Alopecia – hair loss; autoimmune & other reasons

Male pattern baldness, thinning at the forehead scalp line, can have genetic reasons and can be more likely when autoimmunity is a factor. The hair follicles become dysfunctional due to autoimmune changes. Malnutrition of adequate protein, trace minerals, and B vitamins, methylated forms, may also be involved, and also essential fatty acids and phospholipids play a role.

Nutrients that play a role in hair growth or other growth and energy pathways:

  • Methyl folate, methyl B12, choline, other B vitamins,
  • Magnesium, especially Epsom salt soaks, which provides sulfate also,
  • Trace minerals including boron, silicon, manganese, molybdenum, copper, and especially zinc, and inadequate Iodine in ratio to excess halides (bromide, fluoride, chloride), is likely involved,
  • Nrf2 promoting foods (page G10)/herbals, especially sulfur containing foods like onions and cruciferous vegetables. Herbs and Spices adds more of the Nrf2 promoting phytonutrients in addition to trace minerals and other vitamins. See page G10. Nrf2 Promoting Foods, on the site: effectivecare.info.
  • p53 promoting foods is a similar list with some more specific herbals.
  • Fennel seeds or fennel oil, seem to particularly help hair growth, and other
  • Phospholipid rich foods also can help build strong flexible membranes which are needed for strong hair or healthy cells: seeds, nuts, whole grains, cumin, coriander, cardamom,
  • Protein adequacy – hair is made of protein,
  • Omega 3, EPA/DHA, is also involved in having strong flexible membranes,
  • Moderate carb, higher fat from coconut & olive oil & pumpkin seeds/blanched almonds, can help reduce inflammation.

Low stomach acid may be factor in low B vitamin level. 2 spoons of apple cider vinegar or lemon juice with a meal can help low stomach acidity & increase B vitamin intake. It is similar type of acidity.

Fennel seeds or Fennel oil (how to make it yourself link)

Fennel seeds – eat them and are used in a scalp and hair oil by making your own or buying some Make your own, link: How to make Saunf – Fennel Oil and use for Hair Growth Benefits; Prevents Hair Loss Cleanses Scalp. (herzindagi.com)

Fennel Seed Oil product page, *unaffiliated: Fennel Seed Oil Benefits.

  • Free radicals are detrimental to the hair. Without enough antioxidants in the body, free radicals can cause oxidative stress, which impedes hair growth and causes thinning. Fennel seeds are packed with antioxidants, as well as nutrients like pantothenic acid, iron, molybdenum, copper, folate, iron, and niacin that stimulate hair growth.” (simplyorganicbeauty.com)

Magnesium, protein & phospholipids are needed for reducing oxidative stress whether it is from fear, worry, physical work or exercise, or from an infection or chronic illness. Volatile chemicals from new vinyl furnishings or smoke or smog may also increase inflammation. Poor sleep quality, bright lights in the evening, or EMF exposure anytime, may be increasing low level chronic inflammation. https://twitter.com/deNutrients/status/1508741284281950211?t=1bZp3cy352Op2cH0H64-Gg&s=19…

This site http://Transcendingsquare.com has my main magnesium blogs: To have optimal magnesium needs protein and phospholipids too (Food sources and supplement types of magnesium and food sources of phospholipids and the basic protein minimal requirements for a healthy diet. We can not have electrically active ions of magnesium present in excess, or other ions.

Protein transport proteins carry magnesium and other trace minerals and may be shared. So too much of one type can cause a deficiency of another type of trace mineral – as seen with the interaction between high intakes of zinc leading to low copper, or high intakes of copper leading to low zinc. (to-have-optimal-magnesium-needs-protein-and-phospholipids-too/)

A personal success story – low oxolates, gluten free, moderate carb Paleo approach:

Carla Coulson shares about her own strategies that helped with her autoimmune and alopecia hair loss symptoms – she uses a Paleo approach which may be a higher protein balance than I tend to recommend (Moderate carb calorie diet: 30% carb/45-50% fat/20-25% protein). Lower carbohydrate intake and adequate protein is likely helpful for reducing inflammation and improving mitochondrial health and cytokine balance.

Cutting out gluten and going on a low oxalate diet were also important steps she says in the article: Cutting out gluten and going on a low oxalate diet were also important steps she says in the article: Auto-immune – going, going, almost gone! CarlaCoulson.com.

Immune Cell – cytokines and myokines

Cytokines or myokines (like cytokines but formed by muscle cells during activity) are inflammatory signals made in response to physical or emotional stress and they cause junior immune cells to differentiate into more specialized types. The types vary to respond to different types of pathogens, or other needs.

Excessive numbers of active immune cells may be created during an infection or stressful time of life from the increased amounts of inflammatory cytokines, or for people with very strenuous physical work or exercise as more myokines form with increased muscle activity. Having an excess of myokines from muscle overwork, or excess cytokines from EMF exposure, infection, or a really stressful day, can lead to more junior immune cells converting into whatever active form the specific type of cytokine or myokine causes.

This increase in immune cells may lead to more risk of antibodies forming against food proteins that also resemble one of our own proteins. These antibodies then attach to our tissue and our own immune cells then attack one of our own cells. This leads to autoimmune damage to cells and tissues that have a lot of that type of protein. The gluten protein found in wheat, barley, rye, and other grains is similar thyroid tissue and can be a factor in autoimmune thyroid disease. Molecular mimicry – dietary molecules mimicking a body protein can cause the immune antibodies to be formed against the body protein.

In the case of spike lodged in a receptor, the numerous immune cells may make autoimmune antibodies against that type of receptors. Video https://odysee.com/@BacktoBasics:e/99-Etappensiege-Original—Dr.-Sherri-Tenpenny:d

The risk of antibodies forming against food proteins is also more likely if leaky bowel membranes are a problem – leaky in the sense that larger size proteins can slip through gaps between cells (called tight junctions). The mucus or jelly like glycocalyx layer that coats our mucus membranes and intestinal lining, helps close that gap between cells. Eating more foods like okra, or slippery elm powder in tea, can help add to the fibrous structure of the glycocalyx.

As a bonus for eating more fiber rich foods, including the gooey ones (mucilaginous starches – can attract and hold water kind of like a sponge), the hair follicle is also supported. The glycocalyx, extracellular matrix (semi-solid fluid environment surrounding our cells), and the hair follicle which grows and supports our individual hairs, are all made in part with proteoglycans. (4)

  • The proteoglycans are part of membrane cell,
  • they are part of the glycocalyx and the extracellular matrix,
  • they are compound by carbohydrates and sulfated amino acids
  • that confers negative charges able to attract water and form gels that resist mechanical forces in the connective tissue,
  • as well as function as a semipermeable and selective membrane to various cationic molecules [positive charged ions or other larger molecules with a positive charge],
  • its direct and indirect interaction with membrane receptors and growth factors regulates several transcription ways involved in the development of multiple pro-oncogenic processes.” (4)

Sulfur containing produce can help promote Nrf2 and provide bioavailable sulfur compounds for our proteoglycan needs. Baths, foot or hand-soaks with Epsom salt, magnesium sulfate, would also help.

Nrf2 is the short name for a gene and the protein it encodes. It helps promote the activation of genes that make antioxidants and promote growth and repair. Sulfarophane is another sulfur containing phytonutrient found in broccoli and other cruciferous vegetables. It is also an Nrf2 promoter. Any of the Nrf2 promoting molecules also tend to be inhibitors of inflammatory pathways as there are circadian cycle proteins that are shared. Simplified example: An assembly line might make one product on the night shift and another on the day shift using the same machine – so the two products can not be made at exactly same time – because the machine is busy.

