Brain health and function: devising an effective treatment protocol with Complementary and Integrative Medicine

Paul Reller, L.Ac.

Brain function and health is an issue important to a large number of patients today, both those that suffer from a diagnosed pathology such as Parkinson’s disease, ADHD, or Mild Cognitive Impairment, a precursor to Alzheimer’s dementia, and those who experience a variety of disorders and symptoms related to brain health and function, such as insomnia, poor short term memory, depressive disorders, anxiety disorders, bipolar disorders, and a variety of sleep disorders, such as apnea, bruxism, or restless leg syndrome. Many endocrine disorders are also related to brain health and dysfunction, as the heart of hormonal regulation lies in the hypothalamus and pituitary complex near the top of the brainstem. A wide variety of health problems point to the need to address the health and function of the central nervous system and the brain. While many advertisements now claim that one specific nutrient supplement or herb is the miracle product that we are all looking for, to improve memory and cognitive function, or to reverse degeneration of the central nervous system, this is not true. The health and function of the brain, brainstem and spinal cord is a complicated issue, and a health professional, such as a knowledgeable Licensed Acupuncturist, may be able to provide the individualized assessment and protocol to help you restore neurological health and function intelligently. A little knowledge of physiology and what current research tells us helps the patient to take an intelligent proactive role in working with a Complementary and Integrative medicine physician to achieve their goals.

The brain and spinal cord are the most important organs in our bodies, centrally controlling most of the functions of the other organs, and coordinating our sense of emotional well being, memory and cognition. Cognition, our process of awareness, understanding, sensing, perceiving, intuiting, reasoning, imagining, judging and relating, is all important to our quality of life, and we take it for granted, despite its complexity, or perhaps because of it. Since so many diseases and dysfunction in our life are related to the brain and central nervous system, an enormous amount of scientific study is being conducted to find treatment protocols related to brain function and health in Complementary and Integrative Medicine. The amount of information is overwhelming, and to utilize this mountain of information, the patient should take a proactive role with a Complementary Medicine physician, such as a knowledgeable Licensed Acupuncturist and herbalist, to choose the best individualized protocol, understand it, and stick with it in a step-by-step process.

There are a number of important considerations to consider in restoration of health and function to the central nervous system. Balance and bioavailability of neurotransmitters, efficient clearing of oxidative stress and neurotoxicity are the chief concerns. Circulation and nutrient supply are vital to these goals, as is the health of the immune system. To achieve specific goals related to an individual health profile, the first step should be to gain some basic understanding of the physiology and anatomy of the brain.

The most important aspects of brain metabolism

When devising the most effective individualized treatment protocol for improving brain function and health, a number of key issues need to be examined and assessed, and priorities need to be established for each individual. The number of ways that we now know to effectively aid brain functionality and improve the health of the brain cells, tissues, circulation and neurotransmission are growing year by year with research, and choosing the right tools from the array of beneficial treatment options is now daunting. This is why each individual must work as a team with a Complementary Medicine physician to choose the most important aspects of brain health to work on. This means that we should gain some understanding of the way that our bodies circulate nutrients and herbal chemicals to the brain, which nutrient and herbal chemicals easily cross the brain-blood barrier and affect the brain, and what aspect of the brain health needs to be focused on. This may include the neurotransmission, with a balance of neurotransmitter bioavailability and receptors, or it may include the health of the energy utilization of brain cells and tissues, especially mitochondrial health. We may also consider neurotoxicity and oxidative stress and damage, and the ability of the brain to repair itself faster than it ages or is damaged from toxicity or oxidative stress. A step-by-step approach may include treatment of vascular health and the blood brain barrier integrity, cerebral circulation, essential nutrient bioavailability, antioxidant aids, detoxification and chelation, and bioavailability of neurotransmitters and restoration of their receptor balance.

Circulation to the brain and the blood brain barrier

We have evolved an elaborate system of restricting and regulating what is allowed into the brain. Since the brain is the seat of control of the rest of the body, this tissue needs greater protection, and the fluids that circulate to the brain cells and tissues are separated into the cerebrospinal fluid and the blood, with a smart barrier set up between these two in most of the brain. This is called the brain-blood barrier, and generally restricts larger molecules, such as bacteria and proteins, from freely entering the cerebrospinal fluid, or extracellular fluid. This is accomplished by the creation of tight cellular junctions in the vascular membrane, or epithelium. Some areas of the brain do not have a blood brain barrier, though, such as the pineal gland, which freely secretes the important hormone melatonin into the circulation to regulate cellular processes throughout the body, and the pituitary gland, whose posterior portion secretes the hormones oxytocin and ADH into the blood. Areas of the brain bordering the central ventricles, or reservoirs of cerebrospinal fluid, are also free of the brain-blood barrier, and these tissues are important seats of regulation of fluid, metabolites and neurohormones, as well as areas that detect toxins in the blood and initiate responses.

Knowledge of the blood brain barrier (BBB) allows nutrient and herbal experts to create effective medicines that are more sure to reach certain areas of the brain. In the unregulated field of herbal and nutrient medicine, though, the consumer and the physician needs to rely upon the integrity of the professional company that supplies these products to insure effectiveness. Products on the shelf, especially cheaper products, and those that rely on heavy advertising to sell, are often not what they claim to be, or base their products on unreliable science, using the cheapest materials instead of the most effective. There is no penalty in the U.S. when companies claim that their nutrient and herbal medicines will cross the blood brain barrier and actually affect the brain the way they are advertised, and instead do not work as advertised. The fact that many of these products are now produced by the pharmaceutical industry, which loses money when nutrient and herbal products effectively compete with their more expensive synthetic drugs, leads many Complementary Medicine physicians and patients to view many of the commercial products with skepticism.

Important nutrients that are able to cross the blood-brain barrier include L-Glutamine, 5HTP, Acetyl L-Carnitine, Phosphotidyl serine, DHA omega-3 essential fatty acid (docosahexaenoic acid), CoQ10, 7-keto DHEA (dehydroepiandosterone), and DMAE (dimethylaminoethanol). Important and often used herbs for brain health and function that contain active chemical metabolites that may easily cross the blood-brain barrier include Gingko biloba, Vinpocetine, Huperzine A, and Bacopa monniera, but many herbal active metabolites may cross the brain-blood barrier. These all will be described later in this article. When devising strategies to promote brain function and health, though, these are the important nutrient and herbal medicines to consider.

On the other side of the blood brain barrier is the cerebrospinal fluid. The cerebrospinal fluid (CSF) is a store of essential nutrients in the brain, brainstem and spinal cord. The main functions of CSF are to protect the brain from trauma, supply nutrients to CNS tissues and cells, and remove waste products of cerebral metabolism to the veinous system. CSF is composed of electrolytes (mostly sodium, but also potassium, magnesium, calcium), much glucose, urea and uric acid, creatinine, and a small amount of protein and protein peptides. The protein concentration of CSF is dramatically lower than that of blood plasma, because of the blood brain barrier, and the concentration of immune cells is also very low, unless there is a CSF infection (e.g. meningitis). Lymphocytes normally account for 60-100% of these immune cells in CSF, and these white blood cells consist of the small T cells and B cells more often than the large NK cells (natural killer). Other types of lymphocytes include T helper cells (Th1 and Th2), which are often involved in chronic inflammatory diseases. Analysis of the CSF for abnormal content is now becoming a more important diagnostic tool, especially in diagnosing early Alzheimer’s and cognitive dysfunction. The level of amyloid beta protein peptide (A-beta) may be an important marker for the development of Alzheimer’s plaque in the brain.

When the integrity of the blood brain barrier is affected, neurological problems may occur. The integrity of the blood brain barrier may be altered by methamphetamines and cocaine, other pharmaceutical drugs, inflammatory cytokines, and environmental toxins. This barrier may also be affected by cardiovascular problems, and disruption of the blood brain barrier is also seen with diabetes and Metabolic Syndrome. The permeability of the brain-blood barrier may be altered by these factors in various ways, allowing a variety of toxins, pathogens, and large molecules to cross. Loss of blood-brain barrier integrity has been recognized as a major cause of profound brain alterations. Studies have shown that regular exercise and various antioxidants reverse this loss of blood-brain barrier integrity induced by methamphetamines, and we can surmise that most problems with the blood brain barrier will be helped by an improved lifestyle and diet. This is a starting point for brain health and functionality. A large number of factors may affect the brain-blood barrier integrity, though, and studies have shown that increased permeability of this barrier is a characteristic of neurodegenerative diseases such as Alzheimer’s and Parkinson’s, and lies at the heart of mild cognitive dysfunction, as well as a host of problems in the brain. Complementary Medicine offers a variety of treatment protocols to help improve or correct problems with this important regulatory barrier.

A key aspect of study of the blood brain barrier and cognitive dysfunction is the regulation of transport of neurotoxic metabolites such as beta-amyloid peptide, a fatty protein fragment that accumulates in the brain and slowly deteriorates brain function. P-glycoprotein (Pgp), or permeability glycoprotein, is a membrane transporter expressed in the blood brain barrier, the intestinal epithelium, liver cells, and kidney cells. P-glycoprotein has been found to regulate the amount of beta-amyloid protein, or so-called “sticky protein”, that is allowed through the blood brain barrier, which leads to various neurodegenerative pathologies, such as Alzheimer’s disease. Pgp, also called ABCB1, is a membrane transporter for an array of substances, though, including peptides, lipids, and many pharmaceuticals, including digoxin, immunosuppressive agents, glucocorticoids (such as prednisone and desmethasone), and steroids, as well as xenobiotics (organic toxins), and some naturally derived drugs, such as colchicine, quinidine, and tacrolimus. New drugs designed to inhibit Pgp may thus be problematic. A better tactic is being researched, normalizing the homeostatic mechanisms of Pgp and other membrane transport proteins to properly regulate transport across the blood brain barrier of beta-amyloid peptides. Current Alzheimer research has focused on the role of advanced glycation endproducts (AGEs) and the receptors for these glycoproteins (RAGEs), as a means to affect the blood brain barrier to prevent the building blocks of cognitive dysfunction and Alzheimer’s disease.

Although the many possible mechanisms of neurodegeneration have made this area of medicine confusing, not only for the patient, but for the physician and researcher as well, promising research has identified a host of pathological problems that may lead to cerebrovascular dysfunction involving the blood brain barrier, and contribute to the cognitive decline and dementia in these diseases. These problems may precede the beta-amyloid accumulation of neurotoxin in Alzheimer’s disease. Besides P-glycoprotein, two membrane receptors are found to regulate amyloid-beta peptide transport across the blood brain barrier. These are the low density lipoprotein receptor related protein 1 (LRP1), and the receptor for advanced glycation endproducts (RAGE). The P-glycprotein (Pgp) and LRP1 membrane transporters regulate the efflux, or clearing, of amyloid beta peptide, while the RAGEs regulate the influx. The neurovascular hypothesis of the origins of neurodegeneration implicates excess expression of RAGE due to excess circulating AGEs, deregulated LRP1, aberrant angiogenesis, and arterial inflammation, as the main factors in this blood brain barrier dysfunction. A set of therapeutic protocols is suggested to reduce neuroinflammation, enhance amyloid-beta clearance and neurovascular repair, and improve blood flow in the brain (see the research link cited below in additional information from the University of Rochester in New York).

LRP1 is a protein receptor in the blood brain barrier cell membrane involved in endocytosis and transfer of the various molecules described above. LRP1 interacts with Apolipoprotein E (apoE4) to import cholesterol into the brain. Dysfunction of this process is also thought to be a factor in neurodegenerative cognitive dysfunction by decreasing cholesterol in the brain and damaging neural function by inhibiting myelin sheaths and support cells responsible for neurotransmission, as well as inhibiting neural growth. LRP1 also interacts with inflammatory kinases (MAPK), calcitonin receptors (regulation of calcium), and thrombospondin 1 (affecting angiogenesis and platelet aggregation). Apolipoprotein E is also now heavily studied for its relation to the pathogenesis of Alzheimer’s disease, cognitive dysfunction, atherosclerosis, and immunoregulation. Chronic inflammation may play a part in dysfunctions related to Apolipoprotein E (APOE). APOE is also produced by the support cells in the brain, and neurons express APOE receptors. Restoration of a healthy homeostasis of lipids, inflammation, angiogenesis, clotting factors, calcium, and cholesterol may all play a part in normalizing LRP1 homeostasis to improve clearing of amyloid beta peptide from the brain. A holistic treatment protocol is warranted, rather than a specific allopathic chemical.

To affect these healthy protocols, nutrient and herbal formulas to block the production and accumulation of advanced glycation endproducts (AGEs) and to inhibit angiogenesis (e.g. IP6), may be combined with herbal formulas to reduce chronic neurovascular inflammation (e.g. from TNF-alpha), and improve cerebrovascular circulation and oxidant clearance. Of course, improved diet and exercise routines, and acupuncture, may be combined with this strategy to improve neurovascular health, the blood brain barrier, and prevent the slow progression of neurodegenerative disease and cognitive dysfunction.

