study sheds new light on that link, recognizing that certain people may be predisposed to develop RA when their diet includes plenty of high-protein foods. More research is needed to clarify the RA/protein link. In the meantime, researchers point out that doctors should pay close attention when RA patients report suspicions about foods they think may play a role in the severity of their condition.
High C - While we're on the subject of rheumatoid arthritis and diet… In the e-Alert "Behavior Mod Squad" (10/2/03), a University of Manchester (UM) study that analyzed the association between RA and dietary vitamin C intake among 25,000 subjects over an eight-year period. Only 73 subjects developed RA, and their diets had one thing in common: low intake of fruits and vegetables.
And almost two years later, another UM study in the e-Alert "Calming the Flame" (8/23/05), the UM team expanded on their previous research (again using the data from the cohort of 25,000 subjects) and found that subjects who consumed the most foods that contained two key carotenoids (zeaxanthin and beta-cryptoaxanthin) were significantly less likely to develop inflammatory polyarthritis (a form of RA) compared to subjects who consumed the least of the two nutrients. Good sources of zeaxanthin and beta-cryptoaxanthin include oranges, tangerines, watermelon, peaches, papaya, plums, nectarines, apricots, pumpkin squash, corn, carrots, cilantro and pickles. http://www.hsibaltimore.com/ealerts/freecopy.html
Tomatoes contain solanine, an alkaloid known for its toxicity. Potatoes, eggplants and peppers are also members of the Solanum family. These plants are known as nightshade plants, and the solanine in their leaves and roots provide natural protection against insects. For most of us non-insects, solanine is neutralized in the intestine. But because solanine foods often trigger joint pain, some researchers believe that arthritis patients may lack the intestinal mechanism that undoes solanine's toxicity.
One report noted that a solanine-free diet won't reduce joint pain right away, and for some patients it may have no effect at all. Meanwhile, a study from Europe shows that rheumatoid arthritis patients may require an entirely different dietary change in order to find relief.
Meat of the matter - Scientists at university research facilities in Norway and Sweden conducted a study to investigate reports that certain foods may increase RA severity. Their plan: Measure antibody response. Antibodies are proteins produced by the body as an immune response to the presence of antigens; substances the body perceives as toxic.
STUDY ABSTRACT
Researchers recruited 14 patients with RA, and 20 healthy control subjects
Blood samples and intestinal fluids were examined for antibody activity
Irregular antibody response was significant among many of the RA patients, but not among the healthy subjects
In particular, high levels of antibodies were detected in the intestines
Researchers concluded that milk, pork, cod, eggs and cereal triggered antibody activity In recent years, we've seen reports that a high intake of red meat might be linked to RA risk. This study sheds new light on that link, recognizing that certain people may be predisposed to develop RA when their diet includes plenty of high-protein foods. More research is needed to clarify the RA/protein link. In the meantime, researchers point out that doctors should pay close attention when RA patients report suspicions about foods they think may play a role in the severity of their condition.
High C - While we're on the subject of rheumatoid arthritis and diet… In the e-Alert "Behavior Mod Squad" (10/2/03), a University of Manchester (UM) study that analyzed the association between RA and dietary vitamin C intake among 25,000 subjects over an eight-year period. Only 73 subjects developed RA, and their diets had one thing in common: low intake of fruits and vegetables.
And almost two years later, another UM study in the e-Alert "Calming the Flame" (8/23/05), the UM team expanded on their previous research (again using the data from the cohort of 25,000 subjects) and found that subjects who consumed the most foods that contained two key carotenoids (zeaxanthin and beta-cryptoaxanthin) were significantly less likely to develop inflammatory polyarthritis (a form of RA) compared to subjects who consumed the least of the two nutrients. Good sources of zeaxanthin and beta-cryptoaxanthin include oranges, tangerines, watermelon, peaches, papaya, plums, nectarines, apricots, pumpkin squash, corn, carrots, cilantro and pickles. http://www.hsibaltimore.com/ealerts/freecopy.html
Monday, September 10, 2007
DID YOU KNOW? One of the biggest new stressors is Electropollution
You are exposed to 100 million times more Electropollution than your grandparents. It comes from the ElectroMagnetic Radiation (EMR) and ElectroMagnetic Frequencies (EMF) that are emitted by every wired and wireless device you use today: Microwaves, computers, game consoles, wireless phones, PDA's, iPods, and cell phones. Many Wellness and Public Health experts believe that they may also be the greatest risk to your health in the 21st Century. Electropollution protection products.
