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Gut Brain Therapy: From the horse's mouth

Thank you all for the opportunity to have an open discussion about the theory and science behind our Gut Brain Therapy™. I have had a number of “light bulb” moments in my 15 years of study of medicine that I think you will find interesting and thought provoking.

I am not a doctor. While I feared that my entering the natural medicine business 15 years ago without appropriate initials behind my name would be a detriment, in the long run I have found it to be a true asset. What I mean by this is that the chiropractor sees the condition you come to them with in chiropractic terms, the naturopath sees your disease through naturopathic eyes, and the medical doctor through the eyes reflective of their training. This is why there are so many options available for the same condition. I entered this “second career” from a place where I had very little in the way of preconceived ideas or beliefs.

At one point early in my path I wanted to know what caused most chronic diseases so I went into the medical literature and searched the current understanding of migraine, irritable bowel, diabetes, arthritis, fibromyalgia, colitis, MS, etc. Not having a medical background I expected the medical descriptions to include an understanding of underlying cause. While the various descriptions included some “current thoughts” about the causes they, in the end, were all described as incurable diseases of unknown cause. Most of the discussions were about the various interventions available to manage the manifested symptoms in those who suffer. Perhaps no one group has a better understanding of this lack of information about root cause than those who suffer from the various types of migraine.

So this was my first huge light bulb moment….that the entire paradigm for the treatment of chronic disease was based on “we don’t know what causes it, we don’t know how to cure it, so this is how we are going to treat your symptoms”.

Now let me also comment that while the bulk of my work has been from the natural medicine perspective I am not against the use of pharmaceutical medicine. There is nothing in natural medicine that will do for a migraine sufferer what an Imitrex or other triptan drug will do for many. By the same token many IBS sufferers find better relief from peppermint oil capsules than any pharmaceutical intervention. The point is that whether you are treating with pharmaceutical medicine or natural medicine as long as the focus is on the treatment of symptoms you offer no hope of a cure.

I would appreciate some feedback on this post. I think this process will be best served if we can initially focus on those things on which we can agree or at least come to common understanding. I look forward to your collective thoughts and input.

All the best,

Tom Staverosky, President
ForeverWell
foreverwell.com
tom@foreverwell.com

Hi All,

Given some of the recent interest in the gut-brain hypothesis first brought up by dizzyinaz for migraine I asked Tom from Foreverwell if he would like to answer some questions about how the gut-brain hypothesis applies to migraine and to discuss what he thought the link was between the two. Tom kindly offered to answer questions about it here on the board. I am in no way endorsing the sales of any products through this discussion but am genuinely interested in the research foreverwell has conducted on this and thought it would be a good idea for others to ask questions about it if interested.

Tom – thanks for taking the time to answer some questions here. I can’t write a very big response right now because it’s late in Sydney but I would like to start with one question if I may. Why do you think the gut can play a role in preventing migraine? Is there some solid evidence-based, scientific data to support this view? It seems to me that, in my case anyway, my gut upset (IBS symptoms) occur after the migraine process begins and never the other way around. From my point of view it seems that an upset gut is yet another symptom of the migraine process itself and does not seem to have a role in causing migraine (the cause of which is genetic). These days migraine is no longer thought of as just a headache but is now known to be much more affecting numerous functions in the body. As Dr Rauch, Professor of neurology said:

"“migraine is a global disturbance of sensory signal processing.” By this I mean that sensory information –- sensations –- are distorted and/or intensified. Not all sensations are involved at any given time. The migraine spectrum may include pain, numbness, or tingling on the skin, motion intolerance and dizziness or vertigo, intolerance of light, sound, taste, or smell. While most of the symptoms are in the head and neck, other parts of the body may be affected.’

Cheers … Scott 8)

Thanks you Scott for your comment and question. Please be patient with my reply. The challenge I face is that I have been inspired to look at disease in general and migraine in particular in a new way. It is likely that we can read the same words and see different meanings. So let’s be willing to challenge each other (and the rest of you when you choose to jump in) to be sure we are speaking the same language.

That is the reason that i started this post the way I did. If we can agree that we do not know the cause of migraine and it seems clear we can all accept that, then we have to be willing to look at how we treat the disease and see if it is helping to understand root cause or not.

Part of the problem is that we say this collection of symptoms = this disease. By not being able to describe a disease by its root cause we end up defining it by its symptoms and therefore the accepted methods of treatment address the manifestation of symptoms not cause. By definition therefore there cannot be a migraine treatment that does not have some mechanism of action that directly affects symptoms. The result is that something that might treat a theoretical root cause seems to be based in pseudoscience.

Now on to your specific question. I would absolutely agree that “migraine is a global disturbance of sensory signal processing" as Dr. Rauch suggests. Can we agree that it seems likely that one, many or all the body’s neurotransmitters would be playing a role in “sensory signal processing” ? Can we also agree that by treating one or many of the manifested symptoms we are not likely to affect a “global disturbance”?

Is it not reasonable to suggest that if migraine is a global disturbance that it would make some sense to look at the affected organism globally? For example if indeed neurotransmitters in general and serotonin in particular are playing some role does it not make sense to look at how and where the body makes serotonin, whether it makes enough or too much, and what impact this knowledge might have on our understanding of migraine disease.

Michael Gershon, MD of Columbia University and the recognized father of neurogastroenterology (the study of the gut brain) has shown that 95% of the body’s serotonin is made in the gut.

Your thoughts and comments please.
All the best,
Tom

Your thoughts please.

.

Hey Tom,

By not being able to describe a disease by its root cause we end up defining it by its symptoms and therefore the accepted methods of treatment address the manifestation of symptoms not cause.

My point of view here is that while we may not yet presently know with precision what the root cause of migraine is, there is a very large body of evidence which strongly suggests that this condition is entirely a genetic abnormality of the brain and thus, at this stage, because the technology is not quite there, we have no cure. There is strong inheritance of the condition (migraine headaches are hereditary in 80% of cases) and such people have what is termed a “migraine brain”.

As with many other conditions, the genetics of migraine is slowly being uncovered and I imagine there are a number of possible determinants – a malfunction in calcium channel activity

http://www.nature.com/ejhg/journal/v6/n4/abs/5200206a.html

a possible thickening of the cerebral cortex not seen in non-migraineurs

or perhaps a genetic platelet abnormality in their ability to retain serotonin

http://www3.interscience.wiley.com/journal/119598854/abstract?CRETRY=1&SRETRY=0

to name a few. Serotonin is a neurotramsmitter that both reduces pain and constricts blood vessels. Interestingly, brain scans show remarkable similarities in the physiology of the brain in a person who suffers from anxiety and probably explains why migraineurs often suffer from anxiety and depression (even more so when the vestibular system is involved).

I personally don’t see any logical reason to differentiate between a natural, alternative or allopathic-labelled treatment. The bottom line is, if we ingest a molecule, and it has a therapeutic physiological effect on the body than it’s a drug no matter where it originates. Indeed many allopathic drugs originate from natural sources such as the powerful chemotherapy drug vincristine (Madagascar periwinkle) and everyday aspirin (Willow bark). And, of course, there are many natural substances that are deadly and certainly don’t equate to health –– snake venom, ricin and tobacco kill people!

For example if indeed neurotransmitters in general and serotonin in particular are playing some role does it not make sense to look at how and where the body makes serotonin, whether it makes enough or too much, and what impact this knowledge might have on our understanding of migraine disease … 95% of the body’s serotonin is made in the gut.