Circulation in the brain past the blood brain barrier

Circulation in the brain is more tightly regulated than in the rest of the body. Both the blood circulation and the cerebrospinal fluid circulation are important, and as stated, these are separated in most areas of the brain by a tight blood-brain barrier that restricts free flow of larger molecules and charged ions. Blood flow to the brain is more vital than to other parts of the body. When blood flow is interrupted, restricted, or excessive, dysfunction occurs, and the ill effects may range from poor cognitive function, dizziness, and headache, to the paralysis and loss of speech seen in strokes. Fortunately, there are elaborate systems to preserve a constant flow and pressure in the blood vessels of the brain. When blood pressure rises, the blood vessels automatically contract with stretch, and through all normal ranges of arterial blood pressure, which greatly exceed those we deem as indicative of chronic hypertension, blood flow will remain constant. Very high, or malignant, blood pressure, though, may result in damage to the arterial linings and to the blood-brain barrier. Patients subjected to very high periods of blood pressure need to treat this arterial lining, or epithelium, to effect better repair. Patients with chronic hypertension, while not damaging the brain arterial lining and blood-brain barrier, do create a situation over time of adaptation, and it is shown that with these patients that what we consider a normal blood pressure, as well as periods of low blood pressure, may result in tissue ischemia in the brain, or poor oxygenation. Often, the patient that had a moderate hyptertension for years, and now takes a number of hypertension drugs, may have a low to normal blood pressure, and be subject to periods of tissue ischemia, with lowered oxygen supply to areas of the brain now causing poor function. Maintenance of the blood vessels is thus very important, as well as maintaining health and function of the brain tissues and cells, even when taking these blood pressure medications.

A number of chemicals in circulation may affect the blood vessels and circulation in the brain as well. Carbon dioxide, acidity (low pH), nitric oxide, and adenosine are the chief compounds that may stimulate dilation of the blood vessels. These chemicals may be beneficial, released from brain cells and tissues in areas of the brain with increased activity and need for more oxygen and nutrients in the blood, or may be harmful, released into circulation due to inflammatory mechanisms, poor control of acidity in the body, poor function of the mitochondria, or excess oxidative stress. When these conditions become chronic, the normal regulatory responses to these chemicals may be altered, adversely affecting the ability of the body to respond to increased need for oxygen and nutrients. Using drugs to inhibit mechanisms of inflammatory mediators, stomach acid production, etc., may decrease pesky symptoms, but will not address the underlying problems that add to poor brain function and health. Acidity and chronic inflammation are two key areas that need to be addressed. Chronic acidity in the body cannot be fully measured, only local acidity in the blood, urine and saliva, and the body’s chief reaction to acidity is buffering with increased circulating carbon dioxide (pCO2) and/or calcium. Calcification of tissues may then occur, also inhibiting the circulatory capability in the body with hardened arteries. These issues become very important to brain health and function, especially in aging, and in patients with chronic problems with inflammation, poor gastric function, hormonal deficiencies, and oxidative stress.

One of the most widely studied herbs in the world is Gingko biloba, and consequently it is now the most widely prescribed and best selling herbal medication in Europe. Of the more than 40 active ingredients in this herb, the flavonoids and terpenoids are believed to exert most of the studied medicinal effects. Both flavonoids and terpenoids have potent antioxidant properties, but the flavonoids are thought to be more neuroprotective and beneficial to arterial health, while the terpenoids are thought to improve blood flow by reducing the platelet aggregation and dilating the blood vessels. Gingko biloba extracts, especially a standardized tincture extract, have been proven to exert benefits to memory and cognitive dysfunction in Alzeimer’s patients, and slow the progression of cognitive dysfunction that precedes dementia. Numerous studies cite the benefits in early stages of neurodegenerative cognitive dysfunction, but like most medications, show little benefit in later stages of dementia. Gingko biloba has also been proven to aid other vascular circulatory disorders, such as intermittent claudication and macular degeneration. Other neurodegenerative disorders, such as glaucoma, have also found proven benefit from Gingko extract. Using a professional quality standardized extract as a base in formulas of tinctured herbal extract is recommended to treat circulation and oxidative stress in the brain.

Gingko biloba by itself is not the answer to correcting problems related to circulation and oxidant stress in the brain, though, and an array of professionally prescribed herbs should be considered in the overall protocol. Some of these more well studied herbs will be explained later in this article. These herbs may be combined in a package of care that includes acupuncture, nutrient medicine, advice with diet and lifestyle, and even deep tissue physiotherapies, which provide proven benefits to immune and hormonal balance, and decrease of inflammatory stress.

Essential nutrient molecules involved in brain function

Choline and inositol are perhaps the most important chemicals in the brain. Choline is an essential water-soluble nutrient, usually grouped with the B vitamins. Phosphatidylcholine is a form of choline that is abundant in cell membranes as well as being a precursor to the most abundant neurotransmitter in the brain, acetylcholine. Often, phosphatidylcholine and phosphatidylserine are combined in nutrient supplements for improving brain function. Choline deficiencies are seen with poor diets and with fatty liver accumulations. Choline deficiency may also cause kidney dysfunction, infertility, hypertension and bone abnormalities. Choline deficiency is not uncommon. It is believed that choline deficiency is more likely with vegan diets, and persons that eat very few eggs, as well as with people who drink a lot of alcohol, and frequently exert themselves with endurance exercise. Recent research from NHANES, by Dr. Steven Zeisel, found that less than 10% of Americans had choline intakes at or above the recommended AI (Adequate intake). Healthy sources of choline include tofu, kidney bean, quinoa, amaranth, spinach, whole milk, chicken, cod fish, egg and beef liver. Soy lecithin is also a good source. Supplementation may be best achieved by taking alpha-GPC (L-alpha glycerylphosphorylcholine, or choline alfoscerate), which is combined with acetyl L-carnitine in the Health Concerns supplement CogniSpark. Alpha-GPC is well studied, easily crosses the blood brain barrier, and like phosphotidylcholine, is derived from lecithin.

Phosphatidylserine is also a phospholipid component of cell membranes, and is essential to brain function. Studies have so far been limited and of poor quality, but some studies have shown that phosphatidylserine improves cognitive function in neurodegenerative disease. The FDA has reviewed these studies and found that the evidence is so far not conclusive, but that the evidence does show a preliminary and limited relationship to cognitive dysfunction and that more reliable studies need to be conducted. An FDA qualified health claim was granted stating that “Consumption of phosphatidylserine may reduce the risk of dementia and cognitive dysfunction in the elderly.” Other proven benefits of phosphatidylserine include a speeding of recovery from exercise, prevention of muscle soreness, and improved well being. Pilot studies also indicate that phosphatidylserine may be beneficial in the treatment of ADHD. Almost all of the phosphatidylserine in supplements today is derived from soy.

Inositol may be used as a medicinal supplement in the forms of inositol, inositol hexacotinate (a Vitamin B3), and IP6 (inositol hexaphosphate). Each of these may be utilized in the treatment protocol for brain dysfunction and health maintenance. Inositol is essential to healthy neural cell membranes, and as a precursor to IP3 (inositol triphosphate), which is important in signal transduction in cells. Inositol hexacotinate is a flush-free form of niacin, which improves nitric oxide metabolism and vasodilation, and is a precursor to the key cell signaling molecules NAD and NADH. Niacin also plays a role in DNA repair and the production of steroid hormones. Niacin is an essential nutrient that is seen in deficiency disease (pellagra), and mild deficiency, causing slowed metabolism and intolerance to cold, and is common nutrient deficiency. IP6 is shown to inhibit excess angiogenesis, serves as a potent antioxidant, and may serve to chelate iron toxicity and uranium radiation toxicity. Inositol is also found in various herbs and foods, including European Mistletoe (Viscum album), Lonicera japonica (Jin yin hua), wheatgrass, lentil, sesame seed, and plantain.

Acetyl L-carnitine is also an essential nutrient in brain function. L-carnitine is a derivative of the amino acid lysine, and the L isomer is the biologically active form. It is not an essential nutrient, as the body may synthesize it from lysine and methionine, but does play an important role as a nutrient medicine. In many disease states, the demand for L-carnitine exceeds the body’s ability to produce it, especially if there is a deficiency of lysine or methionine, of if the health of the intestines is a problem. L-carnitine is found in meats, but studies have indicated that a vegetatarian diet, although containing less L-carnitine, resulted in an adaptation and higher bioavailability of L-carnitine in the individual. Bioavailability of acetyl L-carnitine is found to be higher than simple L-carnitine when taken as a supplement, and it is shown in scientific studies to be beneficial to treat brain function and slow cognitive impairment, maintain nerve and blood circulation, and support testosterone aging. In animal studies, acetyl L-carnitine protected brain cell mitochondrial function, ameliorated excitotoxicity, and improved bioenergetic status in the hippocampus neurons when the animals were exposed to hypoxia. Studies also showed a benefit in the treatment of depression and melancholia associated with alcoholism. One benefit of taking the supplement SamE (a methionine) is to create better bioavailability of L-carnitine.

L-carnitine is an essential cofactor in the metabolism of lipids and production of cellular energy. This amino acid, especially the acetyl form, has an important role in the beta-oxidation of essential fatty acids and transport of long-chain fatty acids, such as the omega-3 DHA, across the inner membrane of the mitochondria in neurons. Taking acetyl L-carnitine with P5P and DHA in the form of krill oil may improve the effectiveness. Since the function of neurons requires much energy, and mitochondria are the creators of this energy in the cells, generating most of the cell’s ATP, aiding mitochondrial health is very important to brain function. Mitochondria are also important to the neuron in a variety of ways, though, involved in cell signaling, programmed cell death (apoptosis), and the cycle of cell growth and differentiation. Problems with mitochondrial health and function lie at the heart of our study of health problems in aging, and mitochondrial dysfunction is strongly implicated in a number of diseases, including bipolar disorder, optic neuropathy, dementia, and epilepsy. While these mitochondrial disorders may be inherited, or the propensity inherited with a single allele, the majority of mitochondrial dysfunctions are caused by acquired mutations due to the adverse effects of drugs, infections, toxins, or other environmental causes.

R-lipoic acid has been well studied as well concerning brain health due to its proven antioxidant effects, aid to glutathione cell detoxification, and aid to mitochondrial health, and is considered a companion to acety L-carnitine in its effects, as well as an essential cofactor in lipid metabolism and blocking of excess production of advanced glycation endproducts (AGEs). The R isomer of alpha lipoic acid, or R-lipoic acid, is better utilized and is the form that our neuronal cells synthesize. There is considerable scientific study of R-lipoic acid as a potent medical treatment of a number of neurological disorders. Consumption of lipoic acid in the diet has not been shown to create significant increases in neural cell concentration, though, and a supplement is considered necessary to enact medical benefits. R-lipoic acid is considered an essential cofactor to a number of mitochondrial enzyme complexes related to energy production and the breakdown (catabolism) of amino acids. R-lipoic acid is also considered to be a potent antioxidant in the brain, and is essential in the regeneration of other antioxidants, such as Vitamins A and C. The metabolite created from R-lipoic acid in the neuron, DHLA, also is able to reduce oxidized CoQ10 to increase the antioxidant effects of this chemical. In animals stressed by aging or oxidative stress, R-lipoic acid was able to significantly increase glutathione synthesis, as well. Glutathione is the chief cellular detoxification pathway in our body. R-lipoic acid significantly affects insulin cell signalling in the brain as well, an important factor in cognitive health. While insulin does not regulate glucose utilization in the brain, it does play an important role in regulation of tissue growth and repair. An article published in Nature (25 March, 2010) reviewing current scientific understanding of neural mechanisms of ageing and cognitive decline stated that: “The major risk factor for neurodegeneration and cognitive decline is the ageing of the brain. Conserved pathways and mechanisms that control organismal ageing, such as the insulin/IGF signalling and mitochondrial function, can modulate pathology and cognitive decline.” Both mitochondrial function and the insulin signalling pathway are vitally important, and R-lipoic acid addresses the health of both of these systems.

L-carnosine is yet another amino acid that is found to be important in the maintenance of brain health and function. With aging, our DNA shorten, and the communicating ends of DNA, or repeated telomeres, are found to have fewer protective repeats, and thus leave our DNA open to more damage and mutation. L-carnosine was found to be protective of these telomeres. Carnosine is the naturally occurring complex of two amino acids, L-histidine and beta-alanine, is a potent antioxidant in the brain, a buffering agent against acidity, and important in the clearing and prevention of advanced glycation endproducts (AGEs). L-carnosine is neuroprotective, countering neurotoxicity from beta-amyloid peptide accumulation and lipid peroxidation of neuronal membranes. At present, much scientific study of L-carnosine is underway to confirm the pathways of neuroprotection and cognitive benefits seen in some studies.

