An Upbuilding Discourse

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Research on Being

Towards a New Paradigm of Health (or the T-DOMES concept)

So this is meant to be an outline of my ideas concerning how disease is caused and how it may be prevented and managed. There is a standard framework set up in advance by the institution of medicine that has its own philosophy pertaining to how the body is to be viewed and treated and this is challenged in specific ways by alternative and complementary medicine. Nevertheless, these are all techniques that manage bodily conditions once illness has struck. When it comes to prevention, there is a lot of obvious and simple advice given about what one must do. Your average text on health tends to construct a simplified conceptual framework of how health functions in order to organize the activities that produce wellness into a whole that may be conceived and acted upon. I have not yet found an author, however, whose way of doing this has completely satisfied me so this is my attempt to produce my own simplified but hopefully useful way of conceptualizing disease treatment and prevention.

Toxicity

The central concept that relates to health is the idea of toxicity. This is the master concept that is usually at work whenever a problem arises whether the matter has to do with nutritional, pharmacological, psychic, or mechanical toxicity. I am thus using this term in a very broad way to include within it any life stress that is chronically maintained or which is beyond the threshold of benefit. Beneath the idea of toxicity are the various specific objects which we must be careful to be aware of in order to maintain wellness. Toxicity is thus the T in the T-DOMES acronym I have produced, the DOMES being a specification of the possible toxicities to avoid, manage, dissipate, and neutralize depending on your desire, circumstance, and temperament.

Digestion

Digestion is the first and most important part of the health equation, the one most likely to be disrupted, and the one that shall bring the most benefit once it is under control. A compromised gut is implicated in a wide range of problems including, obviously, the digestive problems but also autism, fibromyalgia, chronic fatigue syndrome, obesity, muscular pain and so on. In other words, it’s always good to rule out the gut as a causative factor as it may be playing a role in a variety of ailments. Good digestion is also important for the sake of extracting the most nutrition from food, having good energy balance, and so on. Below the macro idea of digestion lies several things. The most obvious one is to have a proper diet that is good for digestion and nutrition and to go through a therapeutic diet if necessary so that the gut may be healed. As far as therapeutic diets specifically for gut healing, it seems the GAPS or SCD diets work in many people. As a quick summary: eliminating lactose, casein, and/or polysaccharides may be useful for a limited time in allowing the gut to heal. Besides the diet, is the issue of having healthy and beneficial probiotic colonies in the gut through consuming fermented foods and supplements. Enzymes as well as betaine HCL (or apple cider vinegar) may also be needed to help weak digestion and/or low stomach acid production. There are also basic things of importance like the proper chewing of food and reduced meal frequency. Chronic stress is also a factor that may reduce stomach acid production. The goal of this level is then to deal with and avoid a wide variety of digestively related ailments and to improve energy production as well as our nutritive status and thereafter to maintain a nutritious and low toxin diet (i.e. PHD style diet or my regular diet).

Outlook

Outlook in life is extremely important both physiologically and psychologically (as if there were a difference) as the physiological tension from stress, depression, anxiety, and so on can affect digestion, the amount of adipose tissue that you have and where it is deposited, brain function, sleep quality, and the adrenal glands. As much as people attempt to turn into machines, our basis in biology cannot and will not be denied. The fact that we have a biological basis means that we need to understand that we all have certain social, sexual, and physiological needs and that we need to accept them and embrace them. Of course, I cannot delve into this topic deeply right now as this is just a cursory summary but the basic point is that we should not be experiencing chronic stress and isolation and learn to take our activities lightly and accept our circumstance as this will lead us towards a better life. In my view, however, this is the most difficult task to manage as the untangling and dissolution of neuroses is no easy feat due to the structural role that neuroses play in the psychic economy of the individual. Nevertheless, progress may be made such as through having valuable relationships, goals in life, practicing meditation, getting sufficient rest, and so on. The goal of this level is to avoid the problems of chronic psychological stress and self-defeating behavior, loneliness and so on.