Yes, I think it does make sense to look at what’s going on with serotonin given the possible platelet problem and the fact that SSRIs alleviate MAV in many sufferers. However, I can’t see how increasing the output of serotonin in the gut can directly affect the brain when you consider the serotonin molecule cannot cross the blood-brain barrier; it’s physically impossible. Brain serotonin is manufactured in serotonergic neurons in the central nervous system only. The only plausible mechanism I can see is that by somehow increasing gut output into the bloodstream, it might have an effect on platelets which might then effect brain blood vessels. But then if there is a genetically determined structural problem with platelets which makes it impossible for them to carry enough serotonin it may not matter how much serotonin there is in the blood. I’m not aware of any evidence for this idea and will have a look at this later on. It’s an interesting angle though.

It would have been great if the study you guys conducted with your formula could have been a double-blinded study to remove the possible effect of bias and placebo which unfortunately plagues migraine studies. Are there any plans to do any further investigation?

While I’m still not sure how your treatment might work in reducing the frequency and/or intensity of migraine, it would be interesting to know if it did affect blood serotonin levels and through that mechanism might increase migraine threshold –– or allow a migraineur to “grow taller in the pool” as Dr Rauch so aptly put it. Perhaps in a future randomised trial you could also look at changes in blood serotonin levels as a secondary outcome.

Look forward to your comments!

Best … Scott 8)

Good morning all,
Thank you Scott for your thoughtful response.

Perhaps it is appropriate for me to articulate the philosophical basis for Gut Brain Therapy so it is clear where i am coming from. In the study of the ancient and/or natural healing traditions including Chinese medicine, Auryveda from India, the naturopathic tradition, shamanic traditions, etc. one sees that disease is viewed as dis-ease, an imbalance in the organism. This imbalance is viewed as a global disturbance that affects mind, body and/or spirit. Let’s leave the spirit and mind side out of this equation for now and simplify things by saying these traditions argue that only the organism is curative and the best path to health and vitality and freedom from disease is to help the body work better.

When I compare this simple philosophy to the philosophical basis for modern medicines efforts to heal those who suffer chronic disease which as we have discussed seems to be “we don’t know what causes it, we don’t know how to cure it, here is how we are going to manage your symptoms” I felt compelled to ask the question “what if the ancient understanding of disease is correct?” What if it is an imbalance in the organism and the only path to cure is to remove the obstacles standing in the body’s way of its ongoing attempt to reach homeostasis.

I have been blessed in my path to meet a handful of doctors who consistently get sick people well, sadly they are few and far between. The common thread amongst these outstanding practitioners is not their degree, some are medical doctors, some are naturopathic doctors, some are chiropractors etc. rather their common thread is their underlying philosophy which has probably been best articulated by my good friend James Sensenig, ND. “Disease is caused by the breakdown of normal function in one of three areas of the organism, the body is not getting something it needs, the body is not eliminating something it cannot use or the vitality is low.” Furthermore these individuals say to me that their job as a doctor is not to treat their patients symptoms, although they will to relieve pain and suffering, but rather to focus on whatever they can do to help the patients body work better, to remove the obstacles to cure.

My first reaction to the articulation of this philosophy was “gee, that makes sense” and my second was “it can’t be that simple”. Over time I came to believe that while the philosophy is simple enough and largely accurate the process of bringing any one patients body back to “normal” function can be anything but simple.

I will also mention here the role that genetics plays within this philosophical basis for dis-ease. If we had 10 people the same age and sex who lived identical lifestyles, ate the exact same diet and developed the same underlying dysfunction two would develop the disease we call arthritis, three would get diabetes, two more would get migraine disease, one would develop bio-polar and two would be depressed. Please understand that I have no sense that these numbers are accurate but rather the point is the role that genetics plays is, as Dr. Sensenig likes to say “genes don’t cause the disease, but rather they direct the body’s balancing mechanisms to adjust for deficiencies or toxic loads until it cannot do so any longer. The symptoms that develop in any one patient are the result of the weak link in the genetic pool of that particular individual.”

I read in the earlier thread about Gut Brain Therapy that some of your forum members are dismissive of the concept that the body is not only capable of healing itself but it is also constantly trying to achieve homeostasis. I have learned from my work with migraine sufferers over the last eight years that the disease has such a dramatic impact on quality of life that I cannot be surprised by their skepticism. However, the evidence is completely overwhelming that the body is designed to heal itself or at the very least has tremendous capacity to compensate, adjust and survive. I always point to the example of my 57 year old brother (I will hit 56 the end of this month) who has been a heavy smoker and serious alcoholic since his entire adult life. Now I am not going to say he is in great health but he is pretty darn functional. Sometimes I look at him and wonder how is this possible.

To further speak to the idea that migraine is as you suggested Scott “entirely a genetic abnormality of the brain” let me ask if anyone can provide any evidence where the identification of genetic markers of any disease has led to a clear understand of the cause and/or cure of the related disease? The stories and reports I have read are anything but conclusive or even broadly illustrative of the disease path.

This is an area where I will turn again to the work of Michael Gershon, MD Columbia University and his colleagues who are studying the gut brain. In Chapter 11 of his book The Second Brain he discusses the use of knock out mice in scientific research. Knock out mice for those of you unfamiliar are mice used in laboratories. Various genes of the animal are removed “knocked out” in an attempt to mimic certain disease states. As Gershon states:

"“The ability to knock out virtually any gene an investigator chooses to delete has had a revolutionary effect on development biology. For a long time birds and worms had seemed to be the animals of choice for studies of developing systems. Bird embryos are accessible and amenable to surgical manipulation, while worms are simple, have small nervous systems, and every one of their nerve cells is known. The ability to pick the characteristics one wants an animal to inherit (via the knockout technique), however, is at least as potent an advantage as any of these properties. The gene knockout technique, however, is full of surprises. Many genes that were confidently thought to be absolutely essential for life, or at least for some critical function, have been knocked out with no discernible consequences. The ability of genes to compensate for the loss of their fellows is prodigious. Take out one gene and others may find a different way to accomplish what the knocked-out gene used to do. In other instances, compensation does not occur, but a function is lost that was not previously suspected to require the expression of the knocked-out gene. Experiments that involve playing games with mouse genes are thus not good for people who like to live predictable lives.”

Later in the chapter Gershon adds, “The power of molecular biology has generated a wave of enthusiasm that has sometimes transcended the bounds of reality. Many people, including a few scientists who should have known better, actually believed that the discovery of the gene or genes responsible for causing a birth defect (abnormality of the brain in the suggested case of migraine…added by me) would carry with it the solution to the problem. Solutions, however, have proven to be elusive. To understand why a birth defect arises, it is necessary, but not sufficient, to know the identity of the abnormal gene. The mechanism of gene action, which is often difficult to work out, is equally important, and is not revealed by the knowledge alone of the identity of the gene or even its product.”

Let me be clear, I don’t have the answer, but inspired by the doctors who I realized were consistently getting sick people well and their underlying philosophy I turned to three of them in 2000 and said “I think what you have taught me is that if we make the best digestive support product we can possibly make (make sure the body is getting what it needs) and the best liver/kidney support product we can possibly make (make sure the body is eliminating what it cannot use) and apply it to any chronic illness we should be able to get noticeable, quantifiable results.” They said yes so i suggested we try this simplistic approach on migraine disease. When they asked why migraine I said because there are 30 + million in this country who suffer and there is not much helping them. If your philosophy can show an impact on something as intractable as migraine gradually people will pay attention.

So that is what we did. While funds continue to limit the scope of what I am able to do, we did complete and publish, in a peer-reviewed journal, our initial study. To date I have been unable to attract the funding to do a broader blinded study. Although I understand the limits of our initial study we did attempt to provide as much credibility as possible by utilizing a standardized, scientifically studied and validated study instrument. The Migraine Specific Quality of Life Questionnaire (MSQ) was originally designed and utilized by GlaxoWellcome in the process of getting Imitrex approved. The MSQ is made available by Medical Outcomes Trust an MD organization in Boston whose goal is to make available to the research community credible instruments for measuring outcomes.

