Digestive issues such as chronic constipation, food allergies, malabsorption, and gastroparesis are prevalent in nearly all cases of neurogenic trauma, including stroke sequela, multiple sclerosis (MS), Parkinson's disease, small fiber neuropathy (SFN), and post-traumatic stress disorder (PTSD). This also applies to adult survivors of childhood trauma. To support optimal digestion under these conditions, targeted supplementation is essential to prevent long-term degeneration and wasting. The cost of one consultation can save you hundreds of dollars otherwise spent on ineffective products, as most clients cannot accurately self-diagnose. While I highly recommend working with a trained clinician for guidance on these issues, these supplements are generally safe to use.
For those already diagnosed with SIBO or constipation, or who have undergone a cholecystectomy, many of these supplements can be taken safely without a prescription. Since the issue of chronic sympathetic dominance has not yet been incorporated into any medical school curriculum, there is a preponderance in alternative medicine to attribute everything to toxicity. Without basic clearance and enzyme support, however, the dozens of single herbs ($$) prescribed by a naturopath will have little to no benefit. The supplement industry can be unscrupulous, with providers often exploiting consumers. I too have spent thousands on various products, despite being in the business.
As TCM practitioners, by understanding the various steps in the cascade of the fight-flight-freeze response, we can use targeted supplementation for our patients with neurogenic trauma. Not everyone needs everything, and since these are long-term patterns that will take a few years to resolve, we want to minimize out-of-pocket costs as much as possible. However, with time and proper support, the function of gut can be restored. These supplements have been universally beneficial for both myself and my clients, increasing transit time, alleviating constipation or dumping syndrome, and supporting the healing process. For TCM providers new to Functional Medicine, you need more training to recommend these to patients.
For Zang Fu practitioners favoring large herbal formulas, it's important to recognize that in cases of chronic sympathetic dominance, the denervation of the middle jiao—which is parasympathetically derived—means that patients must be in a parasympathetic state to effectively absorb these formulas. Many of us cannot achieve this state due to the derangement in the ANS.
Modern supplements are more targeted and ensure efficacy without introducing herbs into what is usually a complex case with many medications. These advanced supplements from reputable sources offer more consistent and effective enzymatic support, ensuring better therapeutic outcomes and optimal absorption. Additionally, they eliminate the issue of herb-drug interactions for clients with extensive medication regimens. The idea is to simplify the treatment plan to include only what is most needed, ensuring safety and maximizing therapeutic benefits.
Bile Salts, TUDCA
Digestive enzymesElevated cholesterol is one of the early indicators of chronic fight-flight or sympathetically dominant states, as well as insulin resistance. Despite the availability of effective treatments like ursodiol or gallbladder flushes to retain the gallbladder, cholecystectomy remains a top surgery in the US. Incorporating bile salts into the dietary regimen of these patients supports better digestive health and overall well-being by improving fat digestion and ensuring better absorption of essential fat-soluble vitamins (Healthgrades) (Home) (Topline MD |) (Specialty Surgical Center).
Cholecystectomy, the surgical removal of the gallbladder, has been associated with an increased risk of developing type 2 diabetes. Post-cholecystectomy, the continuous and unregulated flow of bile into the small intestine can affect the digestion and absorption of fats and carbohydrates, leading to metabolic changes that contribute to insulin resistance and type 2 diabetes.
One study indicated that patients who underwent cholecystectomy had a 20% higher risk of developing type 2 diabetes compared to those who did not have the surgery. The risk is particularly elevated in patients who are also obese, as obesity is a known risk factor for insulin resistance and impaired blood sugar regulation (BioMed Central) (G & L Surgical).
Managing this increased risk involves careful monitoring of blood sugar levels, maintaining a balanced diet rich in whole foods, and engaging in regular physical activity to improve insulin sensitivity. Working closely with healthcare providers to adjust diabetes medications as needed is also crucial for maintaining optimal blood sugar control post-surgery (G & L Surgical).
One effective approach to managing these issues is the use of bile salts. Bile salts aid in the digestion of fats and improve bowel motility, which can alleviate constipation. The taurine derivative TUDCA (Tauroursodeoxycholic acid) also shows promise in addressing chronic constipation and enhancing fat digestion. For patients who have undergone a cholecystectomy, taking bile salts with meals can significantly mitigate symptoms, much like the prescription drug ursodiol. Due to their caustic nature, it is important to take bile salts with food to prevent irritation of the stomach lining.