The most important neurotransmitters in the brain, acetylcholine, serotonin, GABA, epinephrine/norepinephrine (adrenaline), and dopamine are all derived from a few amino acids, namely choline (more of a vitamin), tryptophan (5HTP), glutamate (L-glutamine), and tyrosine. For this reason, the amino acids L-glutamine and L-tyrosine are potentially very helpful to correct problems with brain function. The tryptophan precursor 5HTP is a more widely known nutrient medicine, and does exert more immediate effects for more patients. There is a very fluid relationship in the production of serotonin from 5HTP, though, with 5HTP involved in a number of conversions and pathways, creating melatonin as well, and a balance of these chemicals, and a bioavailability, insures that our homeostatic mechanisms create the right amount of serotonin, as well as melatonin, at any one moment. The Vitamin B6 metabolite P5P is involved in these conversions and is also an essential nutrient to maintain a balanced bioavailability. P5P is also a cofactor in the assimilation of amino acids, and may help one obtain more of the amino acid when taking pills. Another balancing act occurs with the tyrosine pathway, which creates dopamine, which may convert to norepinephrine and then to epinephrine in local tissues. Tyrosine is also converted to other important molecules in the brain as well, though, such as melanin and pyruvate, and is the building block of the thyroid hormones as well. Insufficiency of tyrosine may play a significant role in hypothyroidism and mood disorders, and in clinical studies, patients with mood disorders subjected to increased stress noted improvements in mood and cognitive function after taking L-tyrosine. Patients with normal stress parameters noted no immediate effects. Patients with a subclinical hypothyroidism, though, may find that L-tyrosine supplementation has a more profound effect on mood and cognitive function.

Lastly, B12, or methylcobalamin, may be an essential nutrient medicine in brain health and function as well. B12 is involved in a number of important pathways in the brain, and has been well studied as a medicinal adjunct in the treatment of a wide variety of disorders, including sleep disorders, mood disorders, peripheral neuropathies, cognitive decline, and glutamate neurotoxicity. In the metabolic pathways of choline, B12 serves as a cofactor, with betaine, in the conversion of homocysteine to methionine and SAMe, which helps to maintain cell membrane function and create DNA and RNA via methylation. The betaine in this pathway is derived from choline, and deficiency of B12 could add stress to the choline pathway in the creation of acetylcholine, the most abundant neurotransmitter in the brain. Homocysteine is also integral to the pathway that creates glutathione, our main cellular detoxifier and antioxidant. B12 deficiency, therefore, in this one metabolic pathway, has the potential to add to a number of important dysfunctions in the brain. In clinical use, patients with a deficiency will often report much improvement of a variety of symptoms after taking a high dose liquid sublingual B12 methylcobalamin supplement, or after receiving a B12 intramuscular injection. Since B12 assimilation in the stomach depends on a chemical called intrinsic factor, which is often poorly expressed in patients with a B12 deficiency, common B12 supplement in vitamin pills and multivitamins may not be effective. Since much of our B12 is produced by symbiotic intestinal bacteria when needed, maintenance of gastrointestinal health and use of probiotics may also be helpful.

How do we know which of these nutrient medicines may make a significant effect in an individual patient? We don’t. The more clinical experience the physician has prescribing these nutrient medicines, though, the better they get at assessing each individual and making the best guess. Often, though, this may be a situation where supplements need to be tried for a period of time, and a number of these supplements combined. One patient may respond to one nutrient while another with a similar presentation may respond more to another. The good thing is that these nutrient medicines are inexpensive and good for the patient overall, with no side effects. The bad aspect is that for a number of months, the patient must take a number of pills every day. This inconvenience is overblown by most patients, though, for some reason, and often compliance with prescription is the main obstacle to improvement. Obviously, taking a number of pills for a few months is not that much of a burden, especially when the gains are sometimes dramatic and can have dramatic results in terms of prevention of future devastating neurological problems.

The most effective antioxidants for the brain and CNS

Oxidative stress and the decreased ability to clear free radical oxidants from the brain, brainstem, and spinal cord have long been linked to neurodegenerative states. The affect on mitochondrial function with accumulation of reactive oxygen species (ROS) within the neural cells has been the area of greatest focus. The glutathione metabolism is the primary tool of brain cells to clear intracellular ROS, and a number of nutrient and herbal strategies have been found to increase the glutathione capacity. R-lipoic acid is perhaps the most studied in this regard, but an array of nutrients, herbal chemicals, and even acupuncture has been shown to increase glutathione capacity. N-acetyl cysteine, selenium, zinc monomethionine, P5P, B12 and 5MTHF have all been found to be useful to promote improved glutathione metabolism (read the article on glutathione on this website). Of these, methylselenocysteine, and active form of selenium, is perhaps the most promising in regards to neurodegeneration and brain function and health. Methylseleocysteine is a naturally occurring seleno-amino acid found in aged garlic, and many studies over decades have touted this compound and its ability to enhance glutathione antioxidant capacity.

Besides oxidative stress, iron overload capacity has also been clearly correlated with cognitive decline in the elderly (see study cited below). The decreased ability to transport iron effectively in the blood is the main reason for the iron overload toxicity associated with aging. Iron accumulation is usually slow and worsens with aging. Like all heavy metal toxicities, chelation is important in clearing this neurotoxicity, but improving the blood cell quality, clearing chronic hepatitis, and avoiding excessive and unhealthy iron supplementation regimens when anemia is diagnosed, may be important. A natural low dose plant derived iron supplement, with assimilation cofactors, is recommended if iron deficient anemia is present. In fact, patients with anemia should be screened for excess iron, as this could be the cause of the anemia, not the problem. Inadequate diagnostic workup with anemia is now very common, and any microcytic anemia is routinely treated with iron. Standard medicine still insists that the great majority of cases of iron overload must be linked to a genetic hemochromatosis, despite the numerous studies showing the high prevalence of iron accumulation in patients with cognitive decline and aging. Screening is indicated, chelating therapy recommended, and artificial vitamin C supplement should be avoided, as this worsens the iron overload neurotoxicity.

Oxidative stress and the need for antioxidant clearing increases substantially in the brain with aging. Not only the mitochondrial processes, but damage to DNA and genetic expression occur with advancing oxidative stress as well. Many studies of gene expression show an age-dependant upregulation of oxidative stress-response genes in humans, and it has been widely surmised that increased antioxidant therapy with aging is likely to preserve cognitive health significantly. A host of Chinese herbs exert significant antioxidant effects, including the ginsengs. As stated, flavonoids and terpenoids are the two most studied groups of herbal chemicals with significant antioxidant capacity, and a large number of Chinese herbs have these chemicals in them. Some noted herbs commonly used professionally to treat cognitive dysfunction and neurodegeneration include Siberian Ginseng, Withania somnifera (Ashwagandha), and Schizandra berry.

Some proven herbal medicines for cognitive decline and neurodegeneration

Huperzine, Vinpocetine, Rosemary extract, and Bacopa monniera are just some of the herbs proven to aid cognitive decline. Huperzine A and B are alkaloid chemicals isolated from the root of the club moss Huperzia serrata, or Lycopodium serratum, a Chinese herb (Qian ceng ta). Huperzine A was developed in China as a selective acetylcholinesterase (AChE) inhibitor for the treatment of neurodegenerative diseases, and was found to be more potent than the pharmaceuticals phytostigmine and galanthamine. An AChE inhibitor decreases the enzymatic rate of degradation of the important neurotransmitter acetylcholine. Huperzine A can penetrate the blood brain barrier rapidly and is highly neuroprotective. In microdialysis studies, Huperzine A was found to be able to increase the levels of acetylcholine, dopamine and norepinephrine in brain tissues while not exerting a significant change in 5HT/serotonin. A synthetic racemic analog was created, but the natural herbal Huperzine A is found to be 3 times as potent. In animal studies, Huperzine A was found to increase the endplate potential and prolong the potential rise time in the neuromuscular junction as well, potentially aiding muscle function in athletics. Clinical human trials in China have shown it to be effective in the treatment of Alzheimer’s disease, with no serious adverse events noted, and much milder cholinergic side effects than pharmaceutical anticholinesterase drugs. The NIH National Institute on Aging has completed a phase 2 clinical trial for the treatment of Alzheimer’s disease, and Harvard University has investigated its efficacy to treat epilepsy. Numerous studies in China have affirmed the effectiveness of Huperzine A to improve memory in mild cognitive disorders.

Vinpocetine is a chemical from the periwinkle plant that has been long used in China to treat cerebrovascular disorders, improving blood circulation, dilating blood vessels, improving oxygen utilization, increasing glucose metabolism, and inhibiting platelet aggregation. It has also been shown to inhibit phosphodiesterase to preserve ATP, the source of cellular energy. Rosemary extract has been found to be a potent antioxidant in the brain as well as a Cox-2 inhbitor, decreasing chronic inflammatory symptoms. Together with Huperzine A, this trio of herbal chemicals makes up the formula Vinpurazine by Health Concerns. When combined with alpha-GPC choline (CogniSpark from Health Concerns), these herbs and supplements provide a well rounded and complete treatment for brain function and health, serving both as a treatment and a preventive medicine. Adding the nutrient and herbal formula AGEBlock, by Vitamin Research Products, which includes P5P, L-Carnosine, L-Histidine, R-Lipoic acid, and Yerba Mate extract, forms a trio of medicines that could be play a very significant role in treating or preventing brain dysfunction and ill health. Combining acupuncture with this protocol, with the proven effects of acupuncture stimulation on specific areas of the brain, will work to make this healthy protocol more effective.

Resveratrol, a chemical constituent of the Chinese herb Polygonum cuspidatum (Hu zhang), and found in other herbs and foods (grape skins and wine), has been heavily researched and utilized even in standard medicine. Pharmaceutical companies have applied for patents and FDA approval of forms of resveratrol that may provide a higher dosage reaching the brain. The Chinese developed this chemical, isolating a particular isomer (trans-resveratrol) of the herbal chemical that could be supplied in a sufficient dosage to effect considerable antioxidant and other effects for brain health and function. Much research has been conducted with resveratrol, and more and more surprising data is being found to reveal its effectiveness. A 2011 study at the University of Fribourg, in Switzerland, found that resveratrol improves vascular endothelial function in the aging in part by inhibition of a protein kinase signalling molecule called S6K1, or P70-S6 kinase beta-1, responsible for regulation of growth factors and cell proliferation. S6K1 is overexpressed in aging arterial membranes and the blood brain barrier, leading to increased reactive oxygen species (ROS), such as superoxide dismutase and nitric oxide. A 2011 study at the University of Pais Vasco, in Spain, showed that resveratrol regulated lipolytic activity as well (breakdown of fatty accumulation in the brain), and increased fatty acid release from fat tissues while not affecting glycerol release. This finding could result in further study proving that resveratrol is an effective herbal chemical to reduce beta-amyloid peptide plaque accumulations, and other plaques in the brain. It could also explain how this chemical is able to show profound effect in patients with neurodegenerative disease, since the brain has a high percentage of fatty tissues than other parts of the body, which may generate much of the oxidant stress. A 2011 study at the Keio University School of Medicine in Japan found that resveratrol reduced inflammation, oxidative stress, neoangiogenesis, and extracellular matrix disruption, suggesting that this herbal chemical would prevent arterial aneurysms and improve vascular health. The numerous ways that Resveratrol may serve as a neuroprotective agent, antioxidant, antiinflammatory, and regulating agent makes this herbal therapy important in any treatment protocol concerning brain health and function.

A wide array of Chinese herbal chemicals have demonstrated neuroprotective effects, though. Berberine, an active metabolite in Coptis chinensis (Huang lian) and other Chinese herbs, has demonstrated neuroprotective effects by a block of potassium ATP channels in the substantia nigra, a brain nuclei responsible for many of the symptoms of Parkinson’s disease, exerting an excitatory effect on this area of the brain that is inhibited in this disease by poor dopamine effects. Berberine has also shown potential to inhibit platelet aggregration and thromboxane B2 to aid blood circulation in the brain, and to inhibit cholinesterase activity as well, increasing neurotransmitter function. Berberine is primarily used as an antibacterial agent in Chinese medicine, and shows good antiviral and antifungal activity as well, which may serve to clear chronic inflammatory problems in the CNS. Chronic inflammatory cytokines, such as TNF-alpha, are now known to be intricately tied to neurodegenerative disorders, and berberine and other herbal chemicals are well studied as inhibitors of TNF-alpha, and other problematic overexpressed cytokines. In studies we see these herbal chemicals acting in an evolved modulatory manner, preserving normal homeostasis. Pharmaceutical drugs do not display such modulatory effects. Various alkaloids in Coptis chinensis have also shown potent antioxidant activity and the ability to inhibit beta-amyolid plaque formation. A single herb has this much potential to benefit brain function and health. A formula of herbs containing berberine has tremendous potential to benefit the patient. These formulas may be used as a preventive medicine as well as treatment for more severe conditions.