I understand that the gold standard of scientific research is the double blind placebo controlled study. I would ask that you consider my argument that there is a second gold standard of scientific research which is largely dismissed. That second gold standard is the clinical or laboratory observations of a trained doctor or scientist. These observations have resulted in a vast array of scientific knowledge over thousands of years. The blinded study is best suited for testing the affect of one thing on one thing at a time, so we test to see if this drug or herb or nutrient can have some impact on the head pain or vertigo associated with migraine disease and if the study says yes then we can say that the drug, herb, or nutrient treats the disease. To some degree this approach assumes that everyone who suffers from the disease has the same underlying problem which we just haven’t identified yet.

Dr. Sensenig and the others like him look at five migraine patients and use a variety of different products and modalities to get their individual bodies working better thus removing the obstacles to cure and allowing the body to heal. Within the philosophy that I have tried to articulate in this post, five different migraine sufferers have five different problems, however the starting point is the same gut and liver. It is not that by getting gut and liver working as well as possible that we can cure or even improve every migraine sufferer, it is more along the lines that gut and liver is the starting point and if you don’t get these systems working as well as possible, you don’t have a chance.

I have written a cliff notes version of Michael Gershon, MD’s book The Second Brain and am happy to send you and anyone else who requests it a email copy. Simply send me an email request to tom@foreverwell.com.

Enough for now, more to follow.
All the best,
Tom

Just a side note regarding this quote:
“I read in the earlier thread about Gut Brain Therapy that some of your forum members are **dismissive of the concept that the body is not only capable of healing itself **but it is also constantly trying to achieve homeostasis. I have learned from my work with migraine sufferers over the last eight years that the disease has such a dramatic impact on quality of life that I cannot be surprised by their skepticism. However, the evidence is completely overwhelming that the body is designed to heal itself or at the very least has tremendous capacity to compensate, adjust and survive.”

I think people respond like this because they are frustrated, scared, and haven’t seen any results. However, many of us do believe that the body heals itself, or perhaps in our case, rewires itself to compensate. My neurologist has told me this and the research literature suggests it as well. It does take TIME, however. The issue regarding gut-brain is somewhat different, but I do think there is a connection between the two. How exactly is the million dollar question.

Great thread! Thanks Scott and Tom for your willingness to bring this topic up for discussion. I am still trying to read everything, but I’m so photo phobic at the moment, it’s a challenge. As a chronic IBS with constipation sufferer, and one who’s IBS has been flaring up lately with the use of various SSRIs, this is a topic of HUGE interest. Again, many thanks for the time it has taken for you both to write all this. I hope the conversation benefits us all!

Best,

Molly

Good morning all,
I hope you all had an enjoyable weekend and to the moms reading, Happy Belated Mother’s Day.

I think it would be valuable to share some more details about the enteric nervous system, also known as the gut brain or the second brain. I read more and more about the gut-brain connection and less about the actual existence of the gut brain.

The first question most people ask is where is it? You will not remember seeing the gut brain in biology class or medical school text books. The body’s nervous system is typically categorized as having two components. The central nervous system (CNS) which loosely includes the head brain and the spinal column and the peripheral nervous system (PNS) which includes everything else.

The main purpose of the peripheral system is to collect sensory data to send to the central system for processing. There is no independent analysis or decision making in the PNS. All action and reaction is directed by the CNS.

The nerve tissues that make up the enteric nervous system (ENS) are located within the lining of the principal organs that make up the digestive system, the stomach, the small intestine and the large intestine. What makes the ENS different and unique from the rest of the PNS is that it has the ability to make decisions without interaction with the CNS. In other words the ENS orchestrates the digestive processes without independent direction from the head brain. This is why it is often referred to as the second brain.

It is the ENS which decides when the pancreas should release various enzymes, when the stomach should create more acid or release its contents into the small intestine, when it is appropriate for the gall bladder to add bile to the digestive mix, etc. The digestive function is so amazingly complex and so absolutely critical to the organism it serves, that when you think about it, it makes perfect sense that it would have its own central processor.

What do we know about the ENS and disease? Not much really but evidence is beginning to point to some fascinating possibilities. Nothing in my study of the ENS shocked me more than when I read page 175 of Michael Gershon, MDs book The Second Brain. I copy it here:

“Very recently, it has been discovered that the enteric nervous system is affected in at least some patients with Parkinson’s disease. The same type of lesion (tissue damage) that is found in the brains of patients with Parkinson’s disease is also found in their enteric nervous systems. It thus stands to reason that Parkinson’s induced degeneration of nerve cells in the bowel will affect the propulsion of intestinal contents in the same way that it affects higher integrative function in the brain. Parkinson’s disease may thus eventually cause an enteric as well as a cerebral dementia.

I should not have been surprised to learn that Parkinson’s disease is a disorder of the enteric nervous system as well as the brain. Like many surprises that, in retrospect, seem unsurprising after the shock of discovery is past, this one too might have been anticipated. The enteric nervous system is, after all, a very close cousin of the brain. As I explained to the Society for Neuroscientists at the workshop in Cincinnati, the enteric nervous system has more in common, both chemically and structurally, with the brain than with the remainder of the peripheral nervous system. The enteric nervous system looks as if it were the brain gone south. As a result, it is to be anticipated that illnesses of various types that occur in the brain will also involve the enteric nervous system.

Alzheimer’s disease, as much as Parkinson’s disease, illustrates the validity of this idea. Alzheimer’s affects the enteric nervous system in the same way as it affects the brain. Moreover, just as occurs in Parkinson’s disease, the characteristic lesions that neuropathologists use to diagnose Alzheimer’s disease are found in the enteric nervous system as well as the brain. Since these lesions occur in the bowel, it seems likely that the function of the enteric nervous system is compromised in at least some patients with Alzheimer’s disease; nevertheless, I do not know of a single systematic study of the bowel problems of Alzheimer’s patients. I suppose that in the face of overwhelming dementia, constipation, and even fecal impactions, pale as medical problems. When a patients mind is failing, it may seem perverse to focus on his or her bowel habits. Someday, however, I keep telling myself, I should do just that. Clues to the acquisition of Alzheimer’s disease, a means of getting a definitive diagnosis, and following the efficacy of treatment might all be facilitated by investigations of the enteric nervous system. Biopsies of the enteric nervous system, for example, are much easier to obtain than biopsies of the brain. Who knows? Perhaps one day the ease of obtaining rectal biopsies will cause the rectum to be called “the window on the brain."”

Here we have two neurological diseases that we have always considered to be head brain diseases and the pathology of each is showing up in the gut brain as well. We have always realized that the digestive system is responsible for obtaining nutrients from the food we eat and breaking them down into the components the body can utilize to sustain itself. For a long time science has shown that some 80% of the body’s immune function occurs in the gut and now we are being shown that there is a huge neurological component to the gut. Gee, maybe it is like the philosophy that one reads in the study of ancient and traditional healing philosophies “everything starts in the gut”.

What I find particularly interesting about all of this is how relatively dismissive the medical system is toward gut dysfunction. Most digestive problems are viewed as an annoyance or inconvenience rather than a clear indication that the body is not functioning in an optimal or healthy way. Sadly, when the focus of treating digestive complaints is treating the symptoms we are not really solving the problem.

So one of the confusions I have had in looking at the migraine literature is with all the gastrointestinal components to migraine such as food triggers, nausea, abdominal migraine etc, why is it possible to consider that migraine is simply, as if anything within the human organism can be described as simple, a genetic abnormality of the brain?

Your thoughts please.

All the best,
Tom

Hey Tom,

Thanks for your reply and explanation. Sorry I’m late getting back to you but dropping Effexor and starting Paxil is really knocking me around at the moment and I haven’t felt quite right …

I felt compelled to ask the question “what if the ancient understanding of disease is correct?” What if it is an imbalance in the organism and the only path to cure is to remove the obstacles standing in the body’s way of its ongoing attempt to reach homeostasis.