New Completely Revised 3rd edition of From Fatigued to Fantastic!
Jacob Teitelbaum, M.D. has just released his new completely revised third edition of From Fatigued to Fantastic!The complete guide to overcoming: Chronic Exhaustion, Achiness, Brain fog, Poor Sleep, Decreased Sex Drive, Recurrent Infections, and more
Friday, September 7, 2007
33 Secrets to a Good Night's Sleep
If you are having sleep problems, whether you are not able to fall asleep, wake up too often, don't feel well-rested when you wake up in the morning, or simply want to improve the quality and quantity of your sleep, try as many of the following techniques below as possible:
Emotional Freedom Technique (EFT) can help with insomnia. Most people can learn this gentle tapping technique in several minutes. EFT can help balance your body's bioenergy system and resolve some of the emotional stresses that are contributing to the insomnia at a very deep level. The results are typically long lasting and the improvement is remarkably rapid.
Listen to white noise or relaxation CDs. Some people find the sound of white noise or nature sounds, such as the ocean or forest, to be soothing for sleep. An excellent relaxation/meditation option to listen to before bed is the Insight audio CD.
Avoid before-bed snacks, particularly grains and sugars. This will raise blood sugar and inhibit sleep. Later, when blood sugar drops too low (hypoglycemia), you might wake up and not be able to fall back asleep.
Sleep in complete darkness or as close as possible. If there is even the tiniest bit of light in the room it can disrupt your circadian rhythm and your pineal gland's production of melatonin and seratonin. There also should be as little light in the bathroom as possible if you get up in the middle of the night. Please whatever you do, keep the light off when you go to the bathroom at night. As soon as you turn on that light you will for that night immediately cease all production of the important sleep aid melatonin.
No TV right before bed. Even better, get the TV out of the bedroom or even out of the house, completely. It is too stimulating to the brain and it will take longer to fall asleep. Also disruptive of pineal gland function for the same reason as above.
Wear socks to bed. Due to the fact that they have the poorest circulation, the feet often feel cold before the rest of the body. A study has shown that this reduces night wakings.
Read something spiritual or religious. This will help to relax. Don't read anything stimulating, such as a mystery or suspense novel, as this may have the opposite effect. In addition, if you are really enjoying a suspenseful book, you might wind up unintentionally reading for hours, instead of going to sleep.
Avoid using loud alarm clocks. It is very stressful on the body to be awoken suddenly. If you are regularly getting enough sleep, they should be unnecessary. The Sun Alarm SA-2002 provides an ideal way to wake up each morning if you can't wake up with the REAL sun. Combining the features of a traditional alarm clock (digital display, AM/FM radio, beeper, snooze button, etc) with a special built-in light that gradually increases in intensity, this amazing clock simulates a natural sunrise. It also includes a sunset feature where the light fades to darkness over time - ideal for anyone who has trouble falling asleep.
Journaling. If you often lay in bed with your mind racing, it might be helpful keep a journal and write down your thoughts before bed.
Melatonin and its precursors. If behavioral changes do not work, it may be possible to improve sleep by supplementing with the hormone melatonin. However, I would exercise extreme caution in using it, and only as a last resort, as it is a powerful hormone. Ideally it is best to increase levels naturally with exposure to bright sunlight in the daytime (along with full spectrum fluorescent bulbs in the winter) and absolute complete darkness at night. One should get blackout drapes so no light is coming in from the outside. One can also use one of melatonin's precursors, L-tryptophan or 5-hydroxytryptophan (5-HTP). L-tryptophan is the safest and my preference, but must be obtained by prescription only. However, don't be afraid or intimidated by its prescription status. It is just a simple amino acid.
Get to bed as early as possible. Our systems, particularly the adrenals, do a majority of their recharging or recovering during the hours of 11 p.m. and 1 a.m. In addition, your gallbladder dumps toxins during this same period. If you are awake, the toxins back up into the liver which then secondarily back up into your entire system and cause further disruption of your health. Prior to the widespread use of electricity, people would go to bed shortly after sundown, as most animals do, and which nature intended for humans as well.
Check your bedroom for electro-magnetic fields (EMFs). These can disrupt the pineal gland and the production of melatonin and seratonin, and may have other negative effects as well. One doctor even recommends that people pull their circuit breaker before bed to kill all power in the house (Dr. Herbert Ross, author of "Sleep Disorders"). - devices to protect you from EMF's.
