Overuse of antibiotics could be involved in a number of conditions

To be filed in the "First Do No Harm" bin, overuse of antibiotics may be implicated not only in obesity, but Irritable Bowel Disease, allergies and asthma. Excerpts follow. Info on my practice here.

In Some Cases, Even Bad Bacteria May Be Good
By KATE MURPHY

THE HYPOTHESIS

Overuse of antibiotics increases the risk of obesity.

THE INVESTIGATOR

Dr. Martin Blaser, New York University Langone Medical Center.


Overuse of antibiotics has led to the creation of drug-resistant bacteria — so-called superbugs, like methicillin-resistant staphylococcus aureus. But now some researchers are exploring an equally unsettling possibility: Antibiotic abuse may also be contributing to the increasing incidence of obesity, as well as allergies, inflammatory bowel disease, asthma and gastroesophageal reflux.

Among those sounding the alarm is Dr. Martin Blaser, a professor of microbiology at New York University Langone Medical Center. In a commentary published in August in the journal Nature, he asserted that antibiotics are permanently altering microbial flora of the human body, also known as the microbiome or microbiota, with serious health consequences...

..
His lab has since produced a stream of findings supporting his suspicion. Dr. Blaser and his colleagues discovered, for instance, that the stomach behaves differently after a course of antibiotics eradicates resident H. pylori.

After a meal, levels of ghrelin, a hunger hormone secreted in the stomach, are supposed to fall. But in subjects without H. pylori, the amount of ghrelin in the bloodstream held steady, in essence telling the brain to keep eating.

Moreover, mice in Dr. Blaser’s lab fed antibiotics in dosages similar to those given to children to treat ear and throat infections — which is enough to kill H. pylori in many patients — had marked increases in body fat even though their diets remained the same. (Indeed, farmers have long given antibiotics to livestock to promote weight gain without increasing caloric intake.)

These results dovetail with research by Peter Turnbaugh, a Harvard University geneticist, in collaboration with Dr. Jeffrey Gordon, a gastroenterologist at Washington University in St. Louis. They have found that the ratios of various bacteria in the guts of obese mice and obese humans were significantly different from those of lean controls, suggesting that altering the stomach’s microbial balance with antibiotics might put patients at risk for gaining weight.

Antibiotic overuse may be the root of other health problems, too. An epidemiologist at New York University, Yu Chen, has found an inverse correlation between H. pylori infection and childhood-onset asthma, hay fever and skin allergies in 7,600 participants in the National Health and Nutrition Survey.

Observation research has shown that the elimination of H. pylori actually increases the risk of gastric reflux, which is itself associated with asthma as well as esophageal diseases. Researchers in Switzerland and Germany have reported that mice given H. pylori actually are protected against asthma...

But wider use of antibiotics may be wreaking havoc far beyond that resulting from the loss of H. pylori. “We have so far focused on H. pylori because we have the diagnostic tests to detect it, but you could say H. pylori is an indicator organism for what is probably a vast and disappearing microbiota and increasing disease risk,” said Dr. Blaser...

Notes from NGF, Nerve Growth Factor, and Electroacupuncture Article by Manni

Having read the article in full from yesterday's blog post, (link to article here) I wanted to draw attention to a few points. One: they flesh out the concept of acupuncture causing stimulation similar to exercise. I remember reading Anderson's paper a long time ago and was happy to have the citation. Two: It turns out that NGF, nerve growth factor, may be involved en Electroacupuncture's effect on the sympathetic tone of Polycystic Ovarian Syndrome patients(as discussed here.) I discussed PCOS and electroacupuncture here and here. Three: They discuss electroacupuncture's effect on mast cells (MC) and NGF, postulating that acupuncture's effectiveness is due to their modulation of the immune system. I had come to think that the effectiveness of acupuncture for allergy was due to a general decrease in sympathetic tone leading to improved immunity, but they argue pretty convincingly that it may be due to release of these factors. I virtually never use electroacupuncture for allergy, rather manual acupuncture, but I certainly going to try in conjunction with HRV monitoring. Four: They discuss other aspects of NGF on peripheral neuropathy and Central Nervous System insults also, but I didn't include that discussion here.
I have excerpted and highlighted a bit of the article below. (Info on my practice here.)