Adaptogenic Chinese herbs, such as ginseng, Siberian ginseng (Eleutherococcus), and Rhodiola rosea (Hong jin tian) have also shown value as antioxidants and neuroprotective herbs. These various herbs may be combined in formulas in Traditional Chinese Medicine to exert a variety of effects to benefit brain function and health, treating other aspects of the health as well. Ashwagandha (Withania somnifera), an ayurvedic adaptogen has also been extensively studied and proven to exert significant neuroprotective effects and to speed growth and recovery of both neurons and support glial cells. These studies, some of which are cited below, have been conducted both on laboratory animals and in human clinical trials (in vitro and in vivo), and are proceeding through the 3 stage clinical trial processes created for pharmaceutical drugs even though this is unnecessary to prove effectiveness. This FDA staging of human clinical trials was created to judge the safety of harsh pharmaceutical medicines, and these herbs are proven safe by thousands of years of use and clinical record. The array of treatment options in Chinese medicine is extensive in this regard.

Bacopa monnieri (Water hyssop) is an Ayurvedic herb that has long been used to treat neurological disorders, such as epilepsy, and is now much studied for its positive effects treating neurodegenerative disorders. This herb has strong antioxidants and anxiolytic effects, and is considered a nootropic, or enhancer of cognitive ability. It is shown to inhibit lipoxygenase and reduce beta-amyloid plaques in Alzheimer’s disease. This plant is used in traditional Vietnamese cuisine, and normal dosage is very safe and nontoxic. A tincure of the leaf provides many of the important glycosides and flavonoids.

Passiflora incarnata (Passionflower) is an herb that has been much studied in relation to neurological disorders, and has proven effects that are significant in the treatment of insomnia, depression and anxiety. This plant contains many beneficial chemicals that exert significant antioxidant and antiinflammatory effects, as well as neuroprotective effects. Apigenin, kaempferol, luteolin, and quercetin are the main active chemicals. These are all neuroprotective, estrogenic, may increase bioavailability of tyrosine, and inhibit nitric oxide. Other chemicals, such as harmane, harmalol, and harmaline, have shown potent antiparkinsonism effects, and may act as a mild MAO inhibitor and dopaminergic. Passiflora has been found to potentiate some of the effects of St. John’s Wort as well.

Periodic use of these various Chinese herbal formulas and specifics could be vitally important to a great percentage of the population, since studies show that a majority of the population will now suffer from some neurodegenerative dysfunction in life. Whether this is a mild disease, such as attention deficit and hyperactivity disorder, a nagging chronic problem such as fibromyalgia (myoencephalopathy), or a potentially serious problem such as the advance of mild congitive dysfunction to Alzheimer’s dementia, preventive medicine is a smart choice.

The role of acupuncture stimulation in improving or restoring brain function and health

Since 1998, when groundbreaking functional MRI (fMRI) studies were performed at the University of California under the direction of the inventor of the PET scan, numerous studies around the world have documented the direct effects of acupuncture stimulation on specific areas of the brain and the resulting cascade of chemical, hormonal and physiological effects. It has been surmised that much of the positive effects of acupuncture, in fact, occur because of this stimulation of the brain. It is not difficult to understand that if one is taking nutrient and herbal medicines to improve brain function and health that stimulation of the brain with acupuncture will enhance these effects.

The original studies with fMRI showed that acupuncture points specific to visual and auditory pathology did in fact significantly increase brain activity in the corresponding areas of the brain devoted to vision and hearing. These points were chosen at the ends of the acupuncture meridians most corresponding to the brain at the feet and hands or wrists. Subsequent studies are revealing more and more specific information about how this acupuncture stimulation actually affects brain function. For example, it has been demonstrated that much of the effects of acupuncture on pain analgesia occur in the hypothalamus, the neurological seat of command of the endocrine and autonomic nervous systems. A further study in 1999, published in the medical journal Radiology (Radiological Society of North America, Inc.), found that acupuncture stimulation not only affected the hypothalamus, the nucleus accumbens, the raphe nucleus and periaqeductal gray matter, but that acupuncture stimulation at specific points also decreased signal intensity in the limbic system, the area of the brain associated with emotion and pain perception. In this study, the limbic system was the only area of the brain showing a decrease in signal intensity with stimulation of the acupuncture points LI4 and ST36. The limbic system is acknowledged as an area of the brain most important in formation of the cognitive and affective aspects of pain sensation, meaning that patients with chronic pain often experience excess pain sensation that is associated with memory and emotional triggers. Specific areas of the limbic system were found to be deactivated, or calmed, with this treatment, namely the amygdala, hippocampus and rostral part of the anterior cingulate cortex. Stimulation with minimal acupuncture and sham acupuncture on the human subjects had little and no effect on these areas of the brain (Ming-Tung Wu MD, Bruce R. Rosen MD PhD et al, July 1999, 212, 133-141; cited below with a link). The authors of this study noted: “Activation of the hypothalamus and nucleus accumbens of the descending antinociceptive system and deactivation of the limbic areas, which are associated with pain perception, provide a neurophysiologic mechanism for the analgesia effect of acupuncture. Given that the hypothalamus and limbic system provide multidimensional integration of neuroendocrinal and autonomic homeostasis, our finding that acupuncture activates the hypothalamus and limbic system also provide a basis for the versatility of acupuncture for use in conditions other than pain disorders, such as management of nausea and vomiting, asthma, and substance addiction.”

These studies of acupuncture show that brain function may indeed be stimulated and improved with acupuncture, especially if the brain is supplied with specific nutrient aids, and problems affecting the brain function, such as chronic inflammation and metabolic dysfunction are simultaneously treated with specific herbal chemistry. These studies proved that different effects occur with the type of stimulation by the physician as well. Given the complexity of the brain and central nervous system, and the complexity of the pathologies involved in cognitive dysfunction and decline, such a thorough and comprehensive holistic approach is obviously the best type of therapy to integrate into standard medical care to both treat and prevent cognitive dysfunction, central neurological disorders, and even advanced dementias. Simple searches on the internet provide the physician and patient with ever increasing proof of the efficacy of these acupuncture treatments, and provide ever more specific guidance for the acupuncturist in treatment.

In 2000, Harvard Medical School’s Department of Radiology and the MGH-NMR Center demonstrated that acupuncture stimulation at a single point, LI4, with manual manipulation, “produced prominent decreases of fMRI signals in the nucleus accumbens, amygdala, hippocampus, parahippocampus, hypothalamus, ventral tegmental area, anterior cingulate gyrus, caudate, putamen, temporal lobe, and insula in all 11 subjects who experienced acupuncture sensation. In marked contrast, signal increases were observed in all 11 subjects primarily in the somatosensory cortex. The two subjects who experienced pain instead of acupuncture stimulation to the same area elicited signal increases instead of decreases in the anterior cingulate gyrus, caudate, putamen, anterior thalamus, and posterior insula. Superficial tactile stimulation (acupressure) to the same area elicited signal increases in the somatosensory area as expected, but no signal decreases in the deep structures. These preliminary results suggest that acupuncture needle manipulation modulates the activity of the limbic system and subcortical structures. We hypothesize that modulation of subcortical structures may be an important mechanism by which acupuncture exerts its complex multisystem effects.” This study, and many more that followed, demonstrated clearly in all human subjects, that expert manipulation of the needle and clearly felt or observed stimulatory effects, exerts profoundly different effects on the central brain, the regulatory center of our body. The different effects felt at the needle, including the pain sensation, produced different effects on brain function, and did so in a modulatory manner cosistent with natural endogenous homeostatic mechanisms.

In 2004, the National Institutes of Health of the U.S. government, through the National Center for Complementary and Alternative Medicine, started clinical human trials mapping the effects of acupuncture on parts of the brain and assessing modulatory effects of acupuncture stimulation. This study was completed, and last updated in 2008 (trial NCT00079898), and affiliated with Massachusetts General Hospital and Dr. Kathleen Hui MD. Such studies are providing a wealth of information to researchers, who are busy mapping the objective scientific data on specific acupuncture points and types of stimulation on areas of the brain and subsequent physiological effects. A Harvard Medical School neuroscientist, Vitaly Napodow PhD LAc (yes, acupuncturists are employed as researchers and teachers at our most prestigious standard medical universities), states that he is measuring gene expression and molecular changes in the nervous and immune systems in response to stimulation of the brain. These researchers are also clearly measuring how the placebo effect, or treatment expectation, modulates brain activity in a different manner than the acupuncture stimulation. Treatment expectation, a powerful tool in Traditional Chinese Medicine and acupuncture that falls within the traditional category of Qi Gong, is also a means by which a skilled acupuncturist is able to exert profound effects on the brain to modulate both perception and actual chemical and motor responses by working with the patient, as a team, during treatment. We see from such studies that the thorough education and training received by Licensed Acupuncturists at the best medical colleges is superior to short courses on acupuncture techniques that Medical Doctors use to learn how to perform acupuncture needle stimulation. Links to these studies are available below in additional information.

The role of neurotransmitter/hormones in brain function and health

Standard medicine has long persisted in classification of chemicals in our bodies as distinct entities with specific functions, an attitude that lends itself to an allopathic approach in medicine. The public now believes, for the most part, that each chemical in the body is a distinct entity with a single specific function. In the case of neurotransmitters this is certainly not the case, and we have known this for many decades. While a chemical that we call a neurotransmitter has a specific function in neurotransmission in a specific part of the brain, the same chemical may have an opposite function in another part of the brain, and exert effects at hormonal receptors, nociceptors, and nerve plexuses in other parts of the body. The production of neurotransmitters is also very fluid in many cases, as these molecules may undergo frequent transformations in local tissues depending on the need of the body and the array of chemicals surrounding the molecule. A good example is serotonin, which is also called 5-hydroxytryptamine (5HT). This molecule is derived from the amino acid tryptophan, and 80-90% of the serotonin in the body is produced and functions outside of the brain. The array of effects of this simple molecule are extremely varied and dependant more on the cell receptors than the serotonin itself. While serotonin, or 5HT, is given nicknames like the “happiness hormone”, this only serves to simultaneously oversimplify the roles of this neurohormone, and to confuse the public.

Serotonin (5HT) is considered to be an important neurohormonal chemical in the regulation of mood, short term memory, sleep cycling, and cognition. In the midbrain and frontal cortex, there is much interaction between serotonin and dopamine, which is considered to an important neurohormonal chemical in the regulation of feelings of motivation, reward, pleasure, euphoria, compulsion, perseveration, and fine motor function. Dopamine also may convert to norepinephrine, a neurohormonal chemical affecting attention span, alertness, oxygen utilization, and neuroinflammation, or may convert to the more active epinephrine (adrenaline) which may more strongly stimulate the sympathetic nervous system, create anxiety, and affect the insulin system. All of these neurohormonal chemicals may affect the seat of hormonal regulation, the hypothalamus. The amount of local conversion of these neurotransmitters, affects of concentrations of one neurotransmitter on the functions of another, and the effects of substrates on the functions of the neurotransmitters make the whole array of chemicals, and the homeostatic balance, more important than a particular level of just one of these chemicals. For example, norepinephrine may affect receptors on the synapses of the neurons or on the cell membranes of non-neuronal cells. Substrates of the uptake into non-neuronal cells include dopamine, serotonin (5HT), and histamine, all of which will affect the chemical responses triggered by the norepinephrine. Keeping these neurohormonal chemicals available and in a homestatic balance is very important for brain function and health.

Receptors for these neurohormonal chemicals vary according to the need for various neural effects, and a number of types of cell receptors may be primarily stimulated by a single neurotransmitter. The balance between expression of one type of receptor versus another often has a profound effect on brain function, and the amount of stimulation of these receptor types determines the rate of expression of the receptor proteins on neural cell membranes and synapses. Imbalances of receptor types has become more of an issue in many disease pathologies than the levels of neurotransmitters themselves. These receptors for neurotransmitters are also stimulated by different neurotransmitters, as well as different hormones and inflammatory cytokines, albeit with different degrees of affinity for specific receptors types. Not only imbalances of neurotransmitters, but imbalances of hormones and inflammatory cytokines may cause adverse effects related to receptor stimulation, balance of receptor expression, and decreased effects from the primary neurotransmitter affecting the receptor. This is what makes neurological diseases so difficult to understand, and why research is still unclear on the mechanisms of well-studied diseases such as Parkinson’s and Alzheimer’s disease.