To me that all sounds fantastic and I can see how anyone might think it makes sense about vitality being off, some imbalance being present, the body wanting to reach homeostasis, old traditions etc. However, ancient Egyptians believed the heart was the centre of thought and the brain cooled the body; the Romans figured a bad uterus caused hysteria; and you might have heard about blood-letting days in London around 1800. People were drinking radioactive tonics as recently as the early 1940s saying they actually felt better yet they were killing themselves. The US had to ban them in the end. Myths about the body and health linger on even in 2009, some astoundingly ludicrous but pervasive nonetheless. We can philosophise about this, come up with lots of great sounding ideologies and theories, and even write tons about it I’m sure … it’s all emotionally satisfying. But let’s take a skeptical viewpoint and ask this: does a particular treatment actually work? Let’s put aside all the philosophy and really test these claims properly. If it does work as claimed and there is a real and measurable effect beyond background noise and placebo effect, then we should be able to prove it very very easily with a science-based evidence approach. For me it’s really that simple and not complex at all. I’ve been down the road of CAM therapies many times and they never work beyond perhaps feeling a little bit better (sometimes worse) or nicer for a few days which I can easily attribute to either feeling a little more relaxed or just placebo (the placebo effect is not to be underestimated and can produce very large effects in a person’s subjective feelings about any treatment. They feel better even though there has been no physiological change). And some are just plain nonsense (homeopathy for example) with no basis whatsoever in physics, chemistry or the real world. In the 6 years I’ve been on forums I’ve never heard of anyone sorting out this migraine problem without actually using real proven medications. How I wish that wasn’t the case but that’s the reality.

genes don’t cause the disease, but rather they direct the body’s balancing mechanisms to adjust for deficiencies or toxic loads until it cannot do so any longer.

Genes are in fact the root cause of many diseases. Sometimes such genes are activated later in life and sometimes the bummer genes are active right from day one (Down Syndrome). For example, 1 in 4,000 children are born with cystic fibrosis and 1 in 2,500 girls end up with Turner syndrome. Genetic diseases such as Huntington’s kicks in between the ages of 35–44 years. At the end of the day, the human body is not perfect at all and comes with it’s defects. I tend to think that being born with a migraine-prone brain is another defect. For some it takes a lot to cause its expression (another viral illness such as vestibular neuritis) while for others it simply takes a pregnancy to trip the switch. I really don’t think this has anything to do with toxins or imbalance. Both of those words are very general and non-specific and don’t help us to establish exactly what the problem is. If it was toxins, then what toxins? To me that could mean anything. In fact the whole notion of “detox” is, in my opinion, ridiculous. There’s not a scrap of evidence for such claims and not one person who believes in toxins can actually name what the toxin is or why it’s not being eliminated normally. What evidence is there that a particular toxin builds up and is not routinely removed from the body by the liver etc? And what imbalance? How do we define balance versus imbalance? If I’m hungry and my blood glucose is low, is that an imbalance? Whether or not a disease like migraine arrives at our doorstep is mostly just bad luck I think and we have to do our best to produce an environment where a problem with a very strong genetic basis such as this is not being activated. Perhaps the gut formula can be part of that, I don’t know.

the evidence is completely overwhelming that the body is designed to heal itself or at the very least has tremendous capacity to compensate, adjust and survive.

I don’t agree that the body is designed to heal itself in every way. Yes, if we cut ourselves, the blood clots and eventually scar tissue fills in the cut, or if we break a bone, new bone grows to fix the fracture. But how can we assume that this can be extrapolated to anything and everything that goes wrong in the body? What evidence do we have of this? I agree that the body of any animal including ourselves has a great ability to compensate for problems but even that has its limitations. There’s a great book you should read called “Why We Get Sick: The New Science of Darwinian Medicine”. I have to tell you, this is a very refreshing look at disease from an evolutionary biology point of view. There’s a short review here:

http://www.utmj.org/issues/82.1/Book_Reviews_82-71.pdf

and Richard Dawkins does a great interview with the author here:

let me ask if anyone can provide any evidence where the identification of genetic markers of any disease has led to a clear understanding of the cause and/or cure of the related disease?

Have a look at this article which shows the specific gene and/or gene mutation which causes the disease.

And this article is an example of gene therapy actually working in a genetic sight disorder. The results are not great but the technology is premature:

http://news.bbc.co.uk/2/hi/health/6609205.stm

As time goes on, science is unearthing many more of these genetic issues at a fast pace. As the technology matures, treatments will become better and better. That’s the great thing about science: it allows for adaptation to new information and better treatments over time. HIV drugs are far better and much more effective now than they were 10 years ago. By stark contrast, a pseudoscience like homeopathy hasn’t changed in 200 years and it never will. Some diseases are not so simple of course and can involve numerous genetic problems (insulin resistance for example).

To understand why a birth defect arises, it is necessary, but not sufficient, to know the identity of the abnormal gene.

I don’t follow this. If a birth defect occurs then why would we not want to identify the problem gene if the problem is genetic? As I pointed out above, Down Syndrome, Cystic Fibrosis etc are clearly genetic problems whose ultimate cure will depend on gene therapy, at least for CF.

If your philosophy can show an impact on something as intractable as migraine gradually people will pay attention.

Absolutely. In fact, if it is a true solid effect and can be proven then certainly mainstream medicine would adopt it just like it has any other drug that had its origins from a plant.

we did complete and publish, in a peer-reviewed journal, our initial study

That’s great that you did this. You’ve already done far more than most proponents of other CAM therapies. If you can follow this up with a double-blind study to remove the placebo effect and confirmation bias but still show a statistically significant effect, I’m sure much more funding will follow. We once had one person here making unbelievably extraordinary claims about a particular CAM product but never saw a shred of evidence. We kept hearing how a real study would occur but for many of these products, they rely on testimonials and anecdotes which are unreliable. Imagine if we were still relying on testimonials for radioactive tonics! There’d be a lot of dead people.

That second gold standard is the clinical or laboratory observations of a trained doctor or scientist.

This is where people really get tripped up. It’s very important to realise that no one can completely rely on their own subjective experience as evidence that a treatment or experiment actually works without appropriate controls being put in place. It can be and is very deceiving and we simply cannot rely upon it. All of us, no matter how well educated, are prone to misperception, biased memory, confirmation bias, the need to justify our beliefs, influenced by the fact that we’ve invested in a treatment, and influenced in our hoping that the treatment will work. There’s a lot of factors at work that lead to a subjective sense that treatments are effective. It can be very compelling and difficult to make people understand that their own subjective experience is misleading and deceiving. It takes a certain level of skepticism to really appreciate this and probably the hardest thing to deal with when it comes to medical treatments and observation. The way around this is to trust in the abstract numbers generated by a properly controlled study and not the investigator’s own experience. History demonstrates quite clearly that personal experience is mostly misleading and therefore worthless. Anecdotes and subjective experience should be used for generating a hypothesis. From there the real work begins to work out if it is true through the scientific method. Again the radioactive tonics remedy is a good example. People thought they felt better, had more energy and vitality but all the while they were slowly killing themselves.

I find particularly interesting about all of this is how relatively dismissive the medical system is toward gut dysfunction.

My inclination here would be to say that there isn’t much in the way of evidence to show that a certain type of gut dysfunction is a clear sign that can be extrapolated to a particular disease.

All that you said sounds great Tom and there’s a lot there to hypothesise about but are you aware of some good data to back up these ideas? Other published work that can support the gut-brain theory? I don’t think we can get very far unless we can find some evidence to support at least part of it. I’m open to it if it exists. Has the doctor you quoted got any evidence from which he makes his statements? For me, personal observation and anecdotes, particularly when it comes to CAM therapies, is not enough to convince me for the reasons I outlined above. St John’s Wort, for example, is well studied and there is a proven effect there. It would be great to see more of this going on. I really hope you are able to secure more funding for a larger trial. It would not only make for a hugely successful business if it was published in a high impact journal but would be taken up by mainstream medicine and help millions of people with migraine.