The membrane control of the positively charged cationic molecules is an important function of proteoglycans and their presence in hair follicles might help explain why radiation poisoning causes hair to fall out. Proteoglycan replacement therapy was found helpful for reducing hair loss in male or female pattern balding. (5)

Research shows that bioactive proteoglycans, e.g., versican and decorin, can actively trigger follicular phase shift by their anagen-inducing, anagen-maintaining, and immunoregulatory properties. This emerging insight has led to the recognition of “dysregulated proteoglycan metabolism” as a plausible causal or mediating pathology in hair growth disorders in both men and women. In support of this, declined expression of proteoglycans has been reported in cases of anagen shortening and follicular miniaturisation.

To facilitate scientific communication, we propose designating this pathology “follicular hypoglycania (FHG),” which results from an impaired ability of follicular cells to replenish and maintain a minimum relative concentration of key proteoglycans during anagen. Lasting FHG may advance to structural decay, called proteoglycan follicular atrophy (PFA). This process is suggested to be an integral pathogenetic factor in pattern hair loss (PHL) and telogen effluvium (TE).” (5)

Low carb diets or moderate low (30% calories from carbohydrates) can help fight inflammation.

Higher carbohydrate diets, such as the standard American diet, cause the body to use B vitamins and magnesium in greater amounts which can lead to deficiency, and store excess carbohydrates as fats throughout the body or excess fructose is converted into fats stored in the liver. When the body is busy making and storing fats in adipose/fat cells, then it can’t be doing other things like growing hair.

Our body needs us to be efficiency experts for it and our microbiome and part of that efficiency is detox and moisture. The glycocalyx or extracellular matrix or our hair follicles can not work well if to dry. We are about 60-70% water and it helps move nutrients to cells and take away toxins. Thick congestion that makes it hard to breathe is glycocalyx that is too dry while a drippy nose with allergy season thin watery mucus is too wet. Health generally is a balance. Drinking plenty of water and moving regularly can use our motion to help the blood vessels circulate nutrients to all of our cells and our lymphatic system to remove toxins.

Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance. Please seek a functional health practitioner for individual health guidance.

Reference List

  1. Haslam IS, Jadkauskaite L, Szabó IL, Staege S, Hesebeck-Brinckmann J, Jenkins G, Bhogal RK, Lim FL, Farjo N, Farjo B, Bíró T, Schäfer M, Paus R. Oxidative Damage Control in a Human (Mini-) Organ: Nrf2 Activation Protects against Oxidative Stress-Induced Hair Growth Inhibition. J Invest Dermatol. 2017 Feb;137(2):295-304. doi: 10.1016/j.jid.2016.08.035. Epub 2016 Oct 1. PMID: 27702566. https://pubmed.ncbi.nlm.nih.gov/27702566/
  2. Pham CT, Romero K, Almohanna HM, Griggs J, Ahmed A, Tosti A. The Role of Diet as an Adjuvant Treatment in Scarring and Nonscarring Alopecia. Skin Appendage Disord. 2020;6(2):88-96. doi:10.1159/000504786 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7109385/
  3. European Medicines Agency. 2008. Assessment Report on Foeniculum Vulgare Miller. Available: https://www.ema.europa.eu/en/documents/herbal-report/assessment-report-foeniculum-vulgare-miller_en.pdf
  4. Sánchez-álvarez, I. & Ponce-Olivera, R.M.. (2017). Role of proteoglycans in the hair follicle. Dermatologia Revista Mexicana. 61. 474-486. https://www.researchgate.net/publication/322852013_Role_of_proteoglycans_in_the_hair_follicle
  5. Wadstein, Jan & Thom, Erling & Gadzhigoroeva, Aida. (2020). Integral Roles of Specific Proteoglycans in Hair Growth and Hair Loss: Mechanisms behind the Bioactivity of Proteoglycan Replacement Therapy with Nourkrin® with Marilex® in Pattern Hair Loss and Telogen Effluvium. Dermatology Research and Practice. 2020. 1-17. 10.1155/2020/8125081. https://www.researchgate.net/publication/341166634_Integral_Roles_of_Specific_Proteoglycans_in_Hair_Growth_and_Hair_Loss_Mechanisms_behind_the_Bioactivity_of_Proteoglycan_Replacement_Therapy_with_NourkrinR_with_MarilexR_in_Pattern_Hair_Loss_and_Teloge

Individual Nutrition assessment – an example chart note

What is health care? What is included in an individualized health care appointment?

The answer varies with the type of specialist you are seeing – and what they are allowed to do within their facilities’, or the individual’s insurance plans protocols.

My nutrition counseling experience was in prenatal/early childhood, and residential (nursing home) facilities.

Chart notes would be written for high risk clients when working in either role. Occasionally the nutrition assessment and recommendations note would be sent to the physician directly if very high risk.

As a preventive health focused prenatal/early childhood counselor, or for residential facility chart review (nutrition assessments of all nursing home residents considered high risk nutritionally, occasionally would include an in person visit with the resident to visually observe and ask further questions about their health and diet symptoms.

Patients typically do not see a chart note. They might be given the ‘Problem’ and ‘Assessment’ sections as an action list of recommendations on a simpler handout. The medical chart has a Care Plan section where recommendations for a daily change in care might be added – such as adding a high protein snack in the evening.

I would typically spend a half hour to an hour per client and writing a good note might take an additional 15 minutes. Current insurance standards have been set which limit physicians to 15 minutes per patient appointment – and only scheduling/discussing one symptom per appointment. That would make a differential diagnosis fairly impossible.

  • The entirety of a person’s symptoms – and what makes the problems worse, and what seems to improve things – is what provides clues to the underlying issues that may have led to the increased inflammation and/or decreased function.
  • Health is a balance of not too much inflammatory response -> autoimmune or allergies – or too little -> rampant infection and catching every cold.
  • Health is also a balance of enough nutrients and not too many toxins to cope with, whether from air, water, food, or touch, or from internal production of stress chemicals caused by emotional or physical stress.

Autoimmune issues are particularly challenging because many odd symptoms can occur, and more than one type of autoimmune antibody may be involved – not just one ‘autoimmune disease’ – several. Low vitamin D makes autoimmune issues more likely to occur, and low magnesium can make low vitamin D more likely – even with supplements of vitamin D.

Low magnesium also increases inflammation symptoms, pain, and anxiety, depression or anger and irritability.

A physician might look at my example note (below) and think: ‘but this is not my field‘ — exactly — please refer to the specialist – a registered dietitian or clinically trained nutritionist. Caution, there are many ‘nutrition certification’ programs online which are not equivalent to a college education, internship, and the equivalent of a lawyer’s Board Exam.

The client gave permission to share the write-up for educational purposes or maybe to help someone. Patients know that pain hurts, and that health is better. Too often I hear from physicians something like ~ ‘we don’t know what is causing this, … so the patient will probably die‘ – but it is regarding symptoms that likely involve nutrient deficiency.

Even sick patients need to eat or be fed and their nutrient needs are likely increased, or decreased, due to the illness, for a few specific nutrients affecting or being used in excess by the underlying issue. Telling a patient there is no hope is providing a nocebo – a negative expectation. Saying “I don’t know,” – when that is the true situation – would at least not be setting up a roadblock for the patient to seek further information or a second opinion.

If in reading my example chart note*, as a physician, you think, ‘but this is not my field‘ — exactly — you are correct – but it is the patient’s whole health that matters, not just symptoms that may be temporarily controllable by medications.

SOAPE note

The SOAPE chart note* below, is an extended version compared to what would be likely to be written in a patient chart. SOAPE note: Subjective, what the client said; Objective, what the clinician observed; Assessment; what the clinician believes may be underlying issues; Problem/Plan, recommendations being made by the clinician; Evaluation – an opinion statement about the likelihood of positive change, based on the overall attitude or motivation the client is presenting and social factors that may impact the client positively or negatively.

