CAN GLUTAMINE AND ARGININE IMPROVE HYPERPERMEABILITY IN THE GI TRACT OF CHILDREN DIAGNOSED WITH AUTISM?

20 May

Autism Spectrum Disorders (ASD’s) are neurodevelopmental disorders that include Autism, Asperger’s Syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). In recent years, scientific research has identified an association between ASD and compromised digestion. Of particular note, is the relationship between ASD and hyperpermeability syndrome. Hyperpermeability is a term given to a condition where the epithelial (tissue) barrier function of the small or large intestine is impaired. Impaired epithelial barrier function can result in less discrimination in the numbers and types of molecules and/or cells that are able to pass from the gastrointestinal tract to the circulatory system (bloodstream). Tight junctions (the staples holding the tissue cells together) are responsible for epithelial barrier function, connecting epithelial cells in the gastrointestinal lining. It is when these tight junctions lose their integrity that hyperpermeability can occur.

Previous scientific literature has clearly shown that the composition of dietary amino acids is able to alter tight junctions and intestinal permeability. In a recent study, undertaken at Rouen University, France, the amino acids glutamine and arginine were shown to have protective effects on intestinal permeability and tight junctions. Moreover, both intravenous and oral glutamine supplementation was associated with a lower risk of developing intestinal permeability. However, despite arginine proving beneficial in improving gut barrier function, no statistical, significant difference was shown in combining arginine and glutamine compared to using glutamine in isolation.

EPILEPSY AND A KETOGENIC DIET

20 May

Epilepsy is a common neurologic disease, regularly treated with antiepileptic medication. However, recent literature has indicated that antiepileptic medication is largely ineffective in adequately controlling epilepsy in approximately 30 percent of patients. This being so, scientists have looked to identify strategies that may prove beneficial in controlling difficult to control epilepsy. One strategy that has been given extensive scholarly attention is the ketogenic diet, a high fat, low protein, low carbohydrate diet. To date, the majority of literature available has examined the role a ketogenic diet can play in reducing episodes of epilepsy in children. For example, high quality, scientific evidence shows that during treatment with a ketogenic diet, 3 to 33 percent of children become seizure free. Moreover, 7 to 56 percent of patients experienced a seizure reduction greater than 90 percent, while 19 to 38 percent of patients experienced a reduction of 50 to 90 percent.

Reinforcing the foregoing statistical evidence is a recent study undertaken by neurologists at the Institute of Child Health, London. In this study, researchers demonstrated that in a population of 145 children diagnosed with epilepsy, patients consuming a ketogenic diet (72 of the 145) experienced a 38 percent mean reduction in seizure frequency. Now at first glance this may appear relatively insignificant, however, when we consider that the 73 children consuming a non-ketogenic diet experienced a 37 percent increase in seizure frequency we can begin to appreciate the potential role a ketogenic diet can play in the management of epilepsy.

At this point, the exact mechanism underlying why the ketogenic diet is beneficial in controlling epilepsy is unknown.

Before undertaking this strategy, I strongly recommend you discuss the introduction and cessation of a ketogenic diet with a qualified health care professional.

 

Asthma

24 Apr

Asthma. It is indeed a topic worth discussing. In fact, in the last 4 days, a systematic review of complementary and alternative medicine for asthma self-management has been published (all 97 pages). In this review it critically examines the various forms of complementary therapies that have been studied by scientists to see if these therapies actually work. Let us explore what was discussed in the foregoing review.

Although there have been several studies looking at the use of complementary therapies to self-manage asthma, it is important to note that the large majority have shown little. if any, benefit. Moreover, it must be stated that given the term ‘complementary’ can include modalities outside and beyond nutrition, it is important to make mention that there have been 1 or 2 modalities that have shown improvements in pulmonary function, one example discussed in the foregoing review is The Buteyko Method.

From a nutrition perpsective there was really only two studies that clearly showed a significant imporvement in asthma symptoms. The first study (2010) examined the effect of oral magnesium supplementation on airway resistance (resistance to the flow of gases, i.e. oxygen, during ventilation (breathing) in men and women diagnosed with mild to moderate asthma. Participants in the study were assigned 340 mg of magnesium daily for 6.5 months. Over the course of the study participants diagnosed with both mild and moderate asthma showed improvements in the total volume of air expired after a full inspiration, and an overall improvement of 20 percent in forced expiratory volume (FEV1) (the volume of air expired in the first second of maximal expiration), which is often significantly reduced in obstructive and restrictive lung disease. Moreover, their was a 5.8 percent increase in peak expiratory flow rate (capability of the lungs to move air through the body) in the group consuming magnesium. The second study (2010) examined the impact nutritional formulas may have on asthma control in children. In this randomised study, children were divided into two groups, one group using a nutritional formula composed of antioxidants, omega-3 and omega-6 fatty acids. The study should that the children using the nutritional formula experienced a reduction in the scientific markers that are used to assess inflammation in asthma, however, there was no difference in asthma free days between the group using the nutritional formula and the group not using the formula.