Keep the temperature in the bedroom no higher than 70 degrees F. Many people keep their homes and particularly the upstairs bedrooms too hot.
Eat a high-protein snack several hours before bed. This can provide the L-tryptophan need to produce melatonin and serotonin. Also eat a small piece of fruit. This can help the tryptophan cross the blood-brain barrier.
Reduce or avoid as many drugs as possible. Many medications, both prescription and over-the-counter may have effects on sleep. In most cases, the condition, which caused the drugs to be taken in the first place, can be addressed by following the guidelines elsewhere on this web site.
Avoid caffeine. A recent study showed that in some people, caffeine is not metabolized efficiently and therefore they can feel the effects long after consuming it. So an afternoon cup of coffee (or even tea) will keep some people from falling asleep. Also, some medications, particularly diet pills contain caffeine.
Alarm clocks and other electrical devices. If these devices must be used, keep them as far away from the bed as possible, preferably at least 3 feet.
Avoid alcohol. Although alcohol will make people drowsy, the effect is short lived and people will often wake up several hours later, unable to fall back asleep. Alcohol will also keep you from falling into the deeper stages of sleep, where the body does most of its healing.
Lose weight. Being overweight can increase the risk of sleep apnea, which will prevent a restful night’s sleep.
Avoid foods that you may be sensitive to. This is particularly true for dairy and wheat products, as they may have effect on sleep, such as causing apnea, excess congestion, gastrointestinal upset, and gas, among others.
Don't drink any fluids within 2 hours of going to bed. This will reduce the likelihood of needing to get up and go to the bathroom or at least minimize the frequency.
Take a hot bath, shower or sauna before bed. When body temperature is raised in the late evening, it will fall at bedtime, facilitating sleep, Remove the clock from view. It will only add to your worry when constantly staring at it... 2 a.m. ...3 a.m. ... 4:30 a.m....
Keep your bed for sleeping. If you are used to watching TV or doing work in bed, you may find it harder to relax and to think of the bed as a place to sleep.
Have your adrenals checked by a good natural medicine clinician. Scientists have found that insomnia may be caused by adrenal stress (Journal of Clinical Endocrinology & Metabolism, August 2001; 86:3787-3794).
If you are menopausal or perimenopausal, get checked out by a good natural medicine physician. The hormonal changes at this time may cause problems if not properly addressed.
Don't change your bedtime. You should go to bed, and wake up, at the same times each day, even on the weekends. This will help your body to get into a sleep rhythm and make it easier to fall asleep and get up in the morning.
Make certain you are exercising regularly. Exercising for at least 30 minutes everyday can help you fall asleep. However, don't exercise too close to bedtime or it may keep you awake. Studies show exercising in the morning is the best if you can do it.
Establish a bedtime routine. This could include meditation, deep breathing, using aromatherapy or essential oils or indulging in a massage from your partner. The key is to find something that makes you feel relaxed, then repeat it each night to help you release the day's tensions.
Go to the bathroom right before bed. This will reduce the chances that you'll wake up to go in the middle of the night.
Wear an eye mask to block out light. As said above, it is very important to sleep in as close to complete darkness as possible. That said, it's not always easy to block out every stream of light using curtains, blinds or drapes, particularly if you live in an urban area (or if your spouse has a different schedule than you do). In these cases, an eye mask can help to block out the remaining light.
Put your work away at least one hour (but preferably two or more) before bed. This will give your mind a chance to unwind so you can go to sleep feeling calm, not hyped up or anxious about tomorrow's deadlines.
Emotional Freedom Technique (EFT) can help with insomnia. Most people can learn this gentle tapping technique in several minutes. EFT can help balance your body's bioenergy system and resolve some of the emotional stresses that are contributing to the insomnia at a very deep level. The results are typically long lasting and the improvement is remarkably rapid.
Listen to white noise or relaxation CDs. Some people find the sound of white noise or nature sounds, such as the ocean or forest, to be soothing for sleep. An excellent relaxation/meditation option to listen to before bed is the Insight audio CD.
Avoid before-bed snacks, particularly grains and sugars. This will raise blood sugar and inhibit sleep. Later, when blood sugar drops too low (hypoglycemia), you might wake up and not be able to fall back asleep.