I included extra information that might be in a report to the client, with the education they might need to understand the reasoning for the recommendation, or how to proceed. Complex strategies can take several weeks of a class like setting possibly with cooking and tasting demonstrations. My web pages and posts try to provide self care guidance so a motivated learner could just try things and see if they help.

I added some additional info links for the version in this post, to pages or posts that provide some next step guidance, Gluten Free diet? what is that? The products on the market are not ideal suppliers of nutrients in my personal and professional opinion and learning how to bake gluten free can be healthier and less expensive for the nutrient value. My websites are my file cabinet of patient handouts, some of it.

While working as a public health nutrition counselor I did occasionally write a very thorough note for someone with a complicated case, and send it to the client’s physician on their or their child’s behalf.

Nutrient deficiencies can lead to death (niacin/pellagra example) – and can turn around dramatically very shortly after the nutrients and any cofactors are provided (nutrients are a team – refeed gradually and in balance).

Sometimes nutrition care is a life or death situation. Continue the nutrient deficiencies and deterioration can be rapid, and death can be the result. Niacin deficiency, pellagra, has a nickname for symptoms – the four D’s: “Pellagra defines systemic disease as resulting from a marked cellular deficiency of niacin. It is characterized by 4 “D’s”: diarrhea, dermatitis, dementia, and death.” (1) If there is severe lower leg rash and edema – suspect a B vitamin deficiency.


Nutrition assessment

Subjective:

  1. CoV like symptoms, mild, ~ early outbreak mid 2020, left a new problem, 2. swollen throat, reflux like pain/not quite reflux though, flair up of CoV symptoms again later when family had it 2021, again not too bad. 
  2. Swollen throat symptoms – has had labs showing autoimmune thyroid condition.
  3. Thyroid symptoms had improved a year or so earlier after stopping use of wheat/gluten and dairy. Recently started using ginger tea for the throat problem and it sooths. Hasn’t used long term, recent addition. 
  4. Reading about eosinophilic esophagitis did not sound like the problem. 
  5. Reading about histamine/MCAS symptoms did sound like it might be a problem. Tomato/salsa particularly, chicken causes congestion. Likes to drink orange juice.

Objective:

  1. Pale complection, may suggest magnesium deficiency/low vitamin D, low level anemia of chronic inflammation possibly.
  2. Throat visibly enlarged in pattern of enlarged thyroid gland 

Assessment: 

  1. CoV, even with mild symptoms, may have increased autoimmune antibodies, or created new types. Pale complection may suggest magnesium deficiency/low vitamin D, low level anemia of chronic inflammation possibly.
  2. Enlarged thyroid gland would be likely to cause difficulty swallowing at times, particularly if a food flair of the underlying autoimmune antibody sensitivity. (The thyroid gland presses inwards also and can narrow the throat significantly – *personal experience from also being an autoimmune thyroid patient, swallowing a large supplement can be very painful, and may feel stuck even.)
    1. Eosinophilic esophagitis might also be adding to swallowing symptoms if early stages, wouldn’t be causing as severe reflux symptoms as a more advanced case which is more likely to be what is described in articles about the problem. Food sensitivities are the most frequent cause and include gluten, dairy, eggs, and other common food sensitivity foods.
  3. Autoimmune thyroiditis can be a gluten molecular mimicry problem – the thyroid hormone chemically is similar to the gluten molecule. 
  4. Autoimmune antibodies to other food chemicals might also flair up an underlying autoimmune overactive eosinophile problem, white blood cells. Ginger contains a chemical similar to albumin and an egg sensitivity might be triggered by a sudden increase in use of ginger – or chicken – or eggs, or any animal product containing albumin. *also learned from personal experience – this can be a significant problem – I developed sensitivity to eggs and gradually realized I needed to exclude all sources of albumin or my symptoms would flair up again (non healing rash, not quite eczema – more wounds, lack of skin regrowth).
    1. An apparent ‘wheat/gluten’ sensitivity might be an albumin sensitivity, see one of my early posts with the information about plant albumin in wheat and ginger: Wheat is rich in albumin – so are ginger and egg whites.
  5. Histamine sensitivity seems a problem worth working on by decreasing trigger foods. Orange juice could be an additive problem food. The total load is part of the problem but even small amounts can set off the allergy cells that increase inflammatory cytokines and pain/inflammation signals – swollen, itchy, sore throat, dry eyes, but it can also effect mood when a more severe problem – extreme anxiety and fear, or out of control, hyper-excitable.

Problem:

  1. Elevated iron and symptoms of anemia of chronic inflammation may be a lingering CoV effect or of autoimmune conditions – it can be common to have several types of autoimmune antibodies also, and there has been cases of LongCovid where autoimmune antibodies were found. The spike lodges in a receptor and antibodies are made against the receptor, instead of against spike.. 
    1. Iron chelators may help mitigate chronic inflammation damage, restore energy level if that is a problem. The quercetin is one, continue regularly, opposite the niacin protocol if following that., or eat more of the good plant sources of a few, EGCG, pomegranate peel, green tea, oregano, olive leaf extract, there are many see the Iron chelator section of this Resources & Iron Chelators list
    2. Epsom salt soaks for a topical source of magnesium, help immune function, energy level, fluid balance. Continue if already using or start 1-3 times a week.
    3. Sunshine or Full spectrum light 20-30 minutes per day and or a moderate dose vitamin D3 ~ 600-1000 IU. 
    4. Avoid glyphosate residue. Consider supplementing with DMG, dimethylglycine, bulk powder, 1/2 spoonful once or twice a day in water or with a little juice and water. (too much juice is not really good for us).
  2. Thyroid problems in the modern world are likely related to excess fluoride and bromide and too little iodine. Cautiously increasing iodine and 200 mcg selenium may be helpful. Higher dose for one month can help the body to dump fluoride, bromide and chloride. When there is a lack of iodine the body will build molecules with the other halides, but then the thyroid hormone or other chemical won’t work right. Lab tests may show ‘normal’ levels of thyroid hormone but symptoms of hypothyroidism may still be present.
    1. In autoimmune conditions, when possible, it is essential to identify the trigger foods and strictly avoid them. It can take 6 months for antibodies to fade away, at which point symptoms should improve, but memory B cells still exist so even little tastes of the problem foods can set off a new 6 month batch of autoimmune antibodies that will attack the thyroid gland, or esophagus, or wherever else the problem point is located. 
    2. In this case eggs/chicken/ animal products/ ginger/ albumin /*hemp kernels too then/, may be part of the problem foods – 
    3. Elimination type diets that start with the least risky foods and gradually reintroduce things one at a time can be the best way to individualize what is the problem for you the individual. 
  3. Gluten was definitely identified as a part of the thyroid problem by removing, it already had helped to stop that. Dairy has a variety of allergens, and also would have albumin. Removing food triggers strictly, can help a swollen thyroid gland reduce in size – versus get more swollen when trigger foods are eaten.
    1. Gluten free baking recipes and tips for converting recipes: effectivecare.info – G8. Cookies & Bean Soup. -> and it mentions that increasing corn or corn flour instead, is not ideal either. Corn or gluten can increase zonulin which also increases leaky membranes in the gut or blood brain barrier, and more open membranes can increase risk of allergens entering undigested from the diet. See: What is Zonulin? (2)
    2. A quick mix recipe that can be used for pancakes or muffins, a post: Pancakes in a Jiffy – Quick Bread Mix.
  4. Eosinophilic esophagitis may be related to food sensitivities, so as food elimination is attempted it would also be helpful to pay attention to the swallowing symptoms to see if change occurs other than the swollen pressure feeling of the enlarged thyroid gland.
    1. Research shows a strong connection between food allergies and eosinophilic esophagitis (EOE). These six foods are most commonly associated with this allergic response: dairy, wheat, soy, eggs, nuts, and seafood/shellfish. Unfortunately, there is no accurate test to identify food allergies* connected with EOE.” (3
    2. *The food sensitivity is not the same type as tested for people who get hives to peanut butter or eggs or are allergic to bee stings. It is food sensitivity that activates white blood cells though, called eosinophils. 
    3. During normal function eosinophils fight parasites for us. So …. Maybe they are doing something in ‘autoimmune disease’ that involves their normal function too fighting an unidentified parasite – or they are responding to chemicals of the six foods listed above in an allergy-like way. 
    4. Asthma and allergies involve increased eosinophil activity, which can lead to inflammation symptoms and tissue damage: “Eosinophils can consume foreign substances. For example, they fight substances related to parasitic infection that have been flagged for destruction by your immune system. Regulating inflammation. Eosinophils help promote inflammation, which plays a beneficial role in isolating and controlling a disease site.” […] “…eosinophils play a key role in the symptoms of asthma and allergies, such as hay fever. Other immune system disorders also can contribute to ongoing (chronic) inflammation.” (4
  5. Eliminating common histamine problem foods may help anxiety and inflammatory symptoms. Orange juice, tomatoes, fermented foods, or older leftovers, cranberries, others, it is a lengthy list but can make a huge difference *personal issue for me also.
    1. More info on page MCAS/Histamine, jenniferdepew.com: MCAS/HIstamine.
    2. Summary of foods to avoid, or a few helpful in an over-reaction: Histamine Food Lists. it is a document (6)