GABA, or gamma-aminobutyric acid, is the chief inhibitory neurotransmitter in the brain, although it may exert stimulation in some circumstances, depending on the receptors involved and the chemical balance around it. It is well known for its function to inhibit excess neuronal activity and to stop frequent or quick mood changes. At the nerve synapse, GABA works synergistically with glutamate and glutamine. GABA is able to be synthesized and taken as a supplement, but does not cross the blood brain barrier, so L-Glutamine is the preferred nutrient medicine used to have a direct effect on GABA, although a number of herbs are also effective in this regard. P5P is also needed, along with L-Glutamine, to effectively stimulate increased neuronal production of GABA. A combination of L-Glutamine, P5P and inositol hexacotinate will have the greatest effect of increasing GABA potential.

To address the subject of neurotransmitters with Complementary and Integrative Medicine, the role of this approach should be to restore the homestatic balance and bioavailability and let the body do what it is genetically programmed to do, namely function in a healthy manner if given a chance. The affects of this approach may not be as quickly felt as with a pharmaceutical drug, but the overall effect will eventually be much better, and should be sustained without continuing need for therapy. Restoration of health is the sensible goal, and this may be accomplished in an integrative fashion with standard medicine. In addition, a restoration of hormonal balance, and resolution of chronic inflammatory problems may also need to be addressed with this holistic approach.

Herbal medicine and studied effects on neurotransmitters

Effects on neurotransmitters of herbal chemicals has been well studied. The USDA website entitled Dr. Duke’s Phytochemical and Ethnobotanical Databases provides a substantial documentation of such study. Herbs with dopaminergic activity include Uncaria Tomentosa (Cat’s Claw), Alisma plantago (Ze xie), and Euphorbia lathyris. The dopaminergic chemicals in Cat’s Claw are also found in the analagous Chinese herb Uncaria rhynchophylla (Gou teng), namely hirsutine and rhynchophylline. One of these dopaminergic chemicals is pyridoxine, or Vitamin B6, which is the precursor to pyridoxal phosphate (P5P), which is required for the production of dopamine, serotonin, norepinephrine and epinephrine. Other dopaminergic herbs include Mucuna pruriens and Muira puamens, two Ayruvedic and South American herbs that have traditionally been used to stimulate libido due to their dopaminergic chemicals. Diet also may mildly stimulate dopamine production, and whole oats, soy, barley, lentil, rice, pea, wheat, fenugreek, avocado, cacao, mate, and alfalfa all contain chemicals considered dopaminergic. St. John’s Wort (Hypericum perforatum) and Psoralea corylifolia are two herbs with known effects as dopamine reuptake inhibitors. The Uncarias and Mucuna pruriens are also serotonergic, explaining their value in the treatment of various neurological disorders.

The herbs listed on Dr. Duke’s database as serotoninergic includes Fennel, Aged Garlic, Arctium lappa (Niu bang), and Piper nigrum (Hu jiao). Diet may also provide serotonergic chemicals, found in whole oats, peanut, fennel, okra, onion, chives, cashew, celery, carrot and blueberry. The Griffonia seed, though, contains actual 5HTP, the serotonin precursor, and the amino acid tryptophan is also available as a supplement. These products are very effective to afford serotonin bioavailability. St. John’s Wort (Hypericum perforatum) is also shown to be effective in stimulating serotonin, so much so that contraindications with SSRI medications are frequently seen, although the dosage in standard treatment is so low that inducing a serotonin syndrome with concurrent use is very rare. Clinical cases of serotonin syndrome induced by taking Hypericum with an SSRI are virtually nonexistent. Passiflora incarnata (Passionflower) is an herb that has been shown to potentiate the effects of St. John’s Wort, though, and itself has significant effects proven to treat insomnia, depression and anxiety. Passiflora contain rutin, though, which is a 5-HT (serotonin) inhibitor, and is unlikely to increase the serotoninergic effects of St. John’s Wort.

Detoxification of the brain tissues and cells

A number of aspects of neurotoxicity are of great concern in medicine and research today. Heavy metal toxins from the environment, iron overload toxicity, acetaldehyde toxicity, excitotoxicity, and the endogenous neurotoxicity created by accumulations of protein peptides and plaques are areas of great concern in relation to diseases of the brain. Neurotoxicity from chemotherapy agents in cancer therapy, and other neurotoxic pharmaceuticals is also a growing concern. Of course, acute neurotoxicity has been the traditional concern in standard medicine, but the less dramatic chronic slowly developing neurotoxicities are also a slowly growing concern, as more and more of the population suffers from disesases and dysfunctions of the central nervous system. With increased realization of neurotoxicity and its effects has come much research concerning clearing of neurotoxicity, and herbal and nutrient medicines are the front line in this type of therapy, potentiated by the remarkable ability of acupuncture stimulation to affect brain activity and enhance cellular detoxification. The oxidative stress from the body attempting to clear neurotoxicity is considered the primary potential cause for a large percentage of chronic neurological disorders and dysfunctions, and a holistic protocol of circulating, clearing, stimulating and providing antioxidant herbs and nutrient chemicals helps the brain to avoid this disease causing oxidative stress.

Neurotoxicity may occur from dysfunction within the brain and/or from toxins entering the brain through the blood brain barrier. Sometimes both of these sources of neurotoxicity are occurring, exacerbating the problem. Different types of neurotoxicity may occur in the same individual and the effects may be accumulative in many cases. Preventing neurotoxicity is a smart move, and taking safe and effective measures early may easily resolve problems before they manifest. One example is aldehyde toxicity. Aldehydes are organic compounds that are very simple molecules, similar to a carbohydrate or a ketone, but usually with a radical attached. This radical is called the aldehyde group. The name aldehyde comes from the term dehydrogenated alcohol. Acetaldehydes are of main concern, occurring widely in nature but also produced on a large scale industrially. Acetaldehydes are produced by systemic candida infection, with consumption of alcohol, by smoking cigarettes, by breathing, eating or drinking environmental industrial toxins, and also by the pyruvate metabolism within the brain. Oxidative reactions produce acetaldehyde endogenously, and excess reactive oxygen species, or oxidative stress, may contribute to this toxicity. A deficiency of certain protein enzymes may also create acetaldehyde neurotoxicity, and part of the population may have a genetic tendency to underexpress certain of these enzymes. For instance, persons with a genetic propensity for a deficient expression of the enzyme responsible for conversion of acetaldehyde to acetic acid are shown to be at greater risk for Alzheimer’s disease. Acetaldehyde was classified as a Group 1 human carcinogen in 2009 by the International Agency for Research on Cancer as well. We see from this example that both endogenous dysfunctions in the brain and exogenous causes, such as environmental chemicals and candidiasis, may work together to create acetaldehyde neurotoxicity. Each of these sources may be less than dramatic, but when put together they create a toxicity that the body has difficulty clearing.

Signs and symptoms of neurotoxicity

A wide range of signs and symptoms of neurotoxicity makes diagnostic screening difficult, and most cases are unfortunately diagnosed late in a course of disease. By being aware of the potential signs and symptoms of neurotoxicity, though, the patient and physician may take preventive steps and clear this health problem before it causes serious disease and dysfunction. The signs of the more dramatic acute neutotoxicity, seen with such chemotherapy drugs as vincristine, include constipation with decreased bowel motility, peripheral neuropathies (numbness and tingling in the extremities), muscle weakness, decrease in deep tendon reflexes, hoarseness, ocular palsies (problems tracking with the eyes, or focusing), loss of tone of the urinary bladder (frequent or urgent urination), and postural hypotension (dizziness when changing from a lying to a standing posture).

More general symptoms related to neurotoxicity include anxiety, depression, short term memory loss, impaired mental or cognitive functioning, headache, behavioral problems, sexual dysfunction, impaired vision, and limb weakness or numbness. Signs of neurotoxicity are seen in both physical exam with a neurologist, and with current testing, utilizing MRI study, PET scan, and MEG (magnetoencephalogram). These tests are collecting information on brain function and conduction that are still controversial, but with each year and subsequent test data accumulated are showing clearer and clearer pictures of the effects of neurotoxicity. This type of data is now analyzed with laboratory analysis of common neurotoxins in circulation, antibody responses, cytokine measures, and even metabolites of neurotoxins and oxidative metabolism.

Illnesses studied and associated with neurotoxicity

A wide array of chronic illnesses have been scientifically linked to neurotoxicity. These illnesses may not all be caused in part by neurotoxicity, but potentially this problem may play a significant role in the development of most of these pathologies. Anxiety disorders, attention deficit disorders, chronic fatique syndromes, dementias, chemical sensitivity syndromes, hyperactivity, insomnia, memory dysfunction, multiple chemical sensitivity, amyotrophic lateral sclerosis, Parkinsons disease, panic disorder, multiple sclerosis, personality disorders, depressive disorders, psychosis, schizophrenia, mania, bipolar disorders, sleep apnea, sleep disorders, tremor disorders, movement disorders, paresia and paralysis have all been scientifically linked to neurotoxicity.

Excitotoxicity

An important area of neurotoxicity that is still overlooked today is excitotoxicity, and attention to what is in your food may play a large role in reducing this cause of neurological dysfunction. Excitotoxicity is the pathological process by which nerve cells, both neurons and support glia, are damaged by chemical overstimulation. The most widely studied of these concerns chemicals related to the amino acid glutamate, and monosodium glutamate, or MSG, was the reason why researchers first focused on this type of toxicity. Specific glutamate-related excitotoxins, such as NMDA (N-methyl-D-aspartic acid), a synthetic chemical amino acid (metabolite of aspartate) that does not naturally occur in our bodies, create specialized NMDA receptors that glutamate may stimulate. Some drugs act as NMDA receptor antagonists, explaining differing effects in individuals, including ketamine (anesthetic and hallucinogenic), dextromethorphan (cough suppressant now used as a recreational drug), PCP, and Amantadine (antiviral and antiParkinsonism drug now used to treat SSRI-induced sexual dysfunction). Kynurenic acid, a natural metabolite of the amino acid L-tryptophan, is endogenously produced in the brain and counters NMDA neurotoxicity, as an anti-excitotoxin.

Glutamate excitotoxicity cannot be induced by normal supplementation of L-Glutamine in the diet or with pills. Glutamate is considered the major excitatory neurotransmitter in the CNS, but the concentration of glutamate is normally well regulated. With ill health of the brain, brainstem and spinal cord, though, or with the expression of pathological glutamate receptors, and with the circulation of glutamate related excitotoxins, a high concentration of glutamate molecules may occur at the synaptic clefts of neurons, and depending on the type of molecule, may not be easily cleared. Chronic pain signals may create this unnatural accumulation of glutamate outside of the cells and synaptic clefts of neurons with overload toxicity. If the concentration remains high at the synaptic clefts and receptors, the neuron may be induced into an early apoptosis, or programmed cell death. This is seen with ischemic stroke, for example, and measures taken to decrease glutamate exicitotoxicity immediately following a stroke may prevent much injury to the brain. The opening of excess calcium channels by overstimulation of glutamate and NMDA receptors is also a pathological proces by which excitotoxicity may injure the brain cells or cause dysfunction other than induced apoptosis. NMDA receptors also may excessively activate nitric oxide synthesis, resulting in vasodilation and other inflammatory effects. Increased nitric oxide, though, acts as a feedback control to reduce NMDA excitotoxicity, explaining how inositol hexacotinate (a niacin) may reduce excitotoxicity by stimulating nitric oxide.

Chronic pain may be increased in intensity by excitotoxicity related to excessive glutamate stimulation of NMDA receptors, creating hyperalgesia, or the inexplicable sensation of pain without sufficient mechanical cause. Pain signals travel along fast and slow nerve pathways, with acute pain signals generally exciting the fast, or less myelinated, axons, and chronic pain travelling along heavily myelinated C fibers that stimulate the frontal cortex and midbrain, creating an easy association to pain with memories and emotions. One way that this chronic pain is hyperexcited is through NMDA receptors in both the spinal cord and brain. Prolonged firing of these C fibers in chronic pain syndromes causes excess release of glutamate that stimulates NMDA receptors in the spinal cord and heightens pain. Excitotoxicity may play an important role in patients with hyperalgesia, or inexplicably higher levels of pain in chronic pain syndromes. Patients with chronic pain syndromes are thus also more at risk for excitotoxicity induced by food chemicals and environmental toxins as well.