It has been reported that manual acupuncture and EA
effects can be correlated to activation of all kinds of
type A (alpha, beta, gamma and delta) and C sensory
nerve fibers. However, particular significance has
been given to a group of receptors in the skeletal
muscles, which have both low- and high-threshold
for mechanical stimulation, and are innervated by
A-delta fibers and possibly C-fibers. Physiologically
they are activated by strong muscle contractions and
have been denoted ergoreceptors. Based on this, it
has been suggested that EA with repetitive muscle
contraction results in the activation of physiological
processes similar to those resulting from physical
exercise (Andersson et al., 1995).
Both acupuncture and physical exercise release
endogenous opioids, which seems to be essential
in the induction of acupuncture-mediated functional
changes of different organ systems. However,
other systems may be involved in the acupuncture
modulation of stress, pain, autonomic activity and
immune systems. Indeed, research carried out in
the last 20 years shown that through acupuncture
it is possible to affect synthesis, release and action
of several neurotransmitters (catecholamines, glutamate,
acetylcholine, GABA, serotonin) and neuropeptides
(among others: oxytocin, NPY, CCK,
VIP, SP, CGRP, PACAP) in both CNS and PNS.
It has recently been proposed that at least some of
the effects attributed to acupuncture are mediated
by neurotrophins, particularly NGF (Manni et al.,
2010a).
...The results suggested that EA inhibits
hyperactivity in the sympathetic nervous system (Cao
et al., 1983; Chao et al., 1999), a major pathogenetic
cause of PCO (Barria et al., 1993; Lara et al., 1993;
Lara et al., 2000; Lara et al., 2002). Supporting this
hypothesis, in a following study (Stener-Victorin
et al., 2003) we demonstrated the effect of EA
in reducing ovarian NGF along with ovarian and
hypothalamic sympathetic activation markers...

Neutralization of endogenous NGF reversed most
of these abnormalities (Manni et al., 2006). Almost
identical results were obtained by EA treatment
(Manni et al., 2005c), demonstrating that the results
were probably achieved through the actions of EA
on the NGF system.
Overall, the data on EA/NGF interaction in PCOS models indicated that the
therapeutic potential of EA is exerted via its ability
to modulate the activity of the autonomic nervous
system by inducing a long-lasting depression of the
sympathetic nervous system, with a concomitant
down-regulation of NGF in peripheral organs...

Since MC (mast cells) are critically involved
in allergic responses (Song et al., 2009), these observations
suggest that EA, through the modulation
of MC activity, can influence the release of their
preformed mediators, including NGF, in allergic
reactions.

Nice testimonial from a patient with allergies

Just for something different, I thought I'd share with you a testimonial from a patient I've been treating for allergic rhinitis. I received it yesterday and it hopefully speaks for itself. In this particular case, I started with acupuncture alone, and then added Astra Essence, an overall tonic with astragalus to strengthen the lung, as a daily tonic.

I developed allergies to cats and dogs about 30 years ago. I tried allergy shots for a year and they did not seem to help. When I went to friends' houses, I had to take a Zyrtec or Claritin, found that the pills did not always work and also found that they made me feel drowsy and a little off -- just when I'd most like to socialize. You're not supposed to drink when you take those medications, so wine with dinner was a problem.

Over the years, the allergies seemed to be getting worse. Feeling that this was all headed in the wrong direction, I wondered whether acupuncture could help when shots and pills had not. I didn't have much to lose. Dr. Sparrow's experience with her own allergies and acupuncture sounded promising and I liked the fact that she is a trained physician.

Dr. Sparrow has a great manner and is easy to talk to. She explained that the theory is that acupuncture and herbs can help to strengthen and balance your immune system. This made sense, because the medical research links allergies to immune system response.

Most importantly, the acupuncture and herbs are working for me. After just the first few treatments, I have been able to take no pills and still go comfortably to homes of friends with cats and dogs. After a year, it's even better. Dr. Sparrow advises not to challenge one's system too much, so I am still careful but I just don't have to be as careful (or drugged) as I was before. What a relief! As a side bonus, I have not had a cold or other illness in about a year (despite a heavy air travel schedule).

To give the blog readers a break from the academics and harangues about institutionalized medicine... For more information about my practice please click here.
If you have any questions or comments about this case or others please let me know in comments!

Link between Allergies and Depression, Recent Studies

There was an article in the NYTimes discussing some recent studies which show a link between allergies and depression. Because an increase in suicide rates occurs in the Spring, the thought it that the manifestation of allergies, not just the genetics, can exacerbate depression.
This correlation is part of the teachings of Chinese Medicine, of course. The lung is the organ that protects the body. As well as its own functions, the lung rules over the skin the major barrier of the body and the nose. Not only is the emotion that is associated with the lung sadness, but also the lung is responsible for shielding the spirit from negative emotions and hostile energies. So it only stands to reason that people with allergies (low lung energy) would also be more susceptible to depression from a Chinese Medicine standpoint.
To read more about allergies and acupuncture please click here.
Some of the article is excerpted here.

April 11, 2011
Allergies Can Increase the Risk of Depression
By ANAHAD O’CONNOR

THE FACTS

Spring always brings a rash of sneezing, sniffling and stuffy noses. But can seasonal allergies be psychologically harmful?

A wave of emerging research suggests that may be the case. While there’s no firm evidence that allergies cause depression, large studies show that allergy sufferers do seem to be at higher risk of depression.