In the meantime my ex-GF (ND) was yelling at me down the phone telling me to take some probiotics! :lol:

Best … Scott :slight_smile:

DID you ever hear of the yeast connection? Same theory. I was a medical assistant to a Dr who believed and studied natural meds (even though he didn’t use them much in his practice). I do believe it wholeheartedly and like Hippocrates said: let food be your medicine, and medicine be your food. I think that B vitamins are antifungal and anti-yeast and that is why they do help some people. Most antidepressants are antifungals too. I am going to try to test the theory using probiotics and B vitamins along with an anti-yeast/antifungal diet and I will let you know. Do you know of anyone who has done this and, if they had results, please let me know. There is a TV show and website that is called know the cause that preaches this theory also.

I am new to this; I had been diagnosed with Meniere’s for the last 4 years only now to find out that it may be the wrong dx since all tests have come back normal (thank God). So by default I have now been diagnosed with MAV.

Edie

Hi everyone

New to the forum but am so interested in this topic. Are we talking Leaky Gut Syndrome here? Can’t read or write much today, just coming out of a bad vertigo spell but will join in the debate as soon as I’ve stabilised a bit. So good to see such a possibly very relevant subject being aired.

Brenda

Welcome Edie,

natural meds … I do believe it wholeheartedly.

Have a look at what I wrote above: “I don’t see any logical reason to differentiate between a natural, alternative or allopathic-labelled treatment. The bottom line is, if we ingest a molecule, and it has a therapeutic physiological effect on the body than it’s a drug no matter where it originates. Indeed many allopathic drugs originate from natural sources such as the powerful chemotherapy drug vincristine (Madagascar periwinkle) and everyday aspirin (Willow bark). And, of course, there are many natural substances that are deadly and certainly don’t equate to health –– snake venom, ricin and tobacco kill people!”

In fact, this last week, the FDA in the US told the maker of Cheerios cereal to change the info label. As it stands, the claims on the box put it into the category of a drug. So, next time you wake up, pour yourself a bowl full of drugs and add milk! :lol:

When a “natural” substance is found to have efficacious properties in disease treatment it’s usually picked up by the pharmaceutical industry, the active molecule extracted, and the product marketed as a drug.

Welcome to you too Brenda - we’re not really discussing leaky gut; rather, trying to work out if there’s any evidence to support the idea that treating the gut might alleviate migraine or if migraine somehow originates in the gut.

Hi Tom,

George sent me a very good paper today. Something we can sink our teeth into.

[size=130]The minicolumnopathy of autism: A link between migraine and gastrointestinal symptoms[/size]
Medical Hypotheses (2008) 70, 73–80
MF Casanova

In summary:

— Begin quote from ____

• autism and migraine share a very similar set of symptoms, including gastrointestinal problems (news to me).

• It is our contention that in autism a minicolumnopathy (brain) provides for both a hyperexcitable cortex and a serotonergic imbalance that manifests itself early in life as abdominal migraines.

• Increased levels of serotonin (facilitated release or decreased reuptake) have an anticonvulsant effect. This mechanism of action helps explain the link between epilepsy and depression.

• Platelet serotonin is exogenously derived and taken within cells by an active transport mechanism. In autism multiple lines of evidence suggest that platelets are not exposed to increased concentrations of serotonin but, rather, seem to mishandle this chemical.

• Double blind studies of serotonin reuptake inhibitors, clomipramine, and fluvoxamine as well as open label studies of fluoxetine and sertraline, have documented efficacy in treating various symptoms of autism (not unlike migraine).

• The large majority of the body’s serotonin is found in the cells of the gut. Serotonin is released from the gut to the bloodstream but serum levels are kept low by uptake into platelets. In migraineurs there is a deficit in uptake kinetic of serotonin by platelets that accounts for abnormal levels of this chemical. During the headache phase there is a fall in blood levels of serotonin and an increase in its metabolites in both plasma and urine.

• serotonin, a potent vasoconstrictor, was shown to be released from platelets during migraine attacks.

— End quote

— Begin quote from ____

• A therapeutic response to anticonvulsant therapy has been noted in case reports and series of children with abdominal migraine.

• The mechanism underlying cortical hyperexcitability in migraine is unknown but may be related to increased levels of cerebrospinal glutamate and reduced brain levels of Mg2+.

• migraine-like equivalents have been described in young children with autism, e.g. abdominal pain.

• The term ‘‘migraine equivalent or variant’’ is used in these cases where transient organ system dysfunction occurs in some individuals with migraine or familial predisposition to the same. Symptoms include discrete paroxysmal attacks of dizziness/vertigo, abdominal pains, bloating, vomiting (bilious attacks), and diarrhea.

• Abdominal migraine is episodic with recovery between attacks.

• with migraine equivalents … indeed there is probably no field in medicine so strewn with the debris of misdiagnosis and mistreatment, and of well-intentioned but wholly mistaken medical and surgical interventionsto label migraine as a neuroinflammatory condition.

• Early writers believed that migraine was caused by toxins connected to abdominal disorders. More recently, researchers believe that migraine is generated by normal brain structures in response to abnormal physiological reactions in what has been called a wave of ‘‘spreading depression’’.

— End quote

[size=130]Conclusions[/size]
The gastrointestinal complaints of autistic patients are a migraine equivalent. Both autism and migraine are defined by serotonergic abnormalities and a hyperexcitable cortex.

So it looks like the evidence supports migraine originating in the brain in the same way autism originates in the brain. A very similar symptom set. Really interesting to note that platelets do seem to play a role in this somehow as I hypothesised above. It seems likely that there is some abnormality there. The above also supports why stablising brain serotonin with meds is so effective for migraine.

Best … Scott 8)

THANKS! Scott

Question for you ?? Do you think, If there is a relationship betwen migraine and autism what do you think about gluten and casien free diets and the inprovment in autism, do you think the same may hold true for migraines??? my nephew is autisic and has improved from this kinds of diet enough to put him in in a “standard” class 1 grade behind.

and yes naturals are still medicine. marjuana is natural!! so is opium , morphine and look what they can do to your brain even mold and rye.

thanks

edie

Hi Edie,

I’m afraid I don’t know much about how a gluten-free diet might affect migraine. I can only guess that if a person had migraine and Coeliac disease, that eating foods containing gluten would seriously upset the body’s homeostasis. It can cause problems with iron absorption for example. And a “migraine brain” does not like it when homeostasis is upset. But interesting that your nephew improved so much following this. I’d hate to have to give up gluten-containing products on top of a migraine diet though. I’d be left with having bowls of rice and nothing else! :wink:

Best … Scott

Good morning all,
I spent a long weekend attending my son’s college graduation in Nashville, Tennessee, a wonderful moment for any parent. I have not had a chance to get on the computer and have some catching up to do.

I have read through the posts and appreciated everyone’s comments and questions. I will not have time to read all the references you suggested, Scott, at least not for a couple days. You have made several comments that i really must respond to because they affect our ability to clearly communicate. Your statement:

I personally don’t see any logical reason to differentiate between a natural, alternative or allopathic-labelled treatment. The bottom line is, if we ingest a molecule, and it has a therapeutic physiological effect on the body than it’s a drug no matter where it originates. Indeed many allopathic drugs originate from natural sources such as the powerful chemotherapy drug vincristine (Madagascar periwinkle) and everyday aspirin (Willow bark). And, of course, there are many natural substances that are deadly and certainly don’t equate to health –– snake venom, ricin and tobacco kill people!