An array of food additives are called excitotoxins, such as hydrolyzed vegetable protein, aspartame, and MSG, and are also the subject of much research into neurodegenerative pathology and central nervous system (CNS) dysfunctions that may lead to neurodegenerative states. A growing body of sound research has linked these food additives to a wide array of neurological problems, including Parkinson‘s disease, Alzheimer‘s disease, Huntington‘s disease, ALS, learning disorders (ADD), developmental disorders, neuropsychiatric disorders, dementia, and even obesity, migraines, seizure disorders, certain endocrine disorders, and CNS problems in chronic aftereffects of Lyme‘s Disease. These food additives are now present in almost all processed foods. Since scientists discovered health risks associated with MSG additives in the 1970s (MSG is a natural glutamate compound that enhances neurochemical systems related to attraction and enjoyment of food), the food industry did not heed public health warnings, but instead developed a vast array of glutamate compounds, called excitotoxins, that increase our desire to buy their products. Today, MSG-like excitotoxins are disguised as “natural flavorings”, soy protein extract, textured protein, yeast extract, hydrolyzed vegetable protein, and artificial sweeteners such as aspartame (read below to gain a better understanding of aspartame). These altered glutamate molecules accumulate in the brain and cause neural dysfunction over time, as the amino acid glutamate is a key basic building block of many important regulatory chemicals in our brain, as well as itself being a neurotransmitter. Since glutamate is tightly controlled in the brain, and is normally kept at very small concentrations in extracellular fluid, these altered glutamate compounds begin to overload neural firing as they accumulate. The main drug used to treat Parkinson‘s disorders is L-Dopa, or synthetic dopamine, which itself is a weak excitotoxin that has now been proven to actually accelerate Parkinson‘s neurodegeneration with chronic use. At first, L-Dopa may relieve symptoms, but in time these symptoms will worsen in an accelerated fashion. The public needs to start expressing outrage that our food industry treats food chemistry with such a cavalier attitude, and demand that the commercial food industry hire public health experts to guide what they put into our food. Surely, we could have processed foods that improve our health rather than destroy it.

Acetaldehyde toxicity

As stated above, acetaldehydes are organic chemical compounds that are both created as industrial chemicals and produced endogenously in the body. The array of sources of acetaldehydes in an individual may present a challenge to the natural clearing of acetaldehyde toxicity. The best example of acetaldehyde toxicity may be the alcohol hangover, which is caused by an acute overload of acetaldehydes. These symptoms, felt in a milder and chronic form, may represent chronic acetaldehyde toxicity. Systemic candidiasis may be a significant contibutor to this toxicity, as the fungal, or hyphal, form of candida yeast is what enters the blood stream with overgrowth and poor health of the small intestinal lining, and this organism creates acetaldehydes with its metabolic effects. Symptoms of lassitude, fatique, unclear mental processes, and cognitive declines, may vary in intensity with acetaldehyde toxicity and the variance in environmental aldehydes taken in via the food, water and air, varying habits with drinking alcohol, smoking or consumption of various foods that contribute to increased endogenous aldehyde production. Symptoms may also vary depending on the efficiency of the immune and detoxification system in the body at any one time. Long term injury from acetaldehyde toxicity is now well documented. The International Agency for Research on Cancer has stated that sufficient evidence exists for carcinogenicity of acetaldehyde in experimental animals. Studies have also found that acetaldehyde toxicity is damaging to DNA and may cause abnormal muscle development as it binds to proteins.

Clearing of acetaldehyde toxicity should be accomplished with an individualized step-by-step process. Avoidance of environmental acetaldehydes and reducing alcohol consumption and cigarette use to a minimum should be included in the protocol. Assessing for potential candidiasis should be accomplished, and if needed, correction of the gastric function and clearing and restoration of the health of the small intestine should be accomplished. After this, restoring of the microbial balance in the intestine with professional probiotic formulas should be undertaken. Short courses of clearing herbs may punctuate this regimen to insure that a health biotic colonization is achieved. Finally, clearing of acetaldehyde cofactors with herbal and nutrient medicine should be undertaken, as well as improvement in immune function and general health. Finally, restoration of the brain function and health should be accomplished with a holistic protocol to clear the damage caused by the acetaldehyde toxicity. This process may taken a few months. A knowledgeable Licensed Acupuncturist and herbalist will be able to monitor and assess the patient as the therapy progresses, and adjust the protocol according to the individual needs.

Heavy metal, or “toxic metal”, neurotoxicity

The term heavy metal in chemistry refers to a group of elements the exhibit metallic properties, namely a large ionic charge, and that have some degree of density or atomic weight. Some so-called heavy metals are beneficial to humans, such as iron, copper, zinc, cobalt, molybdenum and manganese, but are highly regulated in the body and toxic with excess accumulation. Other heavy metals have no known benefit and often cause serious problems with accumulation, such as mercury, lead, plutonium, cadmium, arsenic, etc. We are most concerned about these that can be labeled toxic metals. Neurotoxic chemicals of most concern are mercury, lead, manganese and arsenic. An enormous amount of toxic heavy metal pollution in the form of carbon compounds that our bodies easily assimilate is found in the environment in the form of airborne pollution from dirty coal fired power plants, smelters, and other industries that burn fossil fuels or melt metals. Heavy metals, even toxic ones, are normally found in the environment, though, and enter our bodies, where we have evolved processed to eliminate them safely. Problems arise when these toxic metals occur in unnatural concentrations in the environment in carbon-based, or organic molecules, and enter the air we breath, the water we drink, and the plants and animals that we eat. For those of us that lack the ability to clear toxic metals efficiently, or that are aging and accumulate uncleared toxic metals, neurological disease and dysfunction is one the greatest concerns.

Standard medicine includes mercury, lead, manganese, aluminum, iron, cadmium and beryllium as sources of “heavy metal poisoning”. Mercury and lead are by far the most common culprits, though, concerning known causes of neurological dysfunction and disease. Numerous reports by the EPA and now the President’s Cancer Council outline the enormous health costs of these two chemicals, and you may refer to a separate article on this website for more complete information and documentation on this subject. These metal molecules in their inert forms are not harmful and easily excreted from the body, but in their organic forms, joined with carbon based molecules, are assimilated into our system and carried to the central nervous system. These are the toxic metal molecules that we have to decrease in the environment and remove from our bodies.

Chelation and excretion are the means that our bodies use to naturally clear heavy metal toxic accumulation from the body. Chelation is the formation of bonds between organic compounds and single central metal atoms. Chelating charged metal ions is the easiest type of chelation, as these charge ions attract more easily. The best chelating agents are those with a high affinity for toxic metal ions. Many biochemicals have the potential to dissolve positively charged metal cations, and proteins, polysaccharides and polynucleic acids are excellent ligands for many metal ion, forming complex organic molecules that carry these metal atoms. In plants, histidine, malate and phytochelatin are typical chelators of metals. Tetracycline antibiotics are chelators of positively charged calcium and magnesium, unfortunately, which explains many of their side effects. In chelation therapy, calcium-sodium EDTA and DMSA are the only ones approved in the U.S. for removal of lead. Today, in other countries, a number of chelating agents are approved, and chelation clinics are becoming more popular. Chelation also removes Vitamins C and E, and it is recommended that natural forms of these nutrients be taken along the chelating formulas.

The most common chelating medicinals in use today are EDTA, chlorella, and alpha-lipoic acid, all of which are very safe, compared to harsher chelating chemicals that have significant side effects and are restricted to monitored use, but are more effective. EDTA (ethylenediaminetetraacetic acid) was discovered and widely used after World War II when it was revealed how many of our military workers had been seriously contaminated with lead poisoning, and EDTA was found to be very effective in chelating lead. EDTA exists in a number of usable forms, with the deprotonated 4 negative form works best in very basic, or high pH, and the protonated H6 2+ form works best in acidic conditions. EDTA is also fairly effective at chelating mercury, and in medicinal use is combined with various inert beneficial metals to increase its effectiveness. It is also thought to reduce atheroscelosis by acting as an antioxidant to clear arterial membrane epithelium, and also acts as an anticoagulant to reduce thrombi. Currently, a major clinical study is being conducted to assess the efficacy on treating coronary arteries, and is believed to be close to FDA approval. In the laboratory, EDTA is used to scavenge metal ions and deactivate metal-dependent enzymes, and to separate metal ions in laboratory analysis. EDTA is also useful as a calcium binding agent and decalcifier in laboratory work, and an inhibitor of metallopeptidases, all of which make EDTA a potentially potent medicinal protocol, if we could get patients to use it.

Oral ChelatoRx is a prescribed dietary supplement that combines calcium disodium EDTA with EDTA conjugated with calcium and sodium, magnesium, potassium, aged garlic, chlorella, malic acid, gugulipid and serrapeptase enzyme, making this a safe and effective product in therapy. The only drawback is that 7 large pills need to be taken on an empty stomach twice per day. The advantages to completing this type of therapy are considerable, though, if there is suspicion that heavy metal toxicity is a potential problem. Malic acid is included to chelate aluminum, and must be accompanied by magnesium to be effective for this purpose. Gugulipid, a chemical in myrrh, and serrapeptase, a potent proteolytic enzyme, will help to clear tissues of lipid and peptide accumulation so that the chelators may be more effective.

Some chelating ability has been found with nutrient medicinals as well. R-lipoic acid, N-acetyl cysteine, and methylselenocysteine are three that are beneficial in treatment of brain function and health, and may serve as mild chelating agents as well. The herbal chemical baicalein has been shown to be a strong iron chelator, and is found in the Chinese herb Scutellaria baicalensis (Huang qin). Other Chinese herbs are purported to have chelating effects, and research is ongoing to confirm this. Milk thistle, dried barleygrass powder, apple pectin, spirulina, CoQ10-H2, kelp, kombu seaweed, zinc monomethionine, and coral calcium formulas are also found to have chelating effects. Activated charcoal is a supplement that is found to effectively chelate heavy metal toxins from the intestinal tract and liver.

What environmental toxins are we clearing?

Accumulations of environmental chemicals from cleaning products, flame retardants, plastics etc., air and water pollutants, and chemicals from the food are the major toxins in our bodies. Of special importance is the accumulations in our tissues, especially in the organ tissues and central nervous system, of small particle heavy metals, such as lead and mercury, that enter our bodies from the air or via the food chain and water supply. We must thank the Obama administration in 2010 for finally enacting effective EPA regulations that curtail the enormous tonnage of airborne lead and mercury toxins in the major industries creating this toxicity, coal-fired power plants, smelters, chloralkili producers, and concrete manufacture. Other heavy metal toxicities are also of concern, not the least of which is iron accumulation. This issue is more thoroughly addressed in my article on lead and mercury on this website. In some individuals, the toxins that are most damaging are composed of the chemicals resulting from breakdown of various pharmaceutical drugs. This is dependant on the types of medications and the number of medications being broken down, or catabolized, in the body. Examples of this toxicity are cited below in additional information links. The amount of toxic pesticides, chemical fertilzing agents, and other farm chemicals is growing as corporations take over more and more of our nation’s farms and destroy more and more of the natural barriers to erosion and runoff into our water supply. As the rate of topsoil depletion accelerates, the need for more chemicals to maintain high crop yields increases. This toxicity also empties into our oceans and accumulates in our seafood. Mining and drilling, especially as we go deeper into the earth, with natural gas fracturing methods, and shale oil drilling, also creates massive amounts of water toxicity due to the need to use water to create pressure to break up rock and force oil and gas to the surface. Much of this “fracking” wastewater contains radioactive and heavy metal contaminants from deep in the eath, and this is dumped into our water supply. Natural toxins are also created by the body’s metabolism, the most damaging and ubiquitous being the oxidant free radicals, and excesses of protein fragments, but normal healthy bodily function and diet are effective in eliminating natural toxic accumulations, unless the body is overly stressed by ill health or obesity. In addition, acetaldehyde toxicity is an area of focus in recent years, and is related to alcoholism and chronic candidiasis as well as environmental aldehydes.

A wide variety of chemical pollutants are studied in relation to brain toxicity and dysfunction, though. One concern is pesticides. In 2012, two separate teams of researchers, one British and one French, released data linking neonicotinoid pesticides, now very common, to neurological dysfunction that has caused a dramatic drop in the popultion of pollenating bees. An article in the New York Times Science section of March 30, 2012, entitled 2 Studies Point to Pesticides as a Culprit in Bees” Decline, outlines study at the University of Stirling, in Scotland, and the National Institute for Agricultural Research, in France, which conclude that these common pesticides produced dysfunction in the bees’s central nervous system that induced significant inability to find their hives. The World Health Organization lists these pesticides as a class 2 or 3 toxin, and states that they block a specific neural pathway, related to the postsynaptic nicotinic acetylcholine receptor. Those with some knowledge of Alzheimer’s disease will note that the acetylcholine metabolism is central to the disease, and that acetylcholinesterase inhibitors, which increase the bioavailability of acetylcholine, are widely used to treat the disease. Studies have indicated that these neonicitinoid pesticides, now the most widely used pesticides worldwide, induce adverse effects on the developing brain (Kimura-Kuroda et al 2012). This class of chemicals is exempt from environmental review, having passed registration after 1984. Finally, in 2008, the Environmental Protection Agency opened a review docket for these chemical pesticides, but delayed the review process to 2012, due to industry complaints over a “level playing field”.