Severe allergies can bring sleeplessness, headaches, fatigue and a general feeling of physical depletion, all of which can worsen mood. Studies have found that allergic reactions release compounds in the body called cytokines, which play a role in inflammation and may reduce levels of the hormone serotonin, which helps maintain feelings of well-being. And it’s well known that some common allergy medications, like corticosteroids, can cause anxiety and mood swings.

Several large studies have found that the risk of depression in people with severe allergies is about twice that of those without allergies. In 2008, researchers at the University of Maryland reported that this link may help explain a widely established — but poorly understood — increase in suicides during the spring every year. Analyzing medical records, the authors found that in some patients, changes in allergy symptoms during low- and high-pollen seasons corresponded to changes in their depression and anxiety scores.

A Finnish population study in 2003 found a link between allergies and depression; however, women were much more likely to be affected. In 2000, a study of twins in Finland also showed a shared risk for depression and allergies, a result of genetic influences, the authors wrote.

Tension Myoneural Syndrome, A Theory

This is from an article in Anesthesiology News. You have to be registered to read the interview in its entirety and to register you have to be willing to have the ad replete glossy sent to your home every month, so I will assume that most will just take my word for it...
This is an interview with a physician named John Sarno, who makes a case for the underlying emotional issues, pain or rage, that can cause a patient to be under pressure to be a perfectionist, that leads to physical pain. He cites the study in the New England Journal of Medicine back in 1994 which shows that bulges and protrusions in discs in people with low back pain frequently may be coincidental. He believes that if you educate people as to the common psychogenic origins of of these pain syndromes, that he calls "tension myoneural syndrome," or TMS, they get better. He has seen more than 10,000 such patients over 30 years and that roughly 3/4 of them have gotten better.
His basic theory goes something like this. That the physical pain serves to distract the patient's attention from emotional pain or rage, which often derives from the pressure people put on themselves to be good or perfect. In this attempt to live up to these high standards, something in the unconscious, an inner child, becomes very, very angry. He tries to educate patients to the fact that the drive to be perfect angers the unconscious. Once the person recognizes that this is what is happening they no longer automatically react to pressure with anger and rage. They no longer need the distraction.
He says that in addition to musculoskeletal maladies, the most common illnesses are gastrointestinal. Migraines and other headaches are classic problems as well. Other conditions that can result are chronic or recurrent sinus infections, and "globus hystericus," the feeling of a lump in the throat. Allergic problems and frequent urination are others.
He postulates that the brain reduces the amount of oxygen to a given part of the body. He uses various physical therapeutic means to increase circulation, heat, exercise and deep massage. He sees increasing circulation as key, and that "the brain was causing all this through the autonomic nervous system, which controls blood flow."


(To read more about acupuncture and my practice, please click here.)

Migraines provide an excellent example of this process. The migraine is a condition of spasmodic narrowing of the blood vessels. The narrowing ususally takes place in one large blood vessel, such as the carotid. First you experience pain ,a nd if it persists long enough, you may have a stroke. Several studies support this oxygen-deprivation hypothesis

.
He goes on to cite a 1993 paper on neuroendocrine-immune interactions in the New England Journal of Medicine (NEJM 1993, 329:1246-1253) that concluded that "the central nervous sytem influences on the immune system are well-documented and provide a mechanism by which emotional states could influence the course of diseases involving immune functions."

I wanted to make a few points about this article since it touches on issues that are important in my practice and my view of Chinese Medicine.
1. The mind and body are not separate entities in Chinese Medicine. Indeed, each organ has its own emotional state that it is responsible for. That is one reason that I was interested in Chinese Medicine. It is a way to help heal the mind through the body without necessarily engaging the cognitive portion. This can be incredibly useful and healthy.
2. The example of migraine is classic Chinese Medicine doctrine. Migraine is often caused by a stagnation of liver qi from an underlying perfectionism and rage. We treat by dredging the liver and calming the Shen, as well as local points which increase circulation.
3. To the extent that I've done research it has been on the autonomic nervous system and it's pivotal role in the effectiveness of acupuncture. Dr. Sarno's theories do nothing to dispute that theory; though he seems to prescribe a slightly different remedy.
4. The increase in circulation has been clearly established with acupuncture treatment with infra-red documentation and the like.
5. I'd never considered that the brain would be selectively decreasing blood flow to an area of the body, but I find this hypothesis fascinating. I frequently will treat the spinal level involved in the nerves that feed an area that is in pain, and thought of the autonomic nervous system as a more general relaxation and restoration of function. More food for thought!
6. The increase in immune function with acupuncture is well documented, I've posted about it here, and here,and am heartened to see other practitioners accepting this link.
7. Globus Hystericus in Chinese Medicine is a common feature of the condition "running piglet" which is treated through the Chong Mai extra meridian and the liver meridian very effectively.