Movement

The idea of movement encompasses both exercise and posture as these are two important things that affect our bodies. Exercise is a necessary activity in life in order to keep us strong and able to engage in a wide variety of activities not to mention that muscle cushions us from injury and provides a reserve store for our immune system to feed upon when necessary. I personally believe in the primacy of high intensity, but slow, weight lifting plus leisure and locomotive activities throughout the rest of life (walking to places, playing sports). Posture is important in weight training to avoid injury but it is also important in general as chronic bad posture can lead to a variety of spinal and muscular problems over time not to mention the fact that out culture is geared towards sitting and inactivity which is generally bad for posture. In this realm I suggest the Gokhale method as it very clearly explains what properly balanced posture is and how to achieve it. The goal of this level is then to avoid the mechanical injuries that arise from bad posture and to avoid other bodily injuries that become easier to incur when one is weaker in the body.

Environment

This is a very broad category that relates somewhat back to outlook in that it is important to exist in an environment that is conducive to your optimal functioning. However, one can be more specific in that many environments have stale or dry air, toxins present from the production of the carpets, furniture, and so on not to mention those present in various products used such as shampoo. The idea is to avoid unnecessary exposure to these sorts of things and also to balance it with being outside and in the sun as this is an activity that produces vitamin D in the body among other benefits. To this we may also relate the idea of time, the body responds to the environment and perceives time. When we engage in shift work and sleep all day, this can have a negative hormonal impact so it is recommended that one sleeps in the right environment at the right time. The goal of this level is to avoid the problems of vitamin D deficiency, exposure to toxicity, disconnection from nature, and so on.

Sanitation

This refers to a specific idea of cleanliness as I do not in any way advocate antibacterial cleaners as they are damaging to yourself and the environment. What I mean is the management of space. This includes the space of the body and as such can be seen as being synonymous with the idea of hygiene. Being “clean,” for me, does not mean the destruction of bacteria but rather the proper colonization of it especially as far as bodily entry points are concerned. The mouth, the nose, the anus, and genitals are all possible points of entry into the body from the exterior environment. If one maintains these areas in proper bacteriological balance then the likelihood of disease diminishes so I suggest probiotic treatments for these areas when warranted. For instance, one may wish to use a suppository or enema to help with the colon if a person has severe digestive issues from a loss of colonic bacteria. If a person is prone to chronic ear infections or sinusitis, it may be useful to introduce probiotics into that area of the body via a netipot. Also UTIs in women can be prevented through probiotic treatments which may be done orally or genitally. As for the mouth, there are many ways of modulating dental hygiene through the food consumed and the products used. The goal of sanitation is thus to control the entry points to the body as well as maintain the space around you in such a way that is does not constitute a threat to you. This does not mean destroying bacteria but, rather, being aware of them.

The Healing Modalities (SHOPP): Supplements, Herbalism, Osteopathy, Probiotics, Psychotherapy, Allopathy

The preceding sections outline the most salient concepts for the maintenance of health and prevention of disease, however, it is inevitable that one will become ill at some point and so it is necessary that one should have a plan for this eventuality. The “plan” that I have produced is constructed of several healing modalities that should be applied to the situation depending on the nature and gravity of the situation and the amount of harm and benefit the medicine is likely to produce in the patient. In life threatening situations, there is no option but going to conventional medicine (allopathy from now on) as this is what allopathy is best at, however, for all other ailments I believe a different approach is warranted due to the amount of problems that allopathic remedies tend to produce in individuals and the fact that this sort of medicine is based on symptomatic treatment as opposed to snuffing out causes.

Supplements

Many diseases are caused by vitamin toxicity or deficiency, as such supplemental vitamins constitute an important healing modality as anyone who has ever heard of scurvy can tell you. Even in the case of vitamin toxicity, vitamins may help since they work synergistically together and thus may be able to modulate one another such as vitamin A and D where toxicity in one is often present because of deficiency in another. Besides vitamins, there are many other compounds that can help in alleviating problems. For instance, alpha lipoic acid can chelate some heavy metals and could thus be useful for people with heavy metal toxicity.

Herbalism

Before getting to pharmacological substances to which bacteria (among other vectors of disease) can more easily adapt to due to their simplicity, it is important to attempt to treat disease with herbal substances. Of course, one should not assume that herbs are safe and nontoxic, it all depends on the herb but these are less likely to cause issues in individuals and are thus worth a try before getting to more dangerous treatment options. These are especially good with more minor ailments as there are many herbs that are antiseptic, antiviral, and antibacterial such as garlic and ginger.