I often point to scurvy as an illustrative disease. Are you suggesting that oranges are a drug because they can have a therapeutic physiological effect on a body suffering from scurvy? I also think it would be valuable to differentiate between natural products and foods. As I like to say you do not have a headache because of a lack of tylenol in your system and you also dont have a headache because of a lack of feverfew in your system. Just because something is natural does not mean that it is a food. I would argue that indeed botanical medicine is closer to pharmaceutical medicine than it is to nutritional medicine, because most herbs that are used therapeutically are not typically used as food.

Scott I would appreciate your definition of chronic disease.

Sorry I don’t have time for more now.

All the best,
Tom

Hey Tom,

Good point to clarify. Things that are necessary for cellular function such as vitamin C, which our bodies cannot manufacture, must be ingested. We also need to ingest carbohydrate, protein and fat. So foods and vitamins and minerals are not classified as drugs per se. Funny to think of an orange as a drug! :lol:

I don’t see any point in separating out natural versus non-natural therapies. As I mentioned, no matter what the source, there will be some sort of active molecule(s) doing the job. How do you define nutritional medicine? Do you consider vitamin C a medicine in the case of someone with scurvy and therefore the orange itself is medicine?

I would define chronic disease as any disease that is either recurrent or of long duration typically with a slow progression but not always. Type 2 diabetes would fit this, chronic fatigue syndrome, heart disease, cancer, asthma, and of course migraine.

Best … Scott 8)

Hi Scott,

well the theory with the gluten/casein is that it is inflammatory whether in you gut or your brain it is your body’s choice as to what it effects. the only way to test this theory is to go gluten/casein free and see . It is along the lines of same theory as the leaky gut being an ID reaction, though the problem is really in the intestines it effects other parts of body

thanks

edie

Hello again,
I have just taken the time to review this thread in some detail and I am reminded of what concerned me from the beginning. Obviously this is mostly a conversation between Scott and myself which is fine. I think I am a little frustrated at your ability to be so dismissive of the philosophical basis from which i am arguing. So let me address some of my earlier points.

The Second Gold Standard of Research. The observational skills of scientist, researchers and doctors cannot be so easily dismissed. Your comment:

“This is where people really get tripped up. It’s very important to realise that no one can completely rely on their own subjective experience as evidence that a treatment or experiment actually works without appropriate controls being put in place. It can be and is very deceiving and we simply cannot rely upon it. All of us, no matter how well educated, are prone to misperception, biased memory, confirmation bias, the need to justify our beliefs, influenced by the fact that we’ve invested in a treatment, and influenced in our hoping that the treatment will work.”

While i can agree that placebo controlled studies are best able to determine what a specific treatment may or may not accomplish, i was speaking more from a philosophical basis. Darwin, Einstein, Newton, Edison, and many others who are credited with adding tremendous amounts to our scientific knowledge did not rely on double blind placebo controlled studies. Rather it was their careful observations that led to their theories that over time have been accepted as scientific fact.

Along these lines how can we look at the various manifestations of migraine and conclude that it is the same disease in all that suffer. How is it possible to look a women who gets migraines every month at her cycle and a man who gets a migraine every time the barometric pressure drops and conclude they have the same disease? The only way it is possible is to conclude that the symptoms = the disease and if you can design a drug or nutritional supplement that relieves their pain than you have treated their disease. But come on, how can you look at those two people and say they have the same problem? This is in essence the problem with the medical paradigm as it exists today. The migraine sufferer has a clearer understanding of what i am saying than the doctors treating them, no disrespect to any doctors intended.

How can we observe that certain foods trigger a migraine and dismiss the possibility that the digestive system is playing a role in migraine disease? To me it is an obvious indication that gut function is playing a role. But because the pain is in the head the focus of research relative to cause must be in the head.

Another comment you made I found somewhat unfair and misleading so i would like to comment on it. You were responding to my comment: “I felt compelled to ask the question “what if the ancient understanding of disease is correct?” What if it is an imbalance in the organism and the only path to cure is to remove the obstacles standing in the body’s way of its ongoing attempt to reach homeostasis.”

And you said:

“To me that all sounds fantastic and I can see how anyone might think it makes sense about vitality being off, some imbalance being present, the body wanting to reach homeostasis, old traditions etc. However, ancient Egyptians believed the heart was the centre of thought and the brain cooled the body; the Romans figured a bad uterus caused hysteria; and you might have heard about blood-letting days in London around 1800. People were drinking radioactive tonics as recently as the early 1940s saying they actually felt better yet they were killing themselves. The US had to ban them in the end. Myths about the body and health linger on even in 2009, some astoundingly ludicrous but pervasive nonetheless. We can philosophise about this, come up with lots of great sounding ideologies and theories, and even write tons about it I’m sure … it’s all emotionally satisfying.”

Please understand that my comments were philosophical and in no way an attempt to say that any and all treatments that were used at some time in the past were reflective of the traditional philosophies and their belief as to what causes disease. The fact that health care practitioners and philosophers had more limited knowledge than we do today is not an indictment of what their observations told them about how disease occurs.

Relative to “myths about the body and health linger on even in 2009” why don’t we each list a few and why we believe they are myths.

  1. Biochemical toxins (drugs) are the best way to cure disease. What is the principal behind this belief? The only one i have been able to find is the success of penicillin (discovered by observation incidentally) in the conquering of infectious disease. This set us on the path of belief that modern medical research would find the “magic bullets” to cure other diseases as well. Can anyone tell you of someone who was cured of their chronic disease by a drug? To the contrary most of the migraine sufferers who I have met who no longer suffer from the disease will credit a life style change, changed my job, got a divorce, changed my diet,etc. rather than claiming they found the right drug.

  2. If someone suffers from both IBS and migraine both the neurologist and the gastroenterologist will assure the patient that the conditions are not related. Interestingly, many of these patients will intuitively know there is a connection. This myth that every condition is largely independent of every other condition is the result of the evolution of medical specialization. You go to this doc for your heart and this doc for your gut and this doc for your head and they each study their particular “piece of the human pie” and they are not trained to look at you holistically. Consequently you end up taking different drugs designed to treat the symptoms of each disease and the doctor has done his/her job but the patient is not better. Furthermore Dr. Gershon’s work showing the existence of the gut brain is still being largely ignored by both the gasto docs and the neuro docs…why? Maybe because it will force them to collaborate and that is not they way they were trained.

  3. The “next” drug is not a problem if it treats the symptom it is designed to treat. Said another way it is okay if you are taking 4,6, or 8 drugs at a time. I spoke recently with a doctor of pharmacy who teaches at a pharmacy school and he told me that when a patient is put on a single class of drugs the doctors are pretty clear on what reaction the body will have to that drug. When they put that patient on a second class of drugs the interaction of two classes is pretty much understood. However once they put a patient on the third class of drug they really dont understand how the combination affects the organism. Now combine that with a conversation I had with the head nurse at a local nursing home. We got into a conversation about health and wellness and she asked me to guess the number of drugs the average person in the nursing home was on. I guessed 5 and she said 12. I was astounded and she commented “oh, that is not the most amazing thing”. “Really?” I said, “what is the most amazing thing?” Her comment was that when a family decides to extend no further effort to keep their loved one alive and the stop all of their medications typically one of two things happens…either nothing or they get better.

Can anyone show me research that shows taking six or eight medications is beneficial to the human organism? Or can you just show that each one has been shown to be effective to some degree at treating the symptoms they were designed to treat.

Listen, I know that many advocates of natural medicine are out to slay the dragon (pharmaceutical medicine) and they see a great conspiracy to keep people sick and that it is all money driven. I am not one of them. Rather my focus is to acknowledge the limitations of all paradigms and philosophies and try to see if maybe there is a better way to look at the problems (diseases) that so many suffer from.