Evaluation:

Client seems motivated and capable of making positive changes for improving health, cheerful and confident amid a complex set of problems, and has support of family.


So does my disclaimer make more sense now?

  • Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

My professional and personal expectations of individualized health care guidance does not include a 15 minute appointment limited to discussing one symptom. In seeking a health care provider I recommend searching for ‘functional health’ or possibly holistic but that is less precisely used than ‘functional’. The orthomolecular approach is also whole body and restoring function oriented.

*am I taking clients? I am working in that direction but I am still in initial stages of having a system set up.


Change is easiest by just practicing the desired habit and the more often it is remembered, practiced, then the more that brain pathway will be strengthened and the old one is gradually deactivated, becomes harder for the nerve cells to fire instead of being an automatic habit like happens without even thinking consciously – to change that ingrained of a habit takes substituting a new pattern rather than trying to ‘attack’ with ‘will power’. Work with nature and it will work with you. Attack and it tends to have an undesired ripple effect.

Pain hurts, health is better.

We all die, the question is quality of life while living – and enjoying that life while living.

Namaste – the soul in me, sees the soul in you.

We are all children, under the care of Mother Nature and Father Sun.

Where there is light there is life, and there is hope.

Reference List

  1. Hegyi J, Schwartz RA, Hegyi V. Pellagra: dermatitis, dementia, and diarrhea. Int J Dermatol. 2004 Jan;43(1):1-5. doi: 10.1111/j.1365-4632.2004.01959.x. PMID: 14693013. https://pubmed.ncbi.nlm.nih.gov/14693013/
  2. What is Zonulin? https://www.creative-diagnostics.com/blog/index.php/what-is-zonulin/
  3. 6 Food Elimination Eosinophilic Esophagitis, oregonclinic.com, https://www.oregonclinic.com/6-Food-Elimination-Eosinophilic-Esophagitis-EOE 
  4. Eosinophilia, symptoms, mayoclinic.com, https://www.mayoclinic.org/symptoms/eosinophilia/basics/causes/sym-20050752

Documents, Posts & Pages

  1. Wheat is rich in albumin – so are ginger and egg whites, post transcendingsquare.com
  2. Resources & Iron Chelators list, document https://docs.google.com/document/d/1XiwJBPoFUnUTQKcRAW_8NMriQMt8b31zjeTY4zV0wJo/edit?usp=sharing
  3. effectivecare.info – G8. Cookies & Bean Soup, webpage
  4. Pancakes in a Jiffy – Quick Bread Mix. post transcendingsquare.com
  5. MCAS/Histamine. webpage, jenniferdepew.com
  6. Histamine Food Lists. document, https://docs.google.com/document/d/17iz9lsJyGqIUUjF0p-totXp4R2GhgRi2Na4gYueisTM/edit?usp=sharing

Screening and testing for intra-cellular pathogens

An important sentence in my last post could have been entered in a longest sentence contest and so I would like to separate the sections and go into more detail:

“But to me it would be great if more experts and more individuals did become interested in looking into the information and maybe add further understanding and research,

and then maybe sooner than later we would  develop a national blood and organ supply that is tested for intra-cellular infectious pathogens;

and develop clear guidance about the importance of measuring both hormone D and vitamin D levels

in order to clearly see which patients are actually deficient in both the vitamin and hormone forms and would therefore need to increase their sun exposure or their intake of vitamin D

and which patients actually have elevated hormone D levels instead of being deficient.

Low vitamin D levels with elevated hormone D levels may suggest the person has an underlying infection with an intra-cellular pathogen and that person would actually benefit more by limiting their sun exposure and their intake of vitamin D – and they might be able to treat the underlying infection with Benicar and antibiotics.” [last post]

A few steps might be necessary for implementing this section: “and then maybe sooner than later we would  develop a national blood and organ supply that is tested for intra-cellular infectious pathogens;” The first step is for the medical and academic communities to admit that intra-cellular infectious pathogens have been found that can cause acute or chronic illness. Research scientists and medical professionals can put their careers at risk if they work on alternative theories instead of working on widely accepted theories. and funding for research regarding alternative topics is unlikely to be available.

Autoimmune disease was suggested to be a normal part of aging in a college textbook that I looked at within the last few years – I don’t remember the title or have the link but I was very sad to find that information in a current academic text. If autoimmune disease is part of aging then why would Rheumatoid Arthritis have a juvenile Rheumatoid Arthritis version? Why would a mother have RA and have a four year old child with juvenile RA – did the child age very rapidly or could RA be passed from mother to child during pregnancy? And more importantly, might they both go into remission if they were to take Benicar and antibiotics while avoiding vitamin D and sun exposure? That mother with RA who knows first hand how much pain her child with RA is likely to experience might really like to know that a cause and effective treatment may have been discovered.

Currently the treatments that are commonly used for RA are immune suppressing drugs which can have severe side effects. Some of the drugs are also used in chemotherapy.  Immune suppressing drugs are used in autoimmune  disease because much of the damage that is caused over time is due to overactive white blood cells. However if the overactive white blood cells are doing their best to try to find an underlying infection then killing them off with immune suppressing drugs is also killing off the body’s only defense against the infection. Intensive treatment with immune suppressing drugs may help make a patient more comfortable over the short term by suppressing symptoms caused by the overactive white blood cells but instead of leading to remission of the disease, the patient’s life expectancy may be shortened to only a few years because the medications are only addressing symptoms instead of treating an underlying cause.

Once the existence of intra-cellular pathogens is officially admitted then the second step to take towards “a national blood and organ supply that is (screened and) tested for intra-cellular infectious pathogens” would be fairly easy and inexpensive to implement. Changes in the screening of potential donors could be put in place before improved testing of the donated tissue might be possible.

I forgot to include the word screened in the original sentence. The problem with testing for the presence of the intra-cellular pathogens currently is that they are hard to grow and take a long time to grow with standard Petri dish agar cultures. However there is already extensive guidelines for screening blood and organ donors regarding their medical history before they are allowed to donate. If tuberculosis can be spread by carriers who haven’t had symptoms of TB then anyone who is known to have had TB in the past should probably never be allowed to donate blood or organs even if they aren’t actively sick anymore. [7 and atrainceu.com from  the post before the last post] And therefore if the autoimmune disease sarcoidosis, Crohn’s Disease, and Rheumatoid Arthritis all involve similar infectious mechanisms then anyone who has been known to have any of those diseases in the past should also not be allowed to donate blood or organs even if they aren’t actively sick anymore.