Studies have shown that common environmental toxins, or pollutant chemicals, accumulate in the body tissues. Even a healthy person with a good diet, in an urban area, accumulates a large amount of toxic chemicals in the tissues over time. The older we are, the more difficult this detox becomes. Since true detox of our tissues is a complicated process, repeated, or habitual, detoxification help is the only real way to clear the body of toxins. Promotion of liver and intestinal health, as well as the avoidance of as many chemicals as possible is also essential, and should become a lifelong process. This involves a diet of organic foods, unpolluted water, and breathing of unpolluted air whenever possible, as well as avoidance of household chemicals such as chemical cleaning products. When this entire regimen is adopted, maximum detox is achieved. Since elimination by the GI tract is one way of detoxifying, fasting may also be a valuable aid, if you can tolerate fasting. What is most important, once again, is a healthy functioning GI and liver system. You may want to correct your digestive problems, and improve liver health with a course of treatment before adopting a detox regimen. This will insure better results. Herbal therapies may also provide stronger intestinal detoxification. Herbs with a high content of tannic acids can precipitate toxic substances in the intestinal lumen, converting them to insoluble substances, so that a high fiber diet or fast can eliminate them. Wu bei zi is an herb used in China for this purpose. Safe and effective herbal and nutrient chelating formulas may be utilized under guidance periodically. Acupuncture works in a symbiotic fashion to help the body detoxify and eliminate more efficiently.

The subject of detoxification is not as simple as many advertisers would lead you to believe. A simple change in diet with a mild herbal formula that aids the intestinal tract helps, but is only mildly effective. Once again, the medical advice presented on medical websites such as this one is more complicated than we would wish for, but provide you with a more complete picture. The idea that the human physiology is simple, and correcting problems with our health can be achieved with the magic pill or simple routine, is a fairy tale, though, that we all buy into in a consumer society. It's easier to advertise simple solutions, and so this is what we repeatedly hear. Reality is more complicated, but can be simplified by putting the process into the hands of a professional and following the professional advice.

How our bodies naturally detoxify

Glutathione S transferase is a family of enzymes of the liver that is used by cells to detoxify and clear toxins and drugs from the body. The P450 and glucuronosyl transferase are emphasized in drug clearing metabolism, but the glutathione enzyme activity has a greater relationship to clearing toxins and cancer causing compounds. Sandalwood essential oil (most safely taken as alcohol extract or double boil water extraction), St. Johnswort and other herbs are found to be potent in increasing this enzymatic activity, as well as the combination of nutrient supplements already mentioned. St. John's Wort (Di er cao), contains a high level of quercetin and quercitrin as well, potent antioxidants, as do many Chinese herbs used to clear and protect the liver. Milk thistle has been well studied and found to benefit liver function and speed enzymatic detox, as have schisandra berries (wu wei zi), turmeric (jiang huang), and alpha lipoic acid (R-lipoic acid is the more active form). Schisandra chinensis berries have been proven to significantly increase the liver glutathione level and glutathione reductase enzyme activity. A percentage of the population lacks the 2D6 gene and has difficulty in liver detox metabolism, and these people are especially in need of herbal and nutrient aids. Studies also confirm that a percentage of the population lacks other significant genetic coding for liver detoxifying enzymes, P450, glutathione S-transferase, and N-acetyl transferase, increasing their risk for leukemia and stomach cancers significantly. The benefits of these detoxifying regimens in preventative medicine appear great in recent scientific study (see citations below).

Formulas in TCM utilize a number of herbs to work synergistically to improve liver function. I utilize such formulas as Ecliptex, Shu Gan +, Adv Chole Clear, and others, which are prescribed based on the individual’s overall health diagnosis. The NIH is currently entering phase three of clinical trials of the simplest liver formula, Xiao Chai Hu Tang, called Sho-Saiko-to in the Japanese clinical trials of liver clearance of Hepatitis C. To check out the study parameters presented by the NIH, click here: http://clinicaltrials.gov/ct2/show/NCT00633230.

Activated charcoal is very effective to attract toxins from the intestinal tract. Flax, fennel and fenugreek seeds have long been used in traditional medicine to cleanse the intestinal tract. The best way is to mix the seeds, take a heaping tablespoon each day, soak in warm water, and then chew thoroughly and swallow. This tastes weird because of the mucilage, but will be very effective if taken for a week or so daily.

Some combinations of herbs and nutrient medicines provide intelligent formulas to achieve detoxificating goals. Acetaldehyde toxicity is common in the population, via chronic candidiasis, air pollution, excess alcohol consumption, etc. and the product AL Cofactors by Vitamin Research includes key nutrients to help the body clear this toxicity and promote increased glutathione metabolism. Such products as this provide an economical treatment product to help achieve goals. It must be noted, though, that taking even such a well formulated product does not achieve complete detoxification and clearance, and each patient is an individual, with different detox needs. This is why a professional that is knowledgeable is able to help you achieve these goals in an objective manner that is thorough and comprehensive.

To reiterate, detoxification and removal of stored heavy metals (chelation) are processes that each healthy body engages in daily. The patient may want to increase the rate of detoxification and chelation, and a variety of strategies, ranging from very gentle, to very strong, are available. Very potent chelation and detoxification needs to be supervised in a clinic, while gentle protocols can be utilized at home, or with therapy from a professional herbalist and Complementary Medicine physician utilizing nutrient medicine. Products on the grocery or drugstore shelf may not be dependable, or may be too gentle. A TCM physician with knowledge of this therapy may utilize three strategies. One, herbs and supplements that are proven to aid the liver in its natural detoxification processes, and the glutathione system in its cellular detox can be prescribed; two, intestinal clearing may be aided by herbal formulas, activated charcoal, and various specific herbs and nutrients, individually prescribed on a case-by-case protocol; and three, chelation of heavy metal and toxin accumulation in tissues can be stimulated with a variety of herbal and nutrient products. You may read more about chelation of heavy metals, and heavy metal environmental toxins on another article on this website, and you may read more about the glutathione metabolism as well.

Addiction and Brain Function

Research into the mechanisms of addiction have revealed much about the brain. The concept of addiction has been a useful crutch for society for some time, explaining why humans engage in unhealthy activities even when they ruin their life and health. We blame the addictive substances in most cases, creating a supposed war on drugs, blaming cigarettes for every health problem imaginable, creating Prohibition of alcohol, and putting the blame for obesity on unhealthy foods. There are ways to increase desire and trigger the brain to have an increased appetite for chemicals, and this realm of food chemistry is now proven to be extensive, more so than the average consumer would like to imagine. There are also ways to trigger patterns of behavior, and the industries of advertising, politics, and even religion have invested much energy into the science of triggering behavioral responses. The individual should know, though, that brain function and response can be consciously controlled and improved, and what may seem like a hopeless addiction and uncontrolled behavior and thought pattern can be corrected with a holistic approach, improving brain health and function, and exerting patterns of conscious behavioral and cognitive actions and thoughts that are proven to benefit brain function and health. All types of addiction and compulsive behavior may be stopped with a comprehensive strategy involving improvement of brain health and function, exertion of real cognitive and behavioral changes, and willpower.

To understand the subject of addiction, we must ask, What is it? Addiction is defined as a persistent and compulsive dependence on a behavior or substance. It has also been defined as an habitual psychological and physiological dependence on a substance or practice that is beyond voluntary control. Judging whether these criteria are met is the problem. Is the addiction beyond voluntary control, and is there an actual physiological aspect to the addiction? Addiction has become one of the most costly public health problems in the United States in regards to substance abuse, with estimates of economic costs exceeding $414 billion per year, and health care costs related to illegal and legal drug addiction exceeding $114 billion per year. This enormous sum does not even include the cost to the economy, and the healthcare costs related to food addictions. The most common addictive substances, alcohol, tobacco, and narcotics are consumed by a majority or near majority of the population by the teenage years, and a Harvard study found that an estimated 15.4 million Americans suffered from a gambling addiction, with more than one-half of these individuals in their teens. Our programs to discourage use of addictive substances, and addictive behaviors, has not worked. Much study has been, and is being, conducted to better understand the actual physiological and psychological mechanisms involved in this behavior and lack of cognitive control.

Persistence in addictive behavior is shown to alter brain function, and even structure, over a long period of time, and these changes do not resolve easily once the addictive behavior and cognitive habits cease. Blaming the addictions on the substances that people are addicted to has been an oversimplification, and often results in the individual addict not taking responsibility to change their behavioral and cognitive patterns, and especially, not to make an effort to repair and improve brain function and physiology. The research into the specific mechanisms and cells or tissues responsible for addiction have, of course, led to complicated understanding, not a simple explanation. Modern medicine continues to search for a simple explanation in order to justify a specific allopathic drug to reverse addiction. The actual needs obviously involve a more complex and holistic approach. Patients may take control of their health problem by understanding the physiology of addiction and taking both physical steps, as well as cognitive and behavioral modifications.

One area of focus is the anterior cingulate cortex of the frontal lobe of the brain. The frontal lobe of the brain encompasses about a third of the brain cerebrum, the most superior and anterior of the regions of the central nervous system, and is often referred to as the forebrain, perhaps the last section of the central nervous system to develop in evolution. The cerebrum is divided into right and left cerebral hemispheres, and largely controls all voluntary, or conscious, actions in the body. The cerebrum is composed of the cerebral cortex, the basal ganglia (nuclei), and the limbic system (seat of emotion and emotionally linked memory). Cognitive and volitive systems of the cerebrum project neural fibers to the thalamus and midbrain. These neural networks facilitate complex behaviors, such as social interactions, thought, judgement, learning, working memory, and speech, or language. Much of our sensory information is processed in the cerebrum. Short-term, or working, memory involves interaction between various areas of the cortex, especially the dorsolateral prefrontal cortex, and the hippocampus. Destruction of the hippocampus is associate with a loss of ability to form new memories.

The frontal lobe of the cerebrum contains most of the highly dopamine-sensitive neurons in the cerebral cortex. The dopamine system is associated with reward, motivation, planning, attention, and short-term memory tasks. The so-called executive functions of the frontal lobes involve the ability to recognize future consequences resulting from current actions, to choose between good and bad, or to decide between better and best, worse and worst, to override and suppress unacceptable social responses, and to determine similarities and differences between objects, actions and events. The frontal lobes also are associated with long-term memories that are more emotionally based, and allows us to judge emotions and modify them to adapt to social function. The medical procedure called a frontal lobotomy was used to treat psychiatric illness, and damaging the pathways between the frontal lobe and the limbic system reduced emotional distress and bad behavior, but also blunted the patient’s emotions, volition (ability to make a conscious decision or choice), and personality.

The frontal lobe of the cerebrum is divided into sections called gyri, denoting the areas divided by tissue divisions, or sulci (folds). The cingulate cortex is a part of the brain that is more medial, or under the outer cerebral lobes, and surrounds the corpus callosum and midbrain control centers, such as the thalamus, hypothalamus, and neocortex. This cingular cortex is usually considered part of the limbic system, or emotional seat, of the brain. The corpus callosum (literally the “tough body”) connects the right and left cerebral hemispheres to coordinate complex cognitive and behavior actions. The focus on the anterior cingulate cortex of the frontal lobe in addiction reveals some interesting aspects of addiction and brain function. Some of the problems acquired in addiction may thus be corrected with conscious control, change of cognitive and behavioral habits, and use of the right therapeutic treatments, such as herbal and nutrient chemicals, and acupuncture.

The two hemispheres of the brain have been found to be specialized to process information differently, and the coordination of these right and left brain processes creates a sense of judgement by which one bases behavior and identity. Your left brain organizes data in a linear fashion, and forms broad perceptions of the past and future on which to base behavior, and judge one’s actions. Preconceived ideas of what is going on may originate in the left brain. Your right brain, on the other hand, is more about the present moment, seeing one’s actions and perceiving the situations as a consequence of what is happening in the present. When one side of the brain is dominant over the other, cognitive and behavioral changes occur. For instance, with addiction, the person may look at their present actions and believe that they are preordained to act in a habitual compulsive manner because they are hopelessly addicted. This would be a left brain dominance. The right brain may look at the choices in the present and see that engaging in the addictive behavior is not what they want, and so not do it. The habits of the addiction, and other unhealthy aspects of their brain function, such as the imbalances caused by depression and anxiety, may tilt the function of the brain more to a left side dominance. The feelings that the present choices are determined are then strong.