I realize that most of what i am sharing is not based in double blind placebo controlled studies and I do understand their value. I do not think that you are willing to acknowledge their limitations. Where has the gold standard of medical research taken us? Do we have a medical paradigm that effectively treats those who suffer from chronic illness? Is the paradigm effective at returning patients to good health? Is the failure of pharmaceutical medicine in the curing of chronic illness a result of poor product design or is the underlying philosophy faulty?

With respect and anticipation of your response,
Tom

Hi Tom,

Thank you for your interest in migraine and your contributions to this forum. I appreciate your sincerity and desire to assist migraine sufferers. I just have a few comments.

Hello again,
I have just taken the time to review this thread in some detail and I am reminded of what concerned me from the beginning. Obviously this is mostly a conversation between Scott and myself which is fine. I think I am a little frustrated at your ability to be so dismissive of the philosophical basis from which i am arguing. So let me address some of my earlier points.

I think philosophy and science are two quite different disciplines, with different methodolgies. Not that there isn’t room for a philosophical approach, just that it is not science.

The Second Gold Standard of Research. The observational skills of scientist, researchers and doctors cannot be so easily dismissed. Your comment:

“This is where people really get tripped up. It’s very important to realise that no one can completely rely on their own subjective experience as evidence that a treatment or experiment actually works without appropriate controls being put in place. It can be and is very deceiving and we simply cannot rely upon it. All of us, no matter how well educated, are prone to misperception, biased memory, confirmation bias, the need to justify our beliefs, influenced by the fact that we’ve invested in a treatment, and influenced in our hoping that the treatment will work.”

While i can agree that placebo controlled studies are best able to determine what a specific treatment may or may not accomplish, i was speaking more from a philosophical basis. Darwin, Einstein, Newton, Edison, and many others who are credited with adding tremendous amounts to our scientific knowledge did not rely on double blind placebo controlled studies. Rather it was their careful observations that led to their theories that over time have been accepted as scientific fact.

These theories have been accepted after numerous other studies confirmed their plausibility. I’m not sure all their theories have actually been accepted as “fact”, eg evolution, but as plausible.

Along these lines how can we look at the various manifestations of migraine and conclude that it is the same disease in all that suffer. How is it possible to look a women who gets migraines every month at her cycle and a man who gets a migraine every time the barometric pressure drops and conclude they have the same disease? The only way it is possible is to conclude that the symptoms = the disease and if you can design a drug or nutritional supplement that relieves their pain than you have treated their disease. But come on, how can you look at those two people and say they have the same problem? This is in essence the problem with the medical paradigm as it exists today. The migraine sufferer has a clearer understanding of what i am saying than the doctors treating them, no disrespect to any doctors intended.

Many diseases are experienced differently by the sufferer but remain the same disease. Similarly, there are many varying triggers for the same disease. This doesn’t mean the disease is a unique disease or even a unique strain. The evidence does seem to stack up that migraine is a disease of the brain, albeit one which manifests in many areas of the body (which we would expect for a brain disease). It is also well known that migraineurs all experience a range of weird symptoms, including in the gut (abdominal migraine) and that there is a relationship between migraine and a range of other conditions. Further, we also know that each migraineur responds differently to various treatments (not just drugs) so there may well be a place for a gut treatment.

How can we observe that certain foods trigger a migraine and dismiss the possibility that the digestive system is playing a role in migraine disease? To me it is an obvious indication that gut function is playing a role. But because the pain is in the head the focus of research relative to cause must be in the head.

I don’t get headaches with migraine but I do sometimes have abdominal symptoms. It is well documented that migraine manifests in an astonishingly varied way. Such is the reach of the brain.

Another comment you made I found somewhat unfair and misleading so i would like to comment on it. You were responding to my comment: “I felt compelled to ask the question “what if the ancient understanding of disease is correct?” What if it is an imbalance in the organism and the only path to cure is to remove the obstacles standing in the body’s way of its ongoing attempt to reach homeostasis.”

And you said:

“To me that all sounds fantastic and I can see how anyone might think it makes sense about vitality being off, some imbalance being present, the body wanting to reach homeostasis, old traditions etc. However, ancient Egyptians believed the heart was the centre of thought and the brain cooled the body; the Romans figured a bad uterus caused hysteria; and you might have heard about blood-letting days in London around 1800. People were drinking radioactive tonics as recently as the early 1940s saying they actually felt better yet they were killing themselves. The US had to ban them in the end. Myths about the body and health linger on even in 2009, some astoundingly ludicrous but pervasive nonetheless. We can philosophise about this, come up with lots of great sounding ideologies and theories, and even write tons about it I’m sure … it’s all emotionally satisfying.”

Please understand that my comments were philosophical and in no way an attempt to say that any and all treatments that were used at some time in the past were reflective of the traditional philosophies and their belief as to what causes disease. The fact that health care practitioners and philosophers had more limited knowledge than we do today is not an indictment of what their observations told them about how disease occurs.

Agreed. Nor should we consider that what we know now is all we will ever know. Discoveries are constantly being made through ongoing research. These days however, we require more stringent evidence as confirmation. This is a good thing.

Relative to “myths about the body and health linger on even in 2009” why don’t we each list a few and why we believe they are myths.

  1. Biochemical toxins (drugs) are the best way to cure disease. What is the principal behind this belief? The only one i have been able to find is the success of penicillin (discovered by observation incidentally) in the conquering of infectious disease. This set us on the path of belief that modern medical research would find the “magic bullets” to cure other diseases as well. Can anyone tell you of someone who was cured of their chronic disease by a drug? To the contrary most of the migraine sufferers who I have met who no longer suffer from the disease will credit a life style change, changed my job, got a divorce, changed my diet,etc. rather than claiming they found the right drug.

I agree drugs are not necessarily the only answer, however I have never met a doctor who suggested this. I have only ever heard a holistic approach regarding the need for general health and wellbeing (diet, exercise, lifestyle) to support drug therapy. They all work together to produce a healthy(ier) individual.

  1. If someone suffers from both IBS and migraine both the neurologist and the gastroenterologist will assure the patient that the conditions are not related. Interestingly, many of these patients will intuitively know there is a connection. This myth that every condition is largely independent of every other condition is the result of the evolution of medical specialization. You go to this doc for your heart and this doc for your gut and this doc for your head and they each study their particular “piece of the human pie” and they are not trained to look at you holistically. Consequently you end up taking different drugs designed to treat the symptoms of each disease and the doctor has done his/her job but the patient is not better. Furthermore Dr. Gershon’s work showing the existence of the gut brain is still being largely ignored by both the gasto docs and the neuro docs…why? Maybe because it will force them to collaborate and that is not they way they were trained.

This has not been my experience, quite the opposite in fact. I recognise however that this is anecdotal and others may have had different experiences.

  1. The “next” drug is not a problem if it treats the symptom it is designed to treat. Said another way it is okay if you are taking 4,6, or 8 drugs at a time. I spoke recently with a doctor of pharmacy who teaches at a pharmacy school and he told me that when a patient is put on a single class of drugs the doctors are pretty clear on what reaction the body will have to that drug. When they put that patient on a second class of drugs the interaction of two classes is pretty much understood. However once they put a patient on the third class of drug they really dont understand how the combination affects the organism. Now combine that with a conversation I had with the head nurse at a local nursing home. We got into a conversation about health and wellness and she asked me to guess the number of drugs the average person in the nursing home was on. I guessed 5 and she said 12. I was astounded and she commented “oh, that is not the most amazing thing”. “Really?” I said, “what is the most amazing thing?” Her comment was that when a family decides to extend no further effort to keep their loved one alive and the stop all of their medications typically one of two things happens…either nothing or they get better.

While I accept this may well be the case these are anecdotal accounts. Again, in my experience most doctors and health professionals are only too willing to acknowledge the limits of medical knowledge in its current form.

Can anyone show me research that shows taking six or eight medications is beneficial to the human organism? Or can you just show that each one has been shown to be effective to some degree at treating the symptoms they were designed to treat.