A third step towards a safer blood and organ supply would be adding the requirement to test donated tissue for the presence of intra-cellular pathogens. It is possible that advances in DNA screening might solve the problems with how difficult and long it takes to grow cultures of the pathogens. Advances in DNA screening [1] might make it possible eventually to simply screen a sample for the presence of DNA from the Mycobacterium tuberculosis pathogen or from the pathogen that Lida Mattman found involved in RA or Lou Gehrig’s Disease (ALS) or from her husband’s coronary.  [video  from  the post before the last post] Prof. Mattman was able to cause coronaries in lab animals by exposing them to the unidentified pathogen that she was able to culture from a tissue sample obtained from her husband after he had a coronary heart attack. In the video, ~19:30, her concern about the possibility of coronary disease being contagious was not just for hospital visitors but was also for other hospitalized patients. A healthy visitor might not be as much at risk as an immune compromised patient who is sharing a hospital room with someone who just had a coronary.

Aspergillosis fungal infections are common in patients with advanced HIV/AIDS and in transplant patients on long term immune suppressing drugs but for most people the fungus is a common contaminant that doesn’t lead to an infection because our immune system prevents it from multiplying.  [atrainceu.com and  from the post before the last post] Prof. Marshall’s protocol suggests focusing more on correcting the imbalance in the hormone D metabolism that allows the pathogens to survive intra-cellularly, rather than focusing on which specific pathogens might be present because there might be a mixture of different pathogens who all developed similar ways to invade and survive within human cells. His protocol focuses on restoring the body’s natural immune mechanisms so the healthy white blood cells can identify and destroy cells that are infected with any intra-cellular pathogen whatever type it might be. However his original goal was finding an effective treatment for sarcoidosis so the Benicar as an angiotensin receptor blocker may be effective in sarcoidosis if the pathogen in that disease developed the ability to make infected cells develop extra Angiotensin Receptor’s as a way to disguise themselves as normal cells but the Benicar might not help someone with Grave’s Disease who has bone marrow cells with abnormal Thyroid Stimulating Hormone (TSH) Receptors. Someone with Grave’s Disease might need a medication developed that blocks TSH Receptors instead of blocking Angiotensin Receptors.

I have the autoimmune hyperthyroid condition called Grave’s Disease. It involves abnormal bone marrow cells and may be similar to Rheumatoid Arthritis and it is associated with Lou Gehrig’s Disease (ALS) (19% comorbidity, 4), and the autoimmune dry eye syndrome, Sjögren’s syndrome. [3] Symptoms similar to those of ALS can also be found in patients with advanced HIV/AIDS and Lyme’s Disease, [4], both of which have disease processes that have been shown to interfere with the immune function of the Vitamin D Receptor.  [page 19, 1, from the post before the last post] Currently my thyroid condition is in remission but that is while avoiding gluten and dietary sources of iodine and vitamin D and avoiding too much sun exposure.

We do not have a large number of children with vitamin D deficiency rickets, which suggests to me, that for most people summer sunlight exposure and the current level of fortification of the food supply with vitamin D is adequate. Canada is farther north than most of the United States and yet their population’s average vitamin D level is normal (50 nmol/L). [5, 6] The number of Americans with vitamin D levels below 30 nmol/L increased between a study performed from 1988-1994 (45% > 30nmol/L, n=18,883) and one performed in 2004 (23% > 30nmol/L, n= 13,369) but there is some controversy over whether differences in how the lab test was processed might have skewed the results. [8] My fear is that some of the difference might represent an increase in the number of people with an underlying intra-cellular infection that causes depressed vitamin D levels and elevated hormone D levels rather than truly being deficient in both vitamin D and hormone D.

Hormone D levels are rarely measured because it is a more unstable chemical found in lower concentrations and current medical theory believes that the enzyme needed to convert the inactive form to the active form is only produced by the kidneys — but it is also produced by white blood cells during inflammatory conditions — autoimmune disease and heart disease are inflammatory conditions.

Magnesium deficiency and/or excess intake of calcium may be involved for some individuals. Zinc and B vitamins are also essential as cofactors for converting between the active and inactive forms of vitamin D so malnutrition in general may increase people’s susceptibility to an intracellular infection. Medical marijuana is also a controversial topic because the plant is categorized as not having medical uses at the federal level but within the healthy body different types of cannabinoids are made for use within membranes and as messenger chemicals. Genetic defects, older age, or malnutrition may prevent some individuals from making the cannabinoids internally. Hemp and some other foods in addition to the marijuana plant also can be an external source of cannabinoids but the amount and types produced may depend somewhat on the fertility of the soil.

I have tried to share this information because it could help improve health and quality of life for many people and reduce the amount of money and supplies being used for ineffective health care. We can’t afford health care that might be making individuals worse and may be spreading disease within contaminated blood, organs, or through procedures and screening tools that don’t recognize that more conditions may be contagious through blood-borne routes than was previously recognized.

While I do not have a PhD I do have a Bachelor’s Degree in Administrative and Clinical Dietetics and fifteen years of public health education experience. Selling products at a profit is not something I have experience at, giving away free health information, possibly along with a motivating freebie as an incentive, is where I do have professional experience.

Another famous quote has been a motivating force for me since I first got concerned about the controversy over vitamin D in 2010:

“And so, my fellow Americans: ask not what your country can do for you — ask what you can do for your country.” – President John F. Kennedy,  Inaugural Address, January 20, 1961 [9]

So, my  fellow Americans and any other readers: chances are if you don’t have rickets and do use some dairy products and breakfast cereals regularly, then you probably don’t have a deficiency of vitamin D but if your levels are below 20 nmol/L then you may have an intra-cellular infection. The possibility of an infection might seem like bad news but it is more informative than “We don’t know what causes your disease or how to cure it but we would love for you to take our side-effect inducing medications until you die or until we find a cure, whichever comes first, thanks so much for being a good sport about it in the meantime.

And the good news would be that the olmesartan/Benicar and antibiotic protocol might be an effective treatment for the underlying cause if an intracellular pathogen was involved in your symptoms. At this stage of research it is not the standard treatment that a general practitioner would be likely to have heard of let alone recommend, but you can look into the protocol and talk to your physician about it yourself. The Marshall Protocol Knowledge Base provides information for patients and for physicians regarding the science behind the protocol and provides guidance for the patient and for the prescribing physician regarding prescriptions, timing of doses, side effects to watch for and other precautions.

Personally I was thrilled to get rid of my severe migraine problem with the use of olmesartan, antibiotics, and avoiding vitamin D foods and supplements and avoiding much time spent in bright sunlight — it wasn’t easy but the migraines were much worse. I was on the medication protocol for a year and half and had been having weekly migraines for over a decade — I was more than thrilled for myself I was thrilled for everyone else who might have migraines or might be tired of hearing “we don’t know what causes your autoimmune disease or how to cure it.” Migraines aren’t autoimmune disease but they can be a symptom of other conditions and more recently I have been diagnosed with autoimmune thyroid disease which can go back and forth between hypo- and hyper- phases for some patients.

More research is needed but a lot of research has occurred if you’re willing to go read more about it yourself. [mpkb.org]

Tangent: I’ve tried to share this information in the past because I believe it is necessary for public health and economic health and environmental health. Medications that have harsh side effects on human health are also likely to have harsh side effects on the environment. Anything we are pouring in our bodies or on our agricultural fields is likely to eventually reach the ground water supply or the ocean where increasing acidity is already beginning to affect the ability of shellfish to form shells – the shell material dissolves in higher acidity.