Chanca PiedraEnzymes play an essential role in breaking down the food we eat into absorbable nutrients, ensuring optimal digestion and nutrient assimilation. These enzymes, including amylase, protease, and lipase, target carbohydrates, proteins, and fats, respectively, facilitating their conversion into simpler molecules. Chronic Fight-Flight-Freeze responses trigger a cascade of events that inhibit the middle jiao or gut, impairing digestion. Over time, this inhibition leads to hypochlorhydria (low stomach acid), small intestinal bacterial overgrowth (SIBO), and other digestive issues, all traced back to the deficiency caused by chronic stress responses. Supplementing with digestive enzymes benefits individuals with enzyme deficiencies, gastrointestinal disorders, or symptoms like bloating, gas, or indigestion. By enhancing the digestive process, these enzymes improve nutrient uptake, support gut health, and alleviate digestive discomfort, contributing to overall well-being and vitality.
A common misconception is that digestive discomfort and issues such as acid reflux stem from excess stomach acid. However, as people age, stomach acid production often naturally declines, not increases. This reduction impairs the digestion and absorption of nutrients, leading to various deficiencies and digestive problems. Using proton pump inhibitors (PPIs) to reduce stomach acid exacerbates this issue by further lowering acid levels, hindering proper digestion, and compromising the stomach lining's integrity over time. Additionally, much of acid reflux results from partially reactive Moro and Spinal Galant reflexes, which influence the body's autonomic responses and exacerbate digestive issues. Understanding the true nature of digestive health and the role of enzymes helps in making more informed decisions about managing digestive issues and promoting long-term gastrointestinal health.
For optimal results, I recommend high-quality brands such as Standard Process, Thorne, and Pure Encapsulations. It's essential not to skimp and opt for the cheapest option; instead, choose a broad-spectrum digestive enzyme. For easy compliance, take a few with your first meal of the day and don't worry about it thereafter. This approach ensures consistent support for your digestive system and overall health. Most clients are able to discontinue Tums and PPIs like prevaced or protonix with simple use of digestive enzymes.
Chanca Piedra, scientifically known as Phyllanthus niruri, is a plant traditionally used in herbal medicine, particularly in South America. It is commonly known as the "stone breaker" due to its reputed ability to dissolve kidney stones and gallstones. In addition to its effects on kidney and gallbladder health, Chanca Piedra is also used for managing uric acid levels and gout. It has been helpful in reducing gallstones as well, depending on the type.
Gout is a panful inflammatory condition caused by the accumulation of uric acid crystals in the joints, leading to inflammation and intense pain. Chanca Piedra has been studied for its potential to reduce uric acid levels in the blood, thereby helping to prevent the formation of these crystals and alleviating gout symptoms. The plant contains compounds like lignans, glycosides, and flavonoids, which contribute to its anti-inflammatory and diuretic properties. These properties help in promoting the excretion of uric acid through urine, reducing its buildup in the body.
Moreover, the antioxidant activity of Chanca Piedra helps protect the tissues from damage caused by uric acid crystals. Its ability to enhance liver function also supports the body's natural detoxification processes, aiding in the breakdown and elimination of excess uric acid.
For more detailed information and scientific studies on the use of Chanca Piedra for uric acid and gout, you can refer to the following sources:
These sources provide comprehensive insights into the benefits, uses, and research surrounding Chanca Piedra and its medicinal applications.
Methylated Bs
Methylation is a crucial biochemical process in the body, impacting everything from DNA production to detoxification and neurotransmitter function. A common genetic variation known as the MTHFR (methylenetetrahydrofolate reductase) mutation can significantly impair this process. Approximately 40-50% of the population carries at least one variant of the MTHFR gene, with about 10-20% having two copies of the common C677T mutation. This mutation reduces the enzyme's function, leading to lower levels of active folate (5-MTHF) and higher levels of homocysteine, which can contribute to various health issues, including cardiovascular diseases and neurological disorders.
To address these methylation defects, it is beneficial to use bioactive, methylated forms of B vitamins, such as methylfolate (5-MTHF) and methylcobalamin (vitamin B12). These forms bypass the need for conversion in the body, ensuring that the necessary methylation processes can proceed efficiently. Supplementing with these bioactive forms supports the methylation cycle, enhancing detoxification, energy production, and overall neurological health.