It is to be expected that many individuals have found beneficial complementary therapies that have very much improved their symptoms, and I validate this. I also wish to encourage individuals to seek out complementary therapies that have been scientifically peer-reviewed, to show that what is offered from a complementary perspective could be of significant benefit.

If you have any questions regarding this post please make contact via info@markhincheynaturopathy.com.au or 0432234822

 

Fatigue

3 Mar

Persistent and severe fatigue is a common part of the presentation of a diverse range of diseases. However, efforts to provide a comprehensive definition of fatigue are ongoing and not without controversy. Most definitions begin by distinguishing between neuromuscular fatigue and cognitive fatigue, the former being a result of strenuous physical exertion that is relieved by rest. Cognitive fatigue, however, refers to a combination of exhaustion and somnolence, perceived increased mental effort in initiating or sustaining mental and physical effort, poor concentration and reduced motivation. It is very common that symptoms of cognitive fatigue are of a chronic nature and are minimally, if at all, relieved by rest or sleep. This being so, extensive research has been undertaken in order to develop strategies that assist in the management of cognitive fatigue. For example, research in complementary medicine has focused primarily on the impact withania and rhodiola provide in enhancing cognitive performance and mood. Moreover, there is minimal research concerning the role withania, rhodiola and ginseng (siberian) play in stress induced fatigue. However, it is not my intention, in this article, to focus on the role of the foregoing herbs.

Fatigue often presents with a cluster of symptoms including exercise intolerance, post-exertional malaise, frequent presentations of pain and affective disorders such as anxiety and depression. It is fatigue of this nature that is common in diseases with significant inflammatory involvement. A common presentation observed in my clinic is an acute ‘flu-like’ illness followed by weeks or months of fatigue, indicative of the aforementioned symptoms. This being so, it is important to understand the mechanisms by which inflammation contributes to fatigue. Currently, scientific evidence suggests that exogenous inflammatory cytokines (small proteins involved in cell to cell communication), induced by various bacterial species, initiates the acute ‘flu-like’ responses outlined. This process is common to sickness behaviour, an adaptive response to infection, characterised by fatigue, depressive behaviour, anhedonia (lack of pleasure), psychomotor slowing, anorexia (lack of appetite), circadian alterations in sleep patterns and increased sensitivity to pain. This is indeed a common theme I see presenting in my clinic.

In the last 2 years there has been research to show that the fatigue induced by exogenous inflammatory cytokines can be ameliorated by the administration of anti-inflammatory interleukin-1 receptor antagonists. However, this is considered a novel therapy, in which your blood is incubated to stimulate white blood cells to produce increased levels of anti-inflammatory interleukin-1 receptor antagonists and then re-injected at a particular site. For example, it has been utilised effectively for individuals suffering from osteomyelitis. Nonetheless, what I find exciting is the possibility that the well known traditional Chinese medicinal plant, Astragalus Membranaceus, potentially can invoke a similar response. However, there is little science to make this conclusion at this point.

If you have a question concerning fatigue please contact Mark Hinchey Naturopathy on 0432234822 or at info@markhincheynaturopathy.com.au

 

The role of therapeutic supplementation in the management of Autism

29 Jan

The use of food and/or food related products in both disease prevention and health promotion is an emerging trend that has given rise to the concept ‘nutraceuticals’. Nutraceuticals is a term that was first coined in 1989 by the US Foundation for Innovation in Medicine (FIS). The FIS defined nutraceuticals as “any substance that is food or a part of food, and provides medical or health benefits, including the prevention and treatment of disease” (Fern, 2012). General forms of nutraceuticals consist of dietary supplementation, including vitamin, mineral, amino acids and herbal substances in various compositions.

Since 1999, there have been several studies indicating the important role nutraceuticals can play in the management of Autism.

1999: Study of 35 participants diagnosed with Autism, all exhibting apraxia (inability to execute a set movement or speech) of speech and hand, showed significant

improvement in apraxia of the hand and general wellbeing with the use of 30 mg/kg/bw of L-carnitine (amino acid) over 8 months.

2004: 20 children aged 3 to 8 years old (18 boys and 2 girls) diagnosed with Autism, commenced using a multivitamin/mineral supplement to a maximum dose of 3ml/5Ib

body weight for 3 months. All childrenin this study showed significant improvements in sleep cycle and digestive function.