And so, my fellow Americans:  Yes, I had a Presidential campaign website in 2012 because I was as serious as a heart attack about my fears regarding our nation’s health and our food supply. The nutrient guidelines are used to make meals and formulas for people who may be incapable of eating to appetite. If the guidelines are not correct than the meals and formula nutrient balance may lead to chronic nutrient deficiencies. All the nutrients work together somewhat so research that only looks at vitamin D alone or calcium alone may be missing deficiencies of magnesium or zinc  or B vitamins or cannabinoids. Our government is responsible for meals for the military and for school children and people living in residential facilities who are on Medicaid or Medicare and for prisoners. the government doesn’t directly set nutrient guidelines but could probably fund research if the elected officials were working towards that goal.

I never claimed to be experienced in politics and there would be little point in my trying to get involved at the local level because nutrient and medical policies are made at the federal level and may be implemented at federal, state and local levels. My credibility and reputation have suffered some setbacks since I started writing online in 2010 but there is unlikely to be another person available who has had my combination of personal and professional health experiences — and so, my fellow Americans: if there are any of you who would like to vote for me in 2016 for President of the United States then I would do my best if elected to help our country become a healthier country which would likely help make it a wealthier country as well.

My campaign slogan was also serious: “A vote for me is probably a bad idea, but a vote for magnesium is a good idea.” I was trying to be clear that I know that I’m not a good role model for normal social skills or skilled at political networking and fundraising, but that I firmly believe that my nutrition platform is very important for the long term economic and physiologic health of our nation. Whether I’m married or divorced,* or how wealthy or broke I am, would probably not make any difference to a person suffering from Crohn’s Disease or ALS or RA or TB or sarcoidosis or HIV/AIDS.

So I’ll get FEC Form 2 filed before I receive $5000 in campaign contributions or within the next 15 days, whichever comes first.  ;-) That is an attempt at humor – I don’t expect to raise $5000 in contributions. The other reason that I ran for office was in protest of the Citizens United decision, so I was running as a write-in candidate in 2012 and hadn’t been aware of FEC Form 2 — I think voters should be able to vote for someone who isn’t underwritten by corporations and billionaires.

*I’ll let you know if my name changes again before Nov. 2016. I’m hitting Publish – with my fingers crossed that it works, but I also made a copy just in case. *The website’s software was due for an update — note to self: always update software as soon as prompted.

/Update: I didn’t fill out the FEC Form 2 or FEC Form 1 which I learned of once I started reading the instructions. The forms are only required if a candidate’s campaign expenditures or donations are reaching or exceeding $5000. I wrote more about this topic:

  • What’s a chad? or Confession is said to be good for the soulAugust 24, 2015.
  • Secretary of Health and Human Services, an additional note, and Fringe Topic: Parvo VirusAugust 31, 2015.

Caring a lot is important but so is experience and good health and I have limited supplies of both of those – I will continue to care and will post updates on health or other topics as I learn more.

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Whether to be compliant or to be healthy seems like an easy question to answer

*I made a significant correction to this post today, so I’m moving it to the front page today.

— but it may not be that easy of a question for a patient of the current medical industry. Personally, I do like to be compliant and agreeable with other people but I also prefer to be healthy and agreeable rather than sick and agreeable. The terms compliant and non-compliant are used in the medical field when documenting how thoroughly a patient is following the recommendations of the medical team. However if the medical team’s recommendations are based on limited knowledge or incorrect information, then complying with the recommendations might not seem like a good idea to a patient. If an industry claims to not know what causes a disease or how to cure it then why should a patient be expected to believe that the same industry knows if a treatment will actually be adding to making the patient worse instead of helping them get better as is hoped? Some of their recommendations might be making the underlying, not well-understood, problem much worse.

The terms compliant and non-compliant may also be used in legal cases when there is conflict between a medical team’s recommendations and the parent’s decisions regarding the care of a child. Painful and possibly ineffective chemotherapy or other cancer treatments might be recommended to try to save a child’s life but if those treatments are just making the last few months, days, or years of the child’s life more miserable then who is being helped? The child and family are missing out on the quality  of life during their last days together and frequently with a significant financial cost. Paying for hope of a last chance cure at the cost of daily enjoyment seems like pretty expensive hope. The pharmaceutical industry’s profit margin may be helped but the child’s last days might be spent in more pain and nausea with less time to spend enjoying the company of their family.

Intravenous vitamin C has been used effectively against a variety of types of cancer at the Linus Pauling Institute for decades but vitamin C isn’t profitable because it can’t be patent protected. — A review article suggests there is some anti-tumor effects from the high dose intravenous vitamin C treatment but that it is not a miracle cure and is providing such a high dose, approximately 200 oranges worth twice a week, that it could be dangerous to a patient who had kidney problems. [8

Patents allow companies to charge higher prices for products because they are the only supplier. Generic products and natural products have market competition to help keep the price down for consumers.

A for-profit prison industry requires prisoners and tax-payer funding to finance their care and provide the profit, and a for-profit medical industry needs people to take medicine, whether they are sick or whether they are trying to prevent sickness. Requiring people to take maintenance medicine for chronic symptom control for years or for the rest of their life will add up to more profit for the medical industry over time compared to providing patients with effective preventive guidance or with a treatment that actually cures their underlying condition.

While I am fortunate not to have cancer I have been struggling with autoimmune and allergy symptoms for as long as I can remember and in my experience as a patient if currently available lab tests don’t reveal any diagnoses that are currently accepted within mainstream medical standards then your symptoms might be labeled psychosomatic – all-in-your-head physical symptoms that may be caused by mental stress or other emotional problems. That might be helpful for a patient who actually has psychosomatic problems but it isn’t very helpful for the long term treatment of a patient with an autoimmune disease.

Unfortunately though, in the current medical industry even if you receive an autoimmune diagnosis the cause is still considered unknown and immune suppressing chemotherapy drugs are frequently the only treatment available. However the good news is that the cause of some types of autoimmune disease has actually been discovered, but the news hasn’t made it into mainstream media or medical practice yet; and more good news, an effective therapy protocol has also been developed and life threatening chemotherapy drugs are not part of the medication protocol.

Severe migraine headaches every week were my worst health symptom, but I also had chronic fatigue and multiple muscle cramps similar to those described by patients with fibromyalgia, and I was sensitive to a variety of food and environmental allergens. I’ve only had a couple migraines since I tried the newly developed medication protocol. I spent a year and a half taking antibiotics every other day, and an angiotensin receptor blocker (olmesartan/Benicar) everyday, and avoiding vitamin D foods, supplements and sunlight everyday. This was not easy or comfortable, the antibiotics cause allergy like symptoms from the increased load of toxins that results from the remains of infected cells that healthy white blood cells were able to kill while on the combination of antibiotics and olmesartan, but the allergic symptoms were not as bad as having migraines that feel like a railroad spike pounding into your skull over and over for three days every week, never mind the muscle cramps, fatigue and other symptoms that I’d had off most of my life.

Not having weekly migraines and other daily symptoms was so wonderful that I wanted to share the good news but I found that it is difficult to get people to see past the mental block of “we don’t know what causes autoimmune disease or how to cure it.” — And we will never know what causes it or how to cure it if we keep ignoring the people who are making advances in figuring out what causes it and how to cure it.