For patients with neurogenic trauma or chronic conditions, ensuring proper methylation through the use of methylated B vitamins can be a key component of a comprehensive treatment plan. By addressing methylation defects, practitioners can provide targeted support that can significantly impact their patients' recovery and long-term health. This approach helps optimize biochemical pathways and minimize the risk of complications related to impaired methylation (CentreSpring MD) (GeneSight). Just read the label and make sure that B6 and B12 are both methylated and you'll be fine.
Pyruvate
Pyruvate is a key player in naturopathic medicine, particularly for its role in driving the Krebs cycle even in hypoxic environments. The Krebs cycle, also known as the citric acid cycle, is a crucial metabolic pathway that generates energy through the oxidation of acetyl-CoA derived from carbohydrates, fats, and proteins. Pyruvate, the end product of glycolysis, is converted into acetyl-CoA by pyruvate dehydrogenase, thereby entering the Krebs cycle.
In hypoxic conditions, where oxygen levels are low, cells often switch to anaerobic glycolysis, leading to lactate accumulation and reduced efficiency in energy production. However, pyruvate can help circumvent this limitation. It acts as a substrate for the Krebs cycle, enhancing the production of ATP, even when oxygen is scarce. This makes it a valuable supplement in naturopathic protocols aimed at improving cellular energy production and reducing fatigue.
Naturopathic practitioners use pyruvate for its ability to support energy metabolism and improve endurance. It is particularly beneficial for individuals with chronic fatigue, fibromyalgia, and other conditions where mitochondrial dysfunction and energy deficits are prevalent. By enhancing the efficiency of the Krebs cycle, pyruvate helps to maintain cellular function and energy levels, promoting overall health and vitality.
Studies have shown that pyruvate can improve exercise performance, increase fat loss, and provide neuroprotective effects, making it a versatile tool in naturopathic medicine. Its role in sustaining the Krebs cycle under hypoxic conditions further underscores its potential in treating a variety of metabolic and energy-related disorders.
Sources:
Vitamin D3, also known as cholecalciferol, is essential for various bodily functions, particularly in the maintenance of bone health. It is synthesized in the skin upon exposure to sunlight, specifically ultraviolet B (UVB) radiation, which converts 7-dehydrocholesterol to previtamin D3. This previtamin D3 is then transformed into vitamin D3 through thermal isomerization. The liver further metabolizes vitamin D3 into 25-hydroxyvitamin D [25(OH)D], the primary circulating form of vitamin D, which is used to assess vitamin D status.A significant concern in neurological disease is the widespread deficiency of vitamin D3, exacerbated by multiple factors. One of the primary contributors is the extensive use of statins. Statins, prescribed to lower cholesterol levels, inhibit the enzyme HMG-CoA reductase, which is not only crucial for cholesterol synthesis but also for the production of 7-dehydrocholesterol, the precursor of vitamin D3. As a result, individuals on statins have a reduced capacity to synthesize vitamin D3, leading to potential deficiencies.
Moreover, the use of sunscreen and limited exposure to natural sunlight further diminishes the skin's ability to produce vitamin D3. Sunscreens, while protecting against skin cancer, block UVB rays necessary for vitamin D synthesis. Additionally, lifestyle changes have led to less time spent outdoors, reducing overall sunlight exposure.
These deficiencies have serious implications for bone health. Vitamin D3 is vital for the absorption of calcium and phosphorus, critical minerals for bone formation and maintenance. Microfibroblasts, which play a role in bone remodeling, rely on adequate levels of vitamin D3 to function effectively. Insufficient vitamin D3 impairs these processes, increasing the risk of osteoporosis and fractures, especially in the elderly population.
Addressing vitamin D3 deficiency involves a combination of dietary intake, supplementation, and safe sun exposure. Foods rich in vitamin D, such as fatty fish, fortified dairy products, and eggs, along with vitamin D3 supplements, can help maintain adequate levels. However, it is essential to balance sun protection with sufficient exposure to sunlight to support natural vitamin D3 synthesis.
Sources:
(1) The Dai Mai, or Belt Vessel, is classically described in TCM as sitting like a bowl of water, encircling the waist and providing stability and regulation to the body's energetic flow.
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