Activities that generate a large production of dopamine, creating a false sense of reward, motivation and focus, such as the taking of amphetamines, or addictive sexual practices, may also alter the anterior cingulate cortex of the frontal lobe. When this habitual excess of dopamine is generated, the dopamine receptor expression is altered on the neurons, and more dopamine is needed to stimulate the effects of dopamine. To correct these aspects of the addiction, gradual changes in conscious congitive processes, as well as behaviors, and consumption, are needed to change the way that this area of the brain works. Utilizing aids to healthy brain function may greatly help this process, which obviously needs to be a thoughtful proactive process to achieve success. Instant reward is probably not realistic, but gradual reeducation of the way the brain works, along with healthy stimulation and repair of damage, is the way to truly overcome addiction and correct the function and the tissues of the brain.

While society sees addicts as individuals that want to get high more than they want to be productive and healthy, the truth is that most people with an addiction are not submitting to an unhealthy compulsive behavior to get high, but just to feel normal. The use of alcohol and drugs to stimulate a rush of dopamine, the use of sex or risk taking to stimulate a rush of dopamine or adrenaline, the eating of sugars, salt or other foods to relieve sensations of stress and fatigue, the use prescription drugs to decrease pain or anxiety, are all means that many people use to maintain a sense of normal daily function. Often, these activities that are habitual change the function and event the tissues in the brain. Understanding the mechanisms of addiction and taking a proactive and individualized approach to correcting them, along with healthy therapeutic protocols to restore healths brain function and tissues, creates a better outcome.

Information Resources

1. A study in 2009, at the University of Kentucky, showed that endurance exercise reversed damage to the brain-blood barrier induced by methamphetamines in laboratory animals: http://esciencenews.com/articles/2009/04/21/exercise.protects.against.damage.causing.leakage.blood.brain.barrier
2. A study in 2005, at the Nagoya University School of Health Sciences and the Okayama and Aichi Medical Universities, noted that viral and low-grade bacterial infections and endotoxins elevate the chronic levels of inflammatory cytokines in both the blood and cerebrospinal fluid, altering the integrity of the blood brain barrier. This study proved that such alteration of the BBB affected the transport of pharmaceuticals into the brain, and that chronic inflammatory cytokines could possibly increase the risk of side effects of many medications by altering the transport across the blood brain barrier: http://www.jstage.jst.go.jp/article/jphs/97/4/97_525/_article
3. A study in 2009. at the University of Iowa, showed that each brain disease may alter the blood brain barrier in unique ways related to which peptides targeted the blood vessels in the barrier, and that viruses may cause these blood brain barrier vessels to produce enzymes that were deficient in the brain cells, which caused lysosomal disease: http://esciencenews.com/articles/2009/09/21/university.iowa.scientists.use.blood.brain.barrier.therapy.delivery.system
4. A study in 2010. at the University of Minnesota, sponsored by the NIH Institute of Environmental Health Sciences, found that addressing the amyloid beta protein peptide transport through the blood brain barrier presents a promising way to stop neurodegenerative cognitive dysfunction at an early stage: http://esciencenews.com/articles/2010/04/12/targeting.blood.brain.barrier.may.delay.progression.alzheimers.disease
5. An article from 2007, from researchers at the University of Rochester, New York, describes how research now supports a comprehensive strategy to stop cerebrovascular dysfunction and cognitive decline, by reducing advanced glycation endproducts (AGEs) and their receptors, LRP1 receptors, improve membrane transport through the blood brain barrier, improve cerebral blood flow, and reduce neuroinflammation: http://www.ingentaconnect.com/content/ben/car/2007/00000004/00000002/art00018
6. An article in 2010, from researchers at Brown University Medical School, in Rhode Island, USA, describes how amyloid beta peptides may be inhibited to reduce the progression of cognitive dysfunction and Alzheimer’s disease by addressing transport mechanisms in the blood brain barrier. Research has found that the receptor for advanced glycation endproducts (RAGEs) are responsible for influx transport, while the P-glyoprotein and low-density lipoprotein receptor-related protein 1 (LRP1) are responsible for efflux transport, or clearing of the amyloid beta peptides: http://www.ncbi.nlm.nih.gov/pubmed/20838242
7. A review of current scientific studies on Gingko biloba extract from the University of Maryland: http://www.umm.edu/altmed/articles/ginkgo-biloba-000247.htm
8. A 2002 study at the Buck Institute for Age Research in Novato, California, found that pre-treatment with R-lipoic acid alleviated the effects of glutathione depletion from oxidative stress: http://www.ncbi.nlm.nih.gov/pubmed/12428720
9. A 2004 study at the Chinese Academy of Sciences in Beijing, China, showed that L-carnosine reduces telomere damage and shortening, a key aspect of aging and neurodegeneration. The telomere is the end of the DNA strand that communicates with other membranes and molecules, and a repeated telomere is thought to protect DNA integrity: http://www.ncbi.nlm.nih.gov/pubmed/15474517
10. A 2009 study at the University of Kentucky found that selenium was shown to both increase glutathione antioxidant capacity and reduce amyloid beta peptide burden, as well as minimize DNA and RNA oxidation, to treat neurodegenative disorders: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683469/
11. A 2011 study in Japan found that both iron overload toxicity and oxidative stress correlated with cognitive dysfunction in the elderly: http://onlinelibrary.wiley.com/
12. A 2005 study in Israel, at the Eve Topf and US National Parkinson Foundation Centers of Excellence for Neurodegenerative Diseases Research, found that an iron chelator and MAO-B inhibitor were perhaps the most effective chemicals found to treat neurodegeneration and brain aging. Iron chelation and MAO-B (monoamine oxidase B) inhbition or modulation has been found to be achieved with herbal and nutrient medicine as well as pharmaceutical drugs, and offers a choice of a treatment protocol with less side effects: http://www.ncbi.nlm.nih.gov/pubmed/15621213
13. A 2003 study in Taiwan examined 25 species of Chinese herbal medicines for MAO-B inhibitory or regulatory effects, and found that three species exhibited significant effects and benefits in the treatment or delay of progressive neurodegeneration, Arisaema amurense (Tian nan xing), Lilium brownie (Bai he), and Uncaria rhyncophylla (Gou teng): http://www.ncbi.nlm.nih.gov/pubmed/14692725
14. Huperzine, an active chemical from a Chinese herb, was shown to be an effective acetylcholinesterase inhibitor as well as a potent antioxidant aid to treat Alzheimer’s disease as early as 2000: http://www.ncbi.nlm.nih.gov/pubmed/10996445
15. A 2003 review of clinical trials of Huperzine A by the Cognitive Drug Research House in the United Kingdom found that this herbal chemical has demonstrated significant benefits to enhance memory, improve cognitive function and quality of life with Alzheimer’s patients, exert potent neuroprotective effets, and is devoid of unexpected toxicity.: http://www.ncbi.nlm.nih.gov/pubmed/12895686
16. Berberine, an active chemical in Coptis chinensis (Huang lian) and other Chinese herbs, has demonstrated neuroprotective effects and potential as a treatment for symptoms of Parkinson’s disease, by the Barrow Neurological Institute in Phoenix, Arizona: http://www.ncbi.nlm.nih.gov/pubmed/20804776
17. Berberine, an active chemical in Coptis chinensis (Huang lian) and other Chinese herbs, has demonstrated neuroprotective effects and potential as a treatment for symptoms of Parkinson’s disease, by the Barrow Neurological Institute in Phoenix, Arizona: http://www.ncbi.nlm.nih.gov/pubmed/20804776
18. Coptis chinensis (Huang lian) has also demonstrated significant antioxidant effects, and the ability to inhibit beta-amyloid plaque formation, in a 2009 study at Pukyong National University in South Korea: http://www.ncbi.nlm.nih.gov/pubmed/19652386
19. The neuroprotective effects of adaptogenic Chinese herbs, such as Eleuthorococcus (Siberian ginseng), Rhodiola rosea (Hong jin tian), and ginseng have been documented at the Russian Academy of Medical Sciences in 2010: http://www.ncbi.nlm.nih.gov/pubmed/21165417
20. This review in 2008 of the numerous scientific studies of the herb Ashwagandha (Withania somnifera) by the University of Toyama in Japan found that chemicals in this herb exert profound neuroprotective effects and stimulate regrowth of both neurons and support glia, as well as improving brain function: http://www.ncbi.nlm.nih.gov/pubmed/18670181
21. This review in 2010 of the numerous scientific studies of the herbal chemical Resveratrol from the Chinese herb Polygonum cuspidatum (Hu zhang), conducted at the Mario Negri Institute for Pharmacological Research in Italy, found that Resveratrol has significant neuroprotective features, and activates sirtuin enzymes which beneficially regulate cell apoptosis, and other aspects of neurodegeneration, making Resveratrol a potentially significant adjunct therapy in the treatment and prevention of Alzheimer’s disease: http://www.ncbi.nlm.nih.gov/pubmed/20848560
22. A study in 2010 at the Chungnam National University in South Korea found that a chemical constituent of ginseng, ginsenoside (a phytohormonal) exerts significant antioxidant and neuroprotective effects on dopaminergic neurons in the brain, and acts via the estrogen receptors: http://www.ncbi.nlm.nih.gov/pubmed/19781563
23. A study in 1999, published in the journal of the Radiological Society of North America, Radiology, concluded from functional MRI studies that acupuncture stimulation was proven to affect the seats of neuroendocrine and autonomic regulation in the body, as well as the seat of the cognitive and emotional associations, the hypothalamus, limbic system, et al: http://radiology.rsna.org/content/212/1/133.full
24. The original fMRI study at the University of California, Irvine, Department of Radiological Sciences, Psychiatry and Human Behavior, in conjunction with Kyung Yee University in Seoul, South Korea, demonstrated that with acupuncture stimulation at points specific to the visual pathologies, that specific manual stimulations of the points produced different functional effects in the brain nuclei, as measured by both fMRI and visual light stimulation combined: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC19456/
25. A 2000 study with fMRI on human subjects at Harvard Medical School demonstrated that acupuncture stimulations affect deep regulatory centers in the brain in a modulatory manner consistent with the patient pathology and symptoms, and also consistent with manual manipulations of the needle by the physician and subsequent sensations and reactions: http://www.ncbi.nlm.nih.gov/pubmed/10643726?dopt=Abstract
26. A National Institutes of Health article in 2010 outlines how the research conducted on acupuncture effects on the brain, utilizing fMRI, PET scan, and MEG (magnetoencephalography), is being used to further map the genetic changes, and molecular changes in the nervous and immune systems: http://nccam.nih.gov/news/newsletter/2010_february/acu.htm
27. A 2010 study at the Beijing University of Traditional Chinese Medicine, in China, showed that electroacupuncture applied at just 2 common points, SP6 and ST40, and manual stimulation at DU20 and DU26, stimulated proliferation of stem cells in the brain following injury from ischemic stroke. This demonstrates the amazing restorative effects of acupuncture, even in stem cell therapy: http://www.ncbi.nlm.nih.gov/pubmed/20848891
28. A 2009 study at the University of Massachusetts found that the herbal chemical baicalein, found in Scutellaria baicalensis (Huang qin) has a strong chelating effect on iron accumulation: http://www.ncbi.nlm.nih.gov/pubmed/19108897
29. A conservative but informative article from the American Heart Association explains some of the pharmacodynamics of prescription drugs and the effect on the liver, with drug-drug contraindications and explanation of ill effects on the liver metabolism with statin drugs to lower cholesterol: http://circ.ahajournals.org/cgi/content/full/109/23_suppl_1/III-50
30. A 2000 FDA labeling approval for a synthetic estradiol oral contraceptive reveals that concentrations of drugs in the body vary considerable from person to person depending on the individual health of the liver metabolism and competition for detox pathways: http://www.fda.gov/cder/ogd/rld/19190s34.pdf
31. A 2011 audit by the U.S. Department of Health and Human Services found alarming data on the overprescription of antipsychotic medications in nursing care facilities and the harmful effects on brain function and health caused by these drugs: http://www.californiahealthline.org
32. A 2008 study published in the European Journal of Cancer Prevention showed that a percentage of the population is born with genetic polymorphisms, or tendency to express misshapen protein enzymes, related to alleles expressing P450, glutathione S-transferase and N-acetyl transferase. In the population with deficient expression of both the glutathione and acetyl transferase enzymes, risk of acquiring acute myeloid leukemia, or bone marrow cancer, increased nearly 12%: http://www.ncbi.nlm.nih.gov/pubmed/18287869. Another study in 2000 found a significant relationship between deficient expression of P450 and glutathione transferase enzymes and esophageal cancers: http://www.ncbi.nlm.nih.gov/pubmed/10868687. These studies were a follow-up to a 1997 study of glutathione deficiency genotypes and the relationship to cancer susceptibility by the University of Pennsylvania School of Medicine: http://www.ncbi.nlm.nih.gov/pubmed/9298582?

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.