Sleep in complete darkness or as close as possible. If there is even the tiniest bit of light in the room it can disrupt your circadian rhythm and your pineal gland's production of melatonin and seratonin. There also should be as little light in the bathroom as possible if you get up in the middle of the night. Please whatever you do, keep the light off when you go to the bathroom at night. As soon as you turn on that light you will for that night immediately cease all production of the important sleep aid melatonin.
No TV right before bed. Even better, get the TV out of the bedroom or even out of the house, completely. It is too stimulating to the brain and it will take longer to fall asleep. Also disruptive of pineal gland function for the same reason as above.
Wear socks to bed. Due to the fact that they have the poorest circulation, the feet often feel cold before the rest of the body. A study has shown that this reduces night wakings.
Read something spiritual or religious. This will help to relax. Don't read anything stimulating, such as a mystery or suspense novel, as this may have the opposite effect. In addition, if you are really enjoying a suspenseful book, you might wind up unintentionally reading for hours, instead of going to sleep.
Avoid using loud alarm clocks. It is very stressful on the body to be awoken suddenly. If you are regularly getting enough sleep, they should be unnecessary. The Sun Alarm SA-2002 provides an ideal way to wake up each morning if you can't wake up with the REAL sun. Combining the features of a traditional alarm clock (digital display, AM/FM radio, beeper, snooze button, etc) with a special built-in light that gradually increases in intensity, this amazing clock simulates a natural sunrise. It also includes a sunset feature where the light fades to darkness over time - ideal for anyone who has trouble falling asleep.
Journaling. If you often lay in bed with your mind racing, it might be helpful keep a journal and write down your thoughts before bed.
Melatonin and its precursors. If behavioral changes do not work, it may be possible to improve sleep by supplementing with the hormone melatonin. However, I would exercise extreme caution in using it, and only as a last resort, as it is a powerful hormone. Ideally it is best to increase levels naturally with exposure to bright sunlight in the daytime (along with full spectrum fluorescent bulbs in the winter) and absolute complete darkness at night. One should get blackout drapes so no light is coming in from the outside. One can also use one of melatonin's precursors, L-tryptophan or 5-hydroxytryptophan (5-HTP). L-tryptophan is the safest and my preference, but must be obtained by prescription only. However, don't be afraid or intimidated by its prescription status. It is just a simple amino acid.
Get to bed as early as possible. Our systems, particularly the adrenals, do a majority of their recharging or recovering during the hours of 11 p.m. and 1 a.m. In addition, your gallbladder dumps toxins during this same period. If you are awake, the toxins back up into the liver which then secondarily back up into your entire system and cause further disruption of your health. Prior to the widespread use of electricity, people would go to bed shortly after sundown, as most animals do, and which nature intended for humans as well.
Check your bedroom for electro-magnetic fields (EMFs). These can disrupt the pineal gland and the production of melatonin and seratonin, and may have other negative effects as well. One doctor even recommends that people pull their circuit breaker before bed to kill all power in the house (Dr. Herbert Ross, author of "Sleep Disorders"). - devices to protect you from EMF's.
Keep the temperature in the bedroom no higher than 70 degrees F. Many people keep their homes and particularly the upstairs bedrooms too hot.
Eat a high-protein snack several hours before bed. This can provide the L-tryptophan need to produce melatonin and serotonin. Also eat a small piece of fruit. This can help the tryptophan cross the blood-brain barrier.
Reduce or avoid as many drugs as possible. Many medications, both prescription and over-the-counter may have effects on sleep. In most cases, the condition, which caused the drugs to be taken in the first place, can be addressed by following the guidelines elsewhere on this web site.
Avoid caffeine. A recent study showed that in some people, caffeine is not metabolized efficiently and therefore they can feel the effects long after consuming it. So an afternoon cup of coffee (or even tea) will keep some people from falling asleep. Also, some medications, particularly diet pills contain caffeine.
Alarm clocks and other electrical devices. If these devices must be used, keep them as far away from the bed as possible, preferably at least 3 feet.
Avoid alcohol. Although alcohol will make people drowsy, the effect is short lived and people will often wake up several hours later, unable to fall back asleep. Alcohol will also keep you from falling into the deeper stages of sleep, where the body does most of its healing.
Lose weight. Being overweight can increase the risk of sleep apnea, which will prevent a restful night’s sleep.
Avoid foods that you may be sensitive to. This is particularly true for dairy and wheat products, as they may have effect on sleep, such as causing apnea, excess congestion, gastrointestinal upset, and gas, among others.
