Over the past decade there has been a steady increase
in alternative medicine meetings. Some are organization-based, some
are presentations of individual practitioners, and some have been sponsored
by groups focused on a certain protocol or sponsored by a manufacturing
company. Our Townsend Calendar is burgeoning with meeting announcements,
yet can certainly not be considered all-encompassing. Although the majority
of these meetings do not carry continuing medical education credits,
the material offered greatly exceeds the breadth and scope of our writings
in the Townsend Letter and all the other publications in the alternative
medical arena. Clearly, we need to have representative individuals report
the pertinent findings or summarize practitioner techniques from a broader
number of the meetings held.
One recent meeting held this June in Mallorca, Spain,
organized by American Biologics Company as well as American Biologics-Mexico
Hospital, organized by Brigitte G. Byrd, offered a relaxed atmosphere
to review a number of orthomolecular and anti-aging theories. Dr. Paul
R. Cheney, MD, PhD's work has been discussed in these pages and elsewhere,
but it is always more provocative to hear the lecturer in person review
his/her findings. As director of the Cheney Clinic in Charlotte, North
Carolina, Dr. Cheney has been preeminent in researching chronic fatigue
syndrome. Notes from his lecture offer some interesting "pearls"
about CFS which we may overlook. We may look at this problem as "Energy/Brain/Pain"
as a triad of brain fag, depleted energy and pain are required before
CFS can be diagnosed. Based on good epidemiology, CFS affects 1% of
the population. The number of disability claims based on CFS has climbed
500% from 1989-1993. If year of onset is graphed from 1983 to present,
the highest number of cases are seen to have started in 1987. It is
unclear what etiologic factor might be responsible for onset in 1987,
although this is essentially 4 years after a similar dating can be made
for AIDS. A review of the physical stigmata for CFS is interesting indeed.
There is lymphatic pain, lymphodynia (pain of the lymph system) particularly
supraclavicular pain and posterior cervical pain, but no lymphadenopathy,
no lymph node enlargement. Peculiarly, there is predominance of left-sided
lymphatic pain, which Cheney speculates is due to the lymphatic duct
emptying in the left jugular vein. Swelling is usually noted over the
left supraclavicular area. In 80% of patients, a crimson crescent is
noted over the uvula and tonsils; this is different from the swelling
and erythema of strep throat. Patients are so hyperreflexic that practitioners
need to take caution not to place themselves in the path of the reflexing
lower extremity on testing. There is abnormality on simple standing
with eyes closed; it is not unusual for a patient to topple over. Very
unusual is the loss of fingerprints on many of the fingers; police departments
report it's very rare for fingerprints to be obliterated, yet nearly
40% of CFS patients have some fingerprint obliteration, and 10% cannot
be fingerprinted whatsoever. This appears to be related to a periarteritis
secondary to fibroblasts congregating in the distal circulation. Cheney
suspects that CFS patients, mimicking in many ways a scurvy process,
might have scurvy contributing to fingerprint obliteration.
Chronic fatigue syndrome reveals remarkable abnormalities
in the laboratory arena as well, but not in usual chemistry and CBC
profiles. Researchers investigating cleavage by-products of antibody
digestion, a relatively new area of study in immunology, are fascinated
by the rapidity of immune product digestion in the CFS patient. What
most people would digest immunologically in 20 minutes, the CFS patient
will cleave in 20 seconds. If some of these immune proteins are important
in regulating energy mechanisms, this would mean that the CFS patient
is depleting important enzyme mechanisms 60 times faster than normal.
Such mechanism activation and depletion is seen not only in studies
of cleavage by-products, but also in relatively new studies of mitochondrial
regulation and synthesis of ATP, demonstrating a severe abnormality
in CFS patients.
In the brain arena, abnormalities are now being
noted in the CFS patient cerebellum which are not seen in AIDS, Alzheimer's,
or Parkinson's. Studies comparing relative index of blood flow in the
cerebrum compared to the cerebellum demonstrates an 81% reduction in
cerebellar blood flow of CFS patients, not seen in any of the aforementioned
brain disorders. It is to be noted for the skeptics who consider CFS
to be a form of depression, that a true case of clinical depression
has no abnormality in cerebral to cerebellum blood flow. Abnormal proteins
are also being demonstrated in the CFS patient's spinal fluid, not seen
in the normal or other brain disorders. CFS patients show abnormality
in their ACTH/adrenal biochemistry. Cheney's clinic has studied the
CFS patient using bicycle ergometry, which clearly and definitively
demonstrates the weakness is related to abnormality in their aerobic
metabolism of energy. A normal individual and athlete will show typical
vital capacities of Oxygen, vO2 of 100%. The same study of the CFS patient,
using the bicycle, reveals vO2 of 60%. Cheney compares this to a different
organism, an organism adjusted to anaerobic metabolism, who does not
use normal oxidative mechanisms of energy production. A normal individual
attempts to convert from anaerobic to aerobic metabolism as quickly
as possible, as anaerobic mechanisms are highly inefficient; the CFS
patient survives continuously on anaerobic mechanisms and quickly fails
any effort to change to normal aerobic mechanisms.
Cheney's presentation provided some insight as to
why careless anti-oxidant supplementation of a CFS patient may actually
worsen the patient instead of improve him/her. When the CFS metabolism
is under such high oxidative stress, adding high levels of certain antioxidants
will simply deplete the limited glutathione reserves the individual
has and potentially worsen the mitochondrial energy mechanisms, increasing
the anaerobic metabolism. It is necessary to ensure that vitamin supplements,
including basic antioxidants, also include chelated minerals, superoxide
dismutase, green pigmented foods, bioflavonoids and glutathione to prevent
upregulation of anaerobic metabolism.