2007:  13 children, aged 5 to 17, using 1.5g/daily of Omega 3 Fatty Acid for six weeks, exhibited a significant reduction in hyperactivity behaviours and stereotypy (i.e.

repetitive or ritualistic movement).

2008:  34 children (30 boys, 4 girls) diagnosed with Autism, were administered L-carnitine at a dose of 50mg/kg/bw twice daily for 3 months. After 3 months children

showed significant improvements via assessment of Autism Treatment Evaluation Checklist, Childhood Autism Rating Scale and Clinical Global Impression Scale.

2011:    141 participants diagnosed with Autism (aged 3 to 60) prescribed a multivitamin/mineral supplement, with a maximum dosage of 3ml/5IB used over 3 months lead

to a significant improvement in nonverbal communication skils, significant reduction in stereotypy and improved metabolic indicators i.e. nutrient status.

At present there are 16 randomised controlled trials being undertaken on the role nutraceuticals can play in the management of Autism. Studies include the role methyl B12 and pyridodoxal-5-phosphate can have on reducing stereotypy, hyperactive behaviours and cognitive processes.

If you have any questions concerning this post, please make contact via info@markhincheynaturopathy.com.au or 0432234822.

 

Effects of Oral Glutamine Supplementation on Athletes After Prolonged, Exhaustive Exercise

12 Dec

Despite the fact that the incidence of infections in sedentary individuals can be decreased by moderate, regular exercise,  there is evidence to suggest that prolonged, exhaustive exercise may be associated with impairment of the immune system. The amino acid glutamine is an important fuel for some cells of the immune system, of particular note, lymphocytes and macrophages. These cell types carry out specific actions in regulating immune system function.

Recent research undertaken at Oxford University has shown that heavy training significantly reduces plasma glutamine levels, and can be responsible for immunosuppression in athletes. In this study, researchers found that after intense training or endurance racing the incidence of infection significantly increased. However, with the provision of glutamine powder (5 grams) in water, the incidence of infection in athletes decreased by over 55 percent, with 57 of the 72 athletes examined suffering no infections despite heavy training and competition.

If you have any questions regarding this post please contact info@markhincheynaturopathy.com.au or 0432234822

Eczema

7 Dec

Eczema is a chronic inflammatory dermatosis that affects 20 percent of the population in industrialised nations, and usually manifests in early childhood. Known also as atopic dermatitis, there is evidence to show that it may give rise to conditions including asthma, food allergy and allergic rhinitis. The precise origins of eczema are not fully understood, suffice to say that a complex interaction between genetic and environmental factors have been implicated in the predisposition and development of the disease. Regarding genetic prediposition, eczema is associated with the foloowing:

* Abnormalities in genes encoding the skin barrier molecules (filaggrin)

* Abnormalities in the cells governing inflammatory responses in the body,

* Abnormalities in the mechanisms regulating the immune system

* Elevation in serum immunoglobulin (IgE)

* Impaired delayed hypersensitivity reactions

* Infectious agents

Of particular interest is the gene responsible for altering hydration of the skin, filaggrin. Professor Irwin McLean and his team from the college of Medicine, Dentistry and Nursing at the University of Dundee reported that defects in the filaggrin gene can cause dry skin, eczema, eczema associated asthma and allergies. At the time of writing Professor McLean and his team have identified 15 mutations in the gene. If you are found to have one of these mutations you have a 60 percent chance of developing eczema, however, if you have two mutations in your gene you have a 100 percent chance of developing eczema.  In recent years, geneticists in the United States and Germany have been able to screen for mutations in the filaggrin gene at a cost of $US500. A worthwhile assessment, if the aforementioned factors prove negative.

Food allergy appears to play a role in a subset of patients with eczema, primarily infants and children with severe eczema. Identifying this subset of patients and isolating the relevant food allergens requires a high index of suspicion based on a well taken clinical history, use of appropriate laboratory tests, and in some cases, oral food challenges. Maternal dietary restrictions during pregnancy or lactation do not appear to have any effect on the incidence or severity of eczema, yet, research strongly supports the notion that breastfeeeding, up to and beyond 6 months, can help to reduce the incidence of eczema, especially in infants with a family history of eczema. Moreover, nutritional interventions such as the use of essential fatty acids, may have an effect on eczema.

Research has demonstrated that a combination of food allergy (of particular note, citrus, cow’s milk, nuts and fish), defects in the gut mucosal barrier (prominent in irritable bowel syndrome), and increased intestinal permeability may be associated with the development of eczema.

If you have any questions regarding this article please contact 0432234822 or write to info@markhincheynaturopathy.com.au

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