Lida Mattman is a research scientist who conclusively showed that Rheumatoid arthritis is caused by a bacteria but that breakthrough hasn’t reached the patient yet. Some types of bacteria can survive in a modified form within the interior of some types of human cells. The form is hard to grow in normal agar gel cultures but Lida Mattman developed techniques that are able to culture the cell wall deficient microbes. She discusses the pathogens that cause Lyme’s Disease and Lou Gehrig’s Disease and other stealth pathogens at the Autoimmunity Research Foundation’s Chicago Conference, March 12, 2005, in this video link: (video, at ~19:30 she recommends not visiting people who had just suffered a coronary/heart attack in person at the hospital, just send a card, as evidence has shown that a infectious but unidentified pathogen is involved in some coronaries and therefore probably also in cerebral strokes which occur in the same way – but she probably doesn’t really mean not to visit your loved ones. She gets a laugh from the crowd as she shared a story about getting a sample to test after her husband had a coronary – so she probably did visit him but the point may also be that we don’t know what we don’t know and it might be dangerous, at least to the immune compromised).

Some types of pathogens, including the virus that causes HIV/AIDS, have forms that can actually enter human cells and survive and grow within the cell. This sets up an inflammatory condition with overactive white blood cells that may be looking for the infection but instead attack other healthy tissue – ‘auto-immune’ – attacking self. Lida Mattman found cell wall deficient bacteria involved in Rheumatoid Arthritis and Lyme’s Disease and other diseases. The bacteria that causes tuberculosis also has a form that can live within cells. The textbookofbacteriology.net site uses the term faculative intracellular parasite in their description of the pathogen that causes tuberculosis. [7]

The specialized pathogens developed ways to disguise the infected cells from healthy immune cells. The angiotensin receptor blocker medication olmesartan is normally given once a day for high blood pressure but for the auotimmune treatment protocol it is given three to four times per day every six to eight hours in order to keep the levels steady all day and night because the infected cells hide by developing angiotensin receptors – blocking the receptors takes away the disguise. I think – this is my rough understanding of how the medication helps in the protocol developed by Trevor Marshall, a biomedical engineer. Blocking the angiotensin receptor disguise somehow allows the healthy immune cells to identify and kill the infected cells instead of continuing to ineffectively attack other healthy tissue (such as finger joints in Rheumatoid arthritis or lung tissue in sarcoidosis).

Correction, (9/16/2015): The part about the angiotensin receptor blocker medication was wrong. The medication olmesartan (Benicar) is not only acting as a angiotensin receptor blocker (which can help reduce the production of inflammatory cytokines which cause pain and fatigue and can help prevent fibrotic tissue from forming). It also acts as an agonist, an activator, of the vitamin D receptors (VDRs). By activating the VDRs the medication is allowing the healthy immune cells to do their normal functions. The pathogens had developed a variety of ways to block the vitamin D receptors in order to ‘hide’ by disabling the immune cell’s normal immune functions that are controlled by the active VDR. It transcribes over 1000 genes that are involved not only in calcium balance but also in cancer metastasis and many other functions. MPKB: Science behind olmesartan (Benicar).

Prof. Marshall is not a medical doctor but he is a biomedical researcher who did not choose to be compliant when he was diagnosed with sarcoidosis and was told that he probably only had a year and a half left to live – over a decade ago. Instead he developed  his specialized medical protocol and then sought and received orphan drug approval by the U.S. FDA so that olmesartan/Benicar can be prescribed for use with the antibiotic Marshall Protocol in addition to it being able to be prescribed for its normal use for treating high blood pressure. Using the blood pressure medication three to four times per day may increase the risk of feeling light headed when standing up quickly but taking it 3-4 times per day doesn’t cause the blood pressure to drop 3-4 times lower than normal. (I did have to catch my balance occasionally and fainted once or twice while taking olmesartan three times per day for a year and a half. Fainting is weird but fifteen years of migraines is worse.)

A three day migraine or chronic arthritic degeneration seems worse to me than feeling light headed when standing up quickly – and the medication protocol isn’t needed for the rest of life as many medications are prescribed for patients with chronic illnesses. While the protocol reduces symptoms after a year or two on the medications, an autoimmune patient might need to follow Trevor Marshall’s protocol for a year or two more than once over their lifetime because autoimmune diseases tend to flair up and go in remission with the patient’s overall level of health or stress or environmental toxin load – there really is a lot we don’t know about autoimmune disease. Having good and bad times, remissions and relapses, may be common in autoimmune disease because just a few remaining infected cells may linger over the years and then multiply again during a stressful or otherwise unhealthy time of life.

Tuberculosis is a disease that has been shown to be caused by a type of bacteria able to live within human cells and the infection can be spread through air-borne respiratory droplets when actively sick patients cough or sneeze. The disease can remain dormant for years in healthy people and the sickness can be spread by people who never got sick themselves and therefore don’t realize that they are carriers. A continuing education session for health professionals recommends using Universal Precautions, in order to protect staff and to help prevent spread of infection between patients, health professionals are recommended to wear adequate masks and gloves and treat all patients as if they were potentially contagious because anyone might be a carrier of a dormant infection. The course, Infection Control and Prevention, Module 5, Element II: Mechanism of Transmission available at atrainceu.com [atrainceu.com] has more information about Universal Precautions.

“Every year, more than 9 million people worldwide develop TB and nearly 2 million people die from the disease. Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis and is spread in airborne droplets when people with the disease cough or sneeze. Most people with healthy immune systems infected with M. tuberculosis never become ill. However, the bacteria remain dormant within the body and can cause tuberculosis years later if host immunity declines.” – atrainceu.com, Infection Control and Prevention, Module 5, Element II: Mechanism of Transmission [atrainceu.com]

Tuberculosis, I learned recently, is also a type of infection that interferes with normal vitamin/hormone D metabolic pathways. The vitamin D receptor (VDR) plays a role in the ability of white blood cells to kill infected cells and cancerous cells. Some pathogens have developed ways to suppress the Vitamin D Receptor’s activity so white blood cells aren’t able to effectively resist the infection process. Other pathogens that have been shown to reduce the activity of the Vitamin D Receptor, in addition to the pathogen that causes Tuberculosis, include the mold Aspergillus, the viruses that cause Epstein-Barr chronic fatigue syndrome and HIV/AIDS, and the autoimmune diseases sarcoidosis, Crohn’s Disease, and Rheumatoid Arthritis. Elevated levels of 1, 25(OH)2D are seen with the bacterial infections: “Elevated 1,25(OH)2D appears to be evidence of a disabled immune system’s attempt to activate the VDR to combat infection.” [page 19, 1]

The Infection Control and Prevention course provides more information about Aspergillus. It is a fairly common mold that generally only becomes a problem for immuno-compromised individuals, [atrainceu.com], but interestingly those at increased risk also include people who have advanced cases of HIV/AIDS and those who have been on long term corticosteroid therapy (which acts similarly to having elevated levels of 1, 25(OH)2D, which is the active hormone form of vitamin D, and is actually not a vitamin. It is a seco-steroid based on a molecule of cholesterol). [2]

It seems to me that people with advanced cases of HIV/AIDs, whether they also have opportunistic aspergillosis or not, might like to know that taking olmesartan/Benicar daily and avoiding vitamin D foods, supplements and sunlight [1] might help their healthy white blood cells to be able to work more effectively again or might at least not add any negative symptoms that can occur when there is elevated levels of hormone D. The elevated hormone level itself is a health risk itself because it is telling the bones to release their stored calcium which can lead to osteoporosis of bones and calcification of soft tissue. The article [1]  doesn’t suggest that AIDS patients might be helped by Benicar because it is a review of research that has already occured article – research has shown that Benicar is helpful for autoimmune diseases like sarcoidosis but more research is needed to find out how the HIV and Epstein-Barr viruses and aspergillus mold suppress the Vitamin D Receptor and how to stop the down-regulation.