Well, this is only anecdotal, but my father takes a cocktail of drugs every day. Before he started he was in a great deal of pain and at risk of a heart attack. I don’t think he’s willing to risk experimenting with suspending his meds. He’s quite fond of life.

Listen, I know that many advocates of natural medicine are out to slay the dragon (pharmaceutical medicine) and they see a great conspiracy to keep people sick and that it is all money driven. I am not one of them. Rather my focus is to acknowledge the limitations of all paradigms and philosophies and try to see if maybe there is a better way to look at the problems (diseases) that so many suffer from.

Again, I think this is admirable but again in my experience doctors themselves are only too happy to acknowledge the limitations. In my experience, where a patient wishes to try a CAM therapy this is generally supported by a doctor (or not ruled out) where there is no evidence of risk in doing so and when taken in conjuction with a drug whose efficacy is supported by evidence (which doesn’t have contraindications with the CAM therapy).

I realize that most of what i am sharing is not based in double blind placebo controlled studies and I do understand their value. I do not think that you are willing to acknowledge their limitations. Where has the gold standard of medical research taken us? Do we have a medical paradigm that effectively treats those who suffer from chronic illness? Is the paradigm effective at returning patients to good health? Is the failure of pharmaceutical medicine in the curing of chronic illness a result of poor product design or is the underlying philosophy faulty?

I don’t think the medical paradigm claims to be perfect. Quite the opposite in fact. That is why research is ongoing - in universities, hospitals and pharmaceutical companies. Perhaps it is not the underlying philosophy which is at fault but human beings themselves? Evolution has produced a lot of imperfect humans, that is for sure :slight_smile:

With respect and anticipation of your response,
Tom

Regards,
Victoria

Hello faithful readers,
Victoria I am most grateful for your thoughtful and intelligent comments. I want to make many comments and am not sure where to begin.

Let me say that I really appreciate the effort that everyone who has commented has made to keep this discussion civil and intellectual. I tried to share my thoughts and theories on another forum once and essentially was treated like a charlatan who was out to steal peoples money. I am confident that what I have learned is valuable and offers exciting potential to at least some migraine sufferers, so thank you again for listening and sharing.

Several years ago in a conversation with Michael John Coleman the executive director of MAGNUM (Migraine Awareness Group, National Understanding for Migraineurs. migraines.org) I suggested that the migraine doctors would not be interested in what I am doing. His comment stuck with me. He said, “Oh, you are going to be surprised. The migraine docs are just as frustrated as their patients with their inability to get any kind of consistent results and anything that shows any promise, whether pharmaceutical or natural, will get attention.” I was reminded of that comment when i read what you posted Victoria because as a group the migraine docs are more willing than most to acknowledge the limitations of their knowledge and the limits of the treatment options so I want you to know that your experience in this regard is common amongst migraine sufferers, in my experience. I must acknowledge that I am prone to getting on my soap box and coming across a bit critical of doctors and pharmaceutical medicine. What I truly understand, as i have mentioned before, is that pharmaceutical medicine is of GREAT value to migraine sufferers and i do not mean to dismiss their contribution. By the way MAGNUM is a wonderful resource and is supported by contributions. If anyone is able and willing please consider a contribution to their efforts.

It is interesting to consider the question, “how much do we really understand?” I have made the following comment to a number of doctor friends through the years: “If all the information necessary to understand exactly how the body works, what causes disease, and what it takes to recover from disease is represented by a gallon of water…what we really and truly understand…so far…is about two teaspoons.” When I have a doctor alone, not surrounded by colleagues they typically respond with something like this “yep, the more i read and learn the more i realize how little we really understand.”

I often tell my migraine customers that the best doctor they will ever find is the one they see in the mirror every morning. I have come to believe that we have an intuitive knowledge of our own health and wellness that is superior to anything anyone can learn from a book. This statement will be more acceptable to those of you in you 40s, 50s, and 60s than to those of an earlier age. It has been amazing to me how many of my customers call and tell me that they always knew that their migraines were related to their gut but that their doctors always assured them that that was not the case.

Now for some more specific comments. Victoria, you said “I think philosophy and science are two quite different disciplines, with different methodolgies. Not that there isn’t room for a philosophical approach, just that it is not science.”

I dont disagree with what you say but let’s remember that if there is not a clear philosophy or theory to explain the basis for a scientific approach then what are we doing. I am specifically referring again to the use of pharmaceutical medicine in the treatment of disease. If we say that migraine is a collection of these symptoms including head pain and vertigo and we can show that a certain drug relieves pain for some people for some period of time but does not stop the next symptom from occurring, can we say, scientifically, that the drug treats the disease? Is migraine caused by a lack of Imitrex in the system? Again I ask the question what is the philosophy or theory behind the use of drugs to treat disease.

You can use a scientific method to show that a drug treats a symptom of a disease…does that mean it treats the disease??

So my point is that while science and philosophy/theory are different if you don’t start from an understanding as to what causes disease you are simply using the scientific method to treat someones symptoms and then saying you are treating the disease.

If you had to choose between the two options which would you choose.

  1. I don’t know what causes the disease and i dont know how to cure it but here is how i am going to manage your symptoms.
  2. I believe that migraine is caused by gut dysfunction, but I cant prove it…yet. Here is the philosophy/theory behind my belief. And here are the products that will help your gut dysfunction heal. It might result in improvement or resolution of your migraine problems or it might not.

Forget that I have a vested interest in #2 and simply ask yourself what would you choose? Personally I would want to control my symptoms while I investigated various theories related to cause.

This leads to another of your comments that I found very interesting I wrote:

“Along these lines how can we look at the various manifestations of migraine and conclude that it is the same disease in all that suffer. How is it possible to look a women who gets migraines every month at her cycle and a man who gets a migraine every time the barometric pressure drops and conclude they have the same disease? The only way it is possible is to conclude that the symptoms = the disease and if you can design a drug or nutritional supplement that relieves their pain than you have treated their disease. But come on, how can you look at those two people and say they have the same problem? This is in essence the problem with the medical paradigm as it exists today. The migraine sufferer has a clearer understanding of what i am saying than the doctors treating them, no disrespect to any doctors intended.”

Your response was:
“Many diseases are experienced differently by the sufferer but remain the same disease. Similarly, there are many varying triggers for the same disease. This doesn’t mean the disease is a unique disease or even a unique strain. The evidence does seem to stack up that migraine is a disease of the brain, albeit one which manifests in many areas of the body (which we would expect for a brain disease). It is also well known that migraineurs all experience a range of weird symptoms, including in the gut (abdominal migraine) and that there is a relationship between migraine and a range of other conditions. Further, we also know that each migraineur responds differently to various treatments (not just drugs) so there may well be a place for a gut treatment.”

Please help me to understand what you mean by disease. We tend to treat disease as an entity. As if we were walking down the street and got attack by migraine or IBS or arthritis. Is that the reality, has it been proven by science? Earlier I asked Scott for his definition of chronic illness and he responded with “I would define chronic disease as any disease that is either recurrent or of long duration typically with a slow progression but not always. Type 2 diabetes would fit this, chronic fatigue syndrome, heart disease, cancer, asthma, and of course migraine.” While I accept his definition it tells me nothing about cause. How can something be the same disease if it is experienced differently by the sufferers. Why is it not possible that it is different diseases?

Are some of you beginning to see that the problem is that all chronic disease is defined by their symptoms and as long as that is the case there is no hope for cure? Maybe the hill I am trying to climb is bigger than i realize :lol:

I have theorized that poor digestive function is leading to malnutrition in the protein metabolism cycles of the body that are responsible for making the internal proteins that allow the human organism to function. If anyone can direct me to any scientific literature on how the human organism digests, absorbs and utilizes protein, I would be most grateful.

In gratitude for our discussion,
Tom Staverosky
tom@foreverwell.com