Don't drink any fluids within 2 hours of going to bed. This will reduce the likelihood of needing to get up and go to the bathroom or at least minimize the frequency.
Take a hot bath, shower or sauna before bed. When body temperature is raised in the late evening, it will fall at bedtime, facilitating sleep, Remove the clock from view. It will only add to your worry when constantly staring at it... 2 a.m. ...3 a.m. ... 4:30 a.m....
Keep your bed for sleeping. If you are used to watching TV or doing work in bed, you may find it harder to relax and to think of the bed as a place to sleep.
Have your adrenals checked by a good natural medicine clinician. Scientists have found that insomnia may be caused by adrenal stress (Journal of Clinical Endocrinology & Metabolism, August 2001; 86:3787-3794).
If you are menopausal or perimenopausal, get checked out by a good natural medicine physician. The hormonal changes at this time may cause problems if not properly addressed.
Don't change your bedtime. You should go to bed, and wake up, at the same times each day, even on the weekends. This will help your body to get into a sleep rhythm and make it easier to fall asleep and get up in the morning.
Make certain you are exercising regularly. Exercising for at least 30 minutes everyday can help you fall asleep. However, don't exercise too close to bedtime or it may keep you awake. Studies show exercising in the morning is the best if you can do it.
Establish a bedtime routine. This could include meditation, deep breathing, using aromatherapy or essential oils or indulging in a massage from your partner. The key is to find something that makes you feel relaxed, then repeat it each night to help you release the day's tensions.
Go to the bathroom right before bed. This will reduce the chances that you'll wake up to go in the middle of the night.
Wear an eye mask to block out light. As said above, it is very important to sleep in as close to complete darkness as possible. That said, it's not always easy to block out every stream of light using curtains, blinds or drapes, particularly if you live in an urban area (or if your spouse has a different schedule than you do). In these cases, an eye mask can help to block out the remaining light.
Put your work away at least one hour (but preferably two or more) before bed. This will give your mind a chance to unwind so you can go to sleep feeling calm, not hyped up or anxious about tomorrow's deadlines.
Tuesday, September 4, 2007
Chronic Back Pain May Shrink the Brain
Scientists Link Long-Lasting Pain With Reduced Levels of Gray Matter. A recent study published in The Journal of Neuroscience has revealed that people who suffer from chronic back pain (CBP) for one year may experience a reduction in the brain's gray matter equivalent to the amount lost by the average person in 10 to 20 years of normal aging.
The study is believed to be the first of its kind to show brain morphometric abnormalities in chronic pain. Also found in the spinal cord, "gray matter" refers to the darker- colored tissue of the brain, which is composed of the bodies of neurons. In the brain, the gray matter includes structures such as the cerebral cortex, the thalamus, the basal ganglia, and the outer layers of the cerebellum.
Gray matter is considered by many to be the "thinking" center of the brain, and is responsible for functions such as memory and information processing. In the study, investigators compared 26 CBP patients with 26 matched normal volunteers. The CBP patients experienced unrelenting pain for one year, "primarily localized to the lumbosacral region including buttocks and thighs, with or without pain radiating to the leg." Of those with CBP, 55 percent had musculoskeletal diagnoses, 20 percent had pure radiculopathy, and 26 percent had a combination of musculoskeletal and radiculopathic pain.
CBP patients were divided into neuropathic and non-neuropathic subtypes, with neuropathic patients experiencing significant radiculopathy, with or without the presence of musculoskeletal pain. The normal decrease in neocortical gray matter volume was found to be 2.8 cm3 (0.5%) per year in both groups. After adjusting for age and gender factors, the investigators found that the resultant gray matter volume loss was 663 ± 27 cm3 in the control subjects and 590 ± 28 cm3 in the CBP patients, reflecting an 11 percent decrease in gray matter volume for those with CBP. CBP patients with sciatica had the largest decrease in gray matter.