Osteopathy

I do not know so much about osteopathy but do know that it has been shown to be effective and involves manipulation similar to chiropractic practice. As such, it seems to be a prudent option if you have some sort of mechanical difficulty and since osteopaths are full doctors they will move you towards allopathy if they believe it is necessary.

Probiotics

Probiotics are very important in preventing and treating disease as these bacteria constitute our endogenous bacterial army that battles against pathogenic bacteria. When a person has insufficient friendly bacteria, that individual becomes more susceptible to disease and when a person is given probiotics during illness, the illness tends to resolve faster. In most cases, except for gut dysbiosis, this will be either a complementary method or a preventative method, nevertheless, it is still very important as it may save you from recurring infections of the same sort as explained above.

Psychotherapy

If you have a psychological problem then psychotherapy should be your first option of treatment. It is just as effective, if not more so, than pharmacological treatment but gets the shaft because it’s easier and more profitable to prescribe medicine instead. In any case, using drugs to treat these sorts of disorders usually functions as symptomatic treatment that does not untangle any issues in the individual thus forsaking him/her to lifelong medication with the associated side effects.

Allopathy

Like I mentioned before, allopathic medicine is very good for emergencies. If you have a life threatening situation on your hands then you do not have the luxury of shopping around for the best treatment but instead need to just stay alive and allopathy knows how to do that. Besides this very special circumstance, I recommend that you use allopathy once other options have been exhausted as its treatments are the most damaging and dangerous. It may be useful, however, to go to an allopathic physician for the sake of certain diagnostics which you may then use for your own purposes and I believe this is the best use of them.

Other Considerations: Saunas, Laughter, Chiropractic, Acupuncture

There are other activities that can help health that are not treatment modalities in themselves or with which I am not familiar enough with to really endorse fully. I will quickly outline these here now.

Saunas

Saunas have been used for health for quite a long time and it makes sense as the sauna is nothing more than a simulation of the fever. The fever in the disease process does not happen for no reason, rather it is an immune defense. By increasing bodily temperature, the immune system is attempting to kill pathogens. This is why fevers should be allowed to run their course so long as they are mild. In any case, this appears to be the basic idea behind the sauna and why it is associated with longevity.

Laughter

Laughter is an activity which can help bring oxygen into the body, reduce stress, and improve outlook. As such, it seems to be something that should be included in a well rounded healing strategy especially considering how easy it is to get dreary when one is sick.

Chiropractic

So far, chiropractic practice has appeared to me as nothing more than a less professional form of osteopathy with fewer qualifications and more possible injury (especially if the manipulations are done on the neck). For this reason, I do not really see why someone should want to see a chiropractor when that person can simply just go and see an osteopath instead. Nevertheless, chiropractic does have a plausible method of functioning so feel free to go to them if you do have certain mechanical problems and prefer them.

Acupuncture

Acupuncture also has a plausible physiological method of functioning (that is, the needles stimulate bloodflow to the areas being pricked thus improving healing), however, I have not seen much in the way of proof that this does, in fact, work except when it comes to headaches and some muscular and joint pain. As such, I recommend that if you believe in it then go ahead and use it, it is unlikely to do you much harm, however, it does not seem very necessary and the clinical evidence behind it does not seem particularly large.