Mycotoxins
Undoubtedly, the most controversial work presented
at the meeting was by A.V. Constantini, MD, who notes that he is "just
a general internist," a country doctor who has taken his retirement
days to investigate this relatively new area of pathology, mycotoxins.
We are pleased to note that Dr. Constantini has agreed to submit future
columns to the Townsend Letter to investigate this field, mycotoxins,
exploring its relationship to cancer and cardiovascular pathology as
well as other chronic diseases. His organization, the Collaborative
Center for Mycotoxins in Food is located in Freiburg, Germany.
At the meeting, Dr. Constantini noted that his work
is not based on individual examinations in a private practice, but on
research in the peer-review literature which has been either ignored
or overlooked. His presentation focused on gout which his literature
review concludes is not a disease of metabolism but an infectious, granulomatous
disorder based on abnormality of mycotoxicity, due to exposure to fungus.
Looking at the veterinarian literature, it is observed that chicken
and turkey develop gout from mycotoxins or oosporeins. Animals dosed
with this mycotoxin develop gout. Could this represent a fungal etiology?
Examination of chickens does not reveal uric acid tophi in joints, but
massive complex granuloma with presence of an orchratoxin. Other animal
studies reveal gout processes, again with an infective etiology. Dr.
Constantini questions how a metabolic process, like gout, can form lesions
holding draining pus? He then looked at one of the standard gout cures,
colchicine, to understand its mechanism of action. Colchicine has no
specific activity against uric acid, but is highly effective in the
acute gout attack. His literature research reveals that colchicine has
an anti-fungal activity. He then looked at agents which are reportedly
anti-fungal, griseofulvin, for example. Griseofulvin has been shown
to eliminate toenail fungus after continued use for one year. Griseofulvin
also has a remarkable effect against gout. This led Dr. Constantini
to suspect that fungus may play an important role in causing a broad
number of diseases. His research suggests that fungal etiologies may
be seen in some forms of cancer, cardiovascular disease, alcoholism,
psoriasis, leukemia, rheumatoid arthritis, bowel-related diseases, and
sarcoidosis. Given the wide range of disorders with a common etiology,
could there be a dietary relationship to fungal disorders? Yes, yes,
yes!
The number one culprit in the diet is PEANUTS! Peanuts
are attacked in storage by aflatoxin, one of the foremost causes of
liver cancer and a highly toxic agent in its own right. Unfortunately
other grains are equally suspect of carrying fungal mycotoxins. Cereal
grains and rice are all stored for periods of time, allowing mycotoxin
exposure and proliferation. Complicating exposure of grains, any fermentation
process allows for further introduction of mycotoxins. This means that
essentially all beers and wines carry mycotoxins as well. Bread baked
with yeast offers its own unique mycotoxin. Hence the classic alcohol,
bread and cheese diet we love and crave offers us a continuous exposure
to mycotoxins which in Dr. Constantini's eyes offers us a perfect diet
to progressively develop chronic disease. Look for Dr. Constantini to
share this work with us on these pages in the future.
Abnormal Clotting
Undoubtedly there is always something suspect when
a manufacturer is the leading proponent of a medical theory. In this
case our publication has advertised American Biologics' microscope for
many years, as a tool for investigative diagnosis and evaluation. Some
letters have appeared in the past scoffing at the claims of the manufacturer
in magnification capabilities. It is one thing to joust in print; it
is quite another to examine the tool in person and review its diagnostics
personally. As an aside, the microscope is now considered an important
academic tool in China as well as a number of other countries overseas.
Given its international recognition, it appears appropriate to investigate
its capabilities at home. American Biologics has given two microscopes
to the Bastyr University of Naturopathic Medicine in Seattle, Washington;
hopefully the university will undertake a serious examination of the
microscope to report to the Townsend Letter in the future.
One diagnostic the microscope permits for office
examination is a close look at the clotting mechanism of patients under
medical treatment. Basically, fibrinogen is actively used and networked
in the formation of the blood clot. Normal clotting examined microscopically
reveals a honeycombed blood clot with well delineated black layers of
fibrin separating the clotted blood cell, platelet, fibrin combination.
Abnormal clotting reveals a milky-colored, amorphous pool of fibrinogen
separating the clotted blood cell, platelet, fibrin combination. These
accumulations of translucent fibrin pools, present in large enough quantities
and encompassing a higher percentage of the blood smear, represents
an abnormal blood clot. Examiners of the blood clot using the HLBTM
(Bradford) technique described, have been able to correlate acute and
chronic pathology to pathology related in the abnormal clotting. Given
the fact that the smear preparation and examination can be accomplished
within 15 minutes of lancing the finger, the technique permits a powerful
tool for evaluation and follow-up as well as patient education, all
within the time constraints of a routine office visit. If the HLBTM
technique proves to be as accurate as reported, it will permit the clinician
to have a far better tool than most other laboratory technology in assessing
treatment progress.
Medical seminars abroad offer one other advantage
for the weary practitioner: a chance to relax, if time is actually taken
to enjoy a vacation. As our holistic colleagues remind us, letting go
is a useful tool in the healing process. Take some time off, and enjoy!
Jonathan Collin M.D.