In addition, the more years someone had chronic back pain, the more loss of gray matter they suffered. Interestingly enough, the authors found that the "mean gray matter volume was not different between neuropathic (nuCBP) and non-neuropathic (non-nuCBP) subtypes." From their findings, the authors arrived at several conclusions: "The role of the brain in chronic pain conditions remains speculative. Our results imply that chronic back pain (CBP) is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes. "Our studies show that CBP (sustained for six months) is accompanied by abnormal brain chemistry, mainly a reduction in the N-acetyl-aspartate-creatine ratio in the prefrontal cortex, implying neuronal loss or dysfunction in this region and reduced cognitive abilities on a task that implies abnormal prefrontal processing. "Our results demonstrate regionally specific reduced gray matter in patients with CBP. At the whole-brain level, this reduction is related to pain duration, regionally depends on multiple pain related characteristics, and is more severe in the neuropathic sub-type. "Given that normal whole-brain gray matter atrophy is 0.5% per year of aging and that atrophy caused by CBP is 5-11%, the magnitude of brain gray matter atrophy caused by CBP is equivalent to 10-20 years of aging. However, this analogy only holds for the overall magnitude, because the regional specificity of atrophy in CBP is distinct from that seen with aging." While this is the first study to show brain morphometric abnormalities in chronic pain, it is not the only study of morphometry in pain conditions.
Another study conducted in 2003 looked at migraine patients and found no significant differences. Perhaps even more interesting was the revelation that "only 18% of whole-brain matter variance could be explained by pain duration." The authors note that most of the whole-brain atrophy in CBP patients "cannot be accounted for by the measured pain characteristics." The authors suggest that this may imply "genetic and experiential predispositions contributing to the observed atrophy." While this study opens the door for significant speculation, it tends to generate more questions than it answers.
From a chiropractic standpoint, it is easy to see why chronic back pain can cause additional symptoms beyond those that would be considered mechanical in nature. These findings most certainly serve as a serious warning to patients with back pain to seek care as soon as possible in order to prevent the condition from becoming chronic. While there will likely be a number of studies that follow up on these findings, chiropractic researchers should explore the possibility of communicating with these authors in an effort to better understand the details of their methodology and findings. This is an area of research in which chiropractic could test the impact of musculoskeletal pain, spinal joint function and the subluxation.
References
1. Apkarian AV, Sosa Y, Sonty S, et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. The Journal of Neuroscience, Nov. 17, 2004 24(46):10410-10475.
2. Matharu MS, Good CD, May A, et al. No change in the structure of the brain in migraine: a voxel-based morphometric study. Eur J Neurol 2003;10:53-57.
The study is believed to be the first of its kind to show brain morphometric abnormalities in chronic pain. Also found in the spinal cord, "gray matter" refers to the darker- colored tissue of the brain, which is composed of the bodies of neurons. In the brain, the gray matter includes structures such as the cerebral cortex, the thalamus, the basal ganglia, and the outer layers of the cerebellum.
Gray matter is considered by many to be the "thinking" center of the brain, and is responsible for functions such as memory and information processing. In the study, investigators compared 26 CBP patients with 26 matched normal volunteers. The CBP patients experienced unrelenting pain for one year, "primarily localized to the lumbosacral region including buttocks and thighs, with or without pain radiating to the leg." Of those with CBP, 55 percent had musculoskeletal diagnoses, 20 percent had pure radiculopathy, and 26 percent had a combination of musculoskeletal and radiculopathic pain.
CBP patients were divided into neuropathic and non-neuropathic subtypes, with neuropathic patients experiencing significant radiculopathy, with or without the presence of musculoskeletal pain. The normal decrease in neocortical gray matter volume was found to be 2.8 cm3 (0.5%) per year in both groups. After adjusting for age and gender factors, the investigators found that the resultant gray matter volume loss was 663 ± 27 cm3 in the control subjects and 590 ± 28 cm3 in the CBP patients, reflecting an 11 percent decrease in gray matter volume for those with CBP. CBP patients with sciatica had the largest decrease in gray matter.
In addition, the more years someone had chronic back pain, the more loss of gray matter they suffered. Interestingly enough, the authors found that the "mean gray matter volume was not different between neuropathic (nuCBP) and non-neuropathic (non-nuCBP) subtypes." From their findings, the authors arrived at several conclusions: "The role of the brain in chronic pain conditions remains speculative. Our results imply that chronic back pain (CBP) is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes. "Our studies show that CBP (sustained for six months) is accompanied by abnormal brain chemistry, mainly a reduction in the N-acetyl-aspartate-creatine ratio in the prefrontal cortex, implying neuronal loss or dysfunction in this region and reduced cognitive abilities on a task that implies abnormal prefrontal processing. "Our results demonstrate regionally specific reduced gray matter in patients with CBP. At the whole-brain level, this reduction is related to pain duration, regionally depends on multiple pain related characteristics, and is more severe in the neuropathic sub-type. "Given that normal whole-brain gray matter atrophy is 0.5% per year of aging and that atrophy caused by CBP is 5-11%, the magnitude of brain gray matter atrophy caused by CBP is equivalent to 10-20 years of aging. However, this analogy only holds for the overall magnitude, because the regional specificity of atrophy in CBP is distinct from that seen with aging." While this is the first study to show brain morphometric abnormalities in chronic pain, it is not the only study of morphometry in pain conditions.