Our medical industry uses donated blood and organs that are screened for many diseases but they can’t screen for diseases that don’t officially have a known infectious agent. Dormant tuberculosis can cause carriers to become sick years after they were exposed and in all those years as a carrier the person might also have been a regular blood donor. Sarcoidosis patients who are in remission are allowed to donate blood and plasma yet there have been organ transplant patients who got sarcoidosis only after receiving the organ transplant. If the organ donor wasn’t known to have active sarcoidosis then the medical industry may not realize that the person might be a carrier of infected cells that could cause symptoms in a more immuno-compromised person. All organ transplant patients are purposely given immune suppressing medications in order to prevent the body’s own immune defenses from attacking the transplanted organ.

The longer autoimmune disease is treated as something without a known cause the longer we may be spreading it through contaminated blood and organ donations. The longer autoimmune disease is treated as something without a known cure the longer patients have to suffer reduced quality of life and shortened lifespans.

  • Tuberculosis: annually worldwide, 9 million infected and 2 million deaths, [atrainceu.com]
  • Epstein-Barr virus (EBV): According to the Centers for Disease Control about 90% of adults have antibodies against EBV, suggesting a current infection or history of exposure. The disease can be spread before a person has active symptoms and the virus can remain in a latent/inactive phase for years and can become active again at any time. [cdc.gov]
  • HIV/AIDS virus: According to the Centers for Disease Control there are about 50,000 people in the U.S. infected with HIV/AIDS each year and there are about 1.2 million people currently in the U.S. with an HIV/AIDS infection. About 12.8% of them may not be aware of their disease status. [cdc.gov]
  • Aspergillosis: According to the Centers for Disease Control the exact prevalence of opportunistic aspergillosis is unknown because it is not required to be reported in the U.S. however it is a common type of fungal infection found in organ transplant patients with a cumulative incidence of 19% over twelve months during a 2001-2006 study. It may also be a problem for up to 15% of patients with cystic fibrosis and 2.5% of patients with asthma, which represents 4.8 million people worldwide, 400,000 of whom might have a more severe form of aspergillosis.  There are 1.2 million people estimated to have aspergillosis as a complication of their tuberculosis disease and there may be 70,000 people who have aspergillosis as a complication of their sarcoidosis disease. [cdc.gov]
  • Sarcoidosis: According to a study of U.S. Navy personnel, “Sarcoidosis Among U.S. Navy Enlisted Men, 1965-1993,” the rate of disease incidence dropped over the time period but was significantly more of a risk for enlisted men who were assigned to aircraft carriers. The study was made at the request of a veteran who wondered if his case of sarcoidosis might have been due to an environmental contaminant.  “Although 70% of case-patients and 66% of controls had ever served on ships, 26% of case-patients and 17% of controls had ever served specifically on aircraft carriers.” (case-patients, n=1121) [3] *Living within the confined quarters of a ship or aircraft carrier may have affected risk of sarcoidosis infections if the disease can remain dormant similarly to tuberculosis. Exposure to the blood or body fluids of a seemingly healthy person might be able to be a source of latent infection for an immuno-compromised individual if the disease is carried within infected white blood cells.
  • Crohn’s Disease: I haven’t found statistics regarding the prevalence of this type of inflammatory bowel disease but the Mayo Clinic site at least mentions that an infectious agent might be involved: [4] Unfortunately they also recommend vitamin D and calcium supplements to help counteract the risk of osteoporosis if steroid therapy is used. [5] This would be bad if the patient actually has elevated levels of hormone D (1, 25(OH)2D) because levels above 42 pg/ml are a signal for calcium to leave the bones which ultimately increases the risk of osteoporosis and calcification of soft tissue. “In fact, there is ample evidence that elevated 1,25(OH)2D leads to bone loss. Brot et al. [53] found that elevated levels of 1,25(OH)2D were strongly associated with decreased bone mineral density and content, and increased bone turnover. When levels are above 42 pg/ml 1,25(OH)2D stimulates bone osteoclasts. This leads to osteoporosis, dental fractures and calcium deposition into the soft tissues [54]. Vanderschueren et al. [55] found that a combination of high 1,25(OH)2D and low 25(OH)D is associated with the poorest bone health.” [1] Adequate magnesium is very important when elevated calcium levels are a problem because it helps the kidneys to excrete excess calcium.
  • Rheumatoid Arthritis: Infection is also mentioned as a possible cause of Rheumatoid Arthritis on the Mayo Clinic site. [6]

That is an incomplete list of statistics but the point was that many people may be affected by pathogens that have developed ways to manipulate our immune system’s normal Vitamin D Receptor metabolism.

Trevor Marshall doesn’t recommend that people who are using his protocol with the help of their physician worry too much about what specific pathogens might be the cause of their own abnormal vitamin D/hormone D levels. Comparing the level of the inactive vitamin D, 25 (OH) D, with the level of the active hormone D, 1, 25 (OH)2D, can suggest infection when the inactive form is low but the active form is normal or elevated. Healthy individuals can remain at 30 pg/ml of the hormone while they are getting plenty of sun exposure and dietary supplies of the vitamin form. Elevated levels are not normal. Elevated levels during active autoimmune disease can be in the 100s while the vitamin level remains low and tends to remain low even when large dose supplements are taken regularly.

The problem is that the infection process has inhibited breakdown of the active hormone and/or causes over production of the enzyme that converts the vitamin into the hormone form so all the large dose vitamin is being converted into the active hormone form which wouldn’t be noticed if only the vitamin level was being measured by the lab – as is the routine currently. The hormone level is a more unstable form that is more expensive to process. The mainstream medical recommendation is based on the theory that the enzyme that can convert the vitamin into the hormone is under careful control by the kidneys, which may be true for healthy people but might not be true for someone with sarcoidosis or Rheumatoid arthritis.

Personal Impact

My own was hormone D level was 55 pg/ml recently which is within the range considered normal but it is towards the high end of the range. It has remained around that level even while limiting dietary sources and exposure to sunlight. The vitamin level was below 10 which is low, above 20 to 30 is the low end of the normal range for the vitamin form of D. So do I have low levels, normal levels or elevated levels?  My endocrinologist’s recommendation that was sent with the vitamin D/hormone D lab report was to start taking vitamin D and calcium in order to help reduce osteoporosis risk but if all levels over 42 pg/ml are causing calcium to leave my bones already then adding extra vitamin D is more likely to add to the infection risk. The use of Benicar and reduced intake of vitamin D and sun exposure is mentioned in this review article about Vitamin D and infection: [1]

My own medical history includes an episode of Epstein-Barr virus/mononucleosis during college and more recently a diagnosis of Grave’s Disease, which is an autoimmune thyroid condition related to Rheumatoid Arthritis in that bone marrow cells become labeled with a thyroid receptor and infiltrate the thyroid gland. The thyroid can become overactive and overproduce thyroid hormone and sometimes the bone marrow cells become mislabeled in a slightly different way and infiltrate the fatty area behind the eye sockets and cause the eyeballs to protrude. 

Professional Impact:

I would like professional guidance about abnormal vitamin/hormone D metabolism iin infection for myself and family and for feeling comfortable about counseling nutrition clients. Without knowing both the vitamin and hormone D levels of a client I can’t really know whether a low vitamin D level alone means the client isn’t getting enough of the nutrient or sun exposure or whether they might have an underlying infection that hasn’t been diagnosed. But without the professional ‘evidence-based’ guidance from the mainstream medical industry I can’t really recommend alternative strategies to a client legally. A professional code of ethics encourages us to do no harm in the health industry but during the earlier phases of medical research it can be more difficult to figure out what might be helpful and what might be harmful.

*I may add to this later but I’m going to try to post it now because I’m having trouble saving it. 2:12pm post was successful, update added, and at 10:54pm.

9/16/2015 correction added. A type of gastro intestinal bacteria, Prevotella copri, has been found to be more prevalent in the GI tracts of people with rheumatoid arthritis.  Intestinal bacteria linked to rheumatoid arthritis (Nov. 5, 2013).

This post is continued on the next two posts:

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./