Another study conducted in 2003 looked at migraine patients and found no significant differences. Perhaps even more interesting was the revelation that "only 18% of whole-brain matter variance could be explained by pain duration." The authors note that most of the whole-brain atrophy in CBP patients "cannot be accounted for by the measured pain characteristics." The authors suggest that this may imply "genetic and experiential predispositions contributing to the observed atrophy." While this study opens the door for significant speculation, it tends to generate more questions than it answers.
From a chiropractic standpoint, it is easy to see why chronic back pain can cause additional symptoms beyond those that would be considered mechanical in nature. These findings most certainly serve as a serious warning to patients with back pain to seek care as soon as possible in order to prevent the condition from becoming chronic. While there will likely be a number of studies that follow up on these findings, chiropractic researchers should explore the possibility of communicating with these authors in an effort to better understand the details of their methodology and findings. This is an area of research in which chiropractic could test the impact of musculoskeletal pain, spinal joint function and the subluxation.
References
1. Apkarian AV, Sosa Y, Sonty S, et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. The Journal of Neuroscience, Nov. 17, 2004 24(46):10410-10475.
2. Matharu MS, Good CD, May A, et al. No change in the structure of the brain in migraine: a voxel-based morphometric study. Eur J Neurol 2003;10:53-57.
Restless Leg Drug (FDA-Approved Drug Makes You Hypersexual and a Compulsive Gambler)
Posted by Dr. Mercola:
Pharmaceutical company GlaxoSmithKline has updated the package insert for its restless legs syndrome (RLS) drug Requip. According to the new insert, Requip may cause “pathological gambling” and “increased libido including hypersexuality.”These side effects are reportedly a class-wide effect, which impact all the drugs belonging to the non-ergoline dopamine agonist class of drugs.
Specifically, the insert reads:
“Impulse control symptoms, including compulsive behaviors such as pathological gambling and hypersexuality, have been reported in patients treated with dopaminergic agents.” Another RLS drug, Mirapex (which is also used to treat Parkinson’s disease), has reported similar symptoms.
The Mirapex package insert reads:
“Patients taking certain medicines to treat Parkinson’s disease or RLS, including Mirapex . . . have reported problems with gambling, compulsive eating, and increased sex drive.”
A 2005 study published in the Archives of Neurology also found that dozens of patients using Mirapex or similar drugs developed serious gambling addictions. Hundreds of people have reportedly contacted lawyers about joining class-action lawsuits that allege Mirapex and Requip caused unusual side effects such as compulsive gambling, shopping, painting and eating.
BrandWeekNRX.com August 14, 2007
Archives of Neurology July 11, 2005 (Free Full-Text Article)
Pharmaceutical company GlaxoSmithKline has updated the package insert for its restless legs syndrome (RLS) drug Requip. According to the new insert, Requip may cause “pathological gambling” and “increased libido including hypersexuality.”These side effects are reportedly a class-wide effect, which impact all the drugs belonging to the non-ergoline dopamine agonist class of drugs.
Specifically, the insert reads:
“Impulse control symptoms, including compulsive behaviors such as pathological gambling and hypersexuality, have been reported in patients treated with dopaminergic agents.” Another RLS drug, Mirapex (which is also used to treat Parkinson’s disease), has reported similar symptoms.
The Mirapex package insert reads:
“Patients taking certain medicines to treat Parkinson’s disease or RLS, including Mirapex . . . have reported problems with gambling, compulsive eating, and increased sex drive.”
A 2005 study published in the Archives of Neurology also found that dozens of patients using Mirapex or similar drugs developed serious gambling addictions. Hundreds of people have reportedly contacted lawyers about joining class-action lawsuits that allege Mirapex and Requip caused unusual side effects such as compulsive gambling, shopping, painting and eating.
BrandWeekNRX.com August 14, 2007
Archives of Neurology July 11, 2005 (Free Full-Text Article)
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