Conclusion

It is my opinion that the T-DOMES strategy should be a sufficient way to maintain very good health indefinitely. The problem is in implementing it fully as I believe many people likely have chronic digestive issues that require healing, chronic anxiety or stress, and may suffer from psychological problems such as anger, loneliness, depression and so on that put their bodies in compromised states of being. This is not even to mention the encouraged sedentariness of our culture and the bad posture that inheres in too much sitting and the toxic environments in which we often work and live. All these problems feed back into eachother very easily such as a job where you’re stuck at a desk all day in bad posture that leads to strain with a loved one which increases your stress and anxiety which you escape from by watching too much television while eating potato chips and ice cream. Here you have bad food with bad posture with bad environment with lack of movement working together to produce psychic and physiological stress that the person in question finds difficult to deal with except by indulging more fully in that which injures him/her. It is thus a difficult path to find a way to unravel ourselves from the traps of culture that attempt to tell us what to do, what to eat, what it is that is worthwhile to do with a life, who should be desired, how a person should act, what to buy and so on and so forth (not to mention the production of anxiety through news media). This often all eventually congeals into a clinically diagnosable disease which can then, through the cycle of unintended consequences and a faulty framework, lead to even more disease via the side effects of treatment if the treatment was even warranted in the first place. That is the additional insult here; that even people who are healthy can be made to be ill through the manufacture of imaginary diseases that need to be managed such as high cholesterol or the medicalization of problems that should be properly dealt with in psychotherapeutic ways such as depression or anxiety or through screening tests on the asymptomantic which often detect non-threatening phenomena that end up leading to unnecessary surgery. All this medicalization of the physiologically healthy even while the ill are symptomatically treated only thus allowing their diseases to progress further instead of instituting programs that reverse the disease process such as happens in GERD and diabetes. This is how one falls into the plague of iatrogenicity that must be avoided and this is why I suggest the T-DOMES framework above as a way to maintain health and to use allopathy only for diagnostics while using the other modalities (SHOPP) for actual healing if at all possible.

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Filed under: Bacteria, Diet, Digestion, Hcl, Health, Iatrogenicity, Medicine, Nutrients, Pathogenesis, Supplements

A Few More Thoughts on Diabetes

After reading some more hyperlipid I have begun to question whether it is the adipose tissue or the liver that goes first in the pathogenesis of diabetes. One way to imagine the progression of diabetes is that through heavy fructose consumption, the liver becomes damaged and stops being able to manage glucose in the blood thus leading to elevated blood glucose levels. The pancreas thus overproduces insulin in an attempt to compensate for this and this process, which is simultaneous with hyperphagia due to disruption to leptin by excess fructose and toxin exposure, leads to the insulin resistance of fat cells and thus elevated NEFAs in the blood.

I have heard that elevated NEFAs appear before elevated BG so I would guess that these processes happen simultaneously but that the adipose tissue fails first as a result of hyperphagia and that this causes the pancreas to overcompensate with insulin hastening the arrival of hepatic insulin resistance soon thereafter. In any case, the factors that cause this remain the same, fructose and other dietary toxins that promote hyperphagia. The question is whether fructose or the hyperphagia that high fructose consumption can induce is the primary factor in this process. If it is the former then hepatic insulin resistance should happen first, if it is the latter then adipose insulin resistance should happen first. These are likely simultaneous processes where one has more susceptibility to what is happening and becomes insulin resistant first.

EDIT: I think that perhaps the way it works is something like this. Fructose damages leptin and this causes hyperphagia. Hyperphagia forces the body to fatten to avoid lipotxicity. At some point, the body refuses to fatten any longer and so the fat cells become insulin resistant and elevated NEFAs is the consequence. The pancreas secretes more insulin in response to the elevated NEFAs. The liver, simultaneous with this, is getting damaged by fructose leading to non-alcoholic fatty liver disease and once the pancreas goes into overdrive to control the elevated NEFAs, hepatic insulin resistance occurs and the liver stops being able to ration out glucose and process fructose well. Now you also have elevated blood sugar levels and the pancreas is going nuts with insulin production. Now you have diabetes. So far this is what makes the most sense to me.

Filed under: Diabetes, Hormones, Insulin, NEFAs, Obesity, Pathogenesis

Some Thoughts on the Pathogenesis of Diabetes

Let me preface this by saying that I am not a scientist at all. I was trained in semiotics and film/video production.

One of the things that I’ve been wondering about ever since I started looking at CarbSane‘s blog is where elevated non-esterified fatty acids (NEFAs) fit in in the grand scheme of things. Let me elaborate a little first so that this makes sense. The theory of fattening and insulin resistance that is usually given goes something like this: carbohydrates are the most insulinogenic macronutrient and the SAD (Standard American Diet) is a high carb diet and over time this leads to chronically elevated insulin levels, especially if you are snacking all the time which you are more likely to do on the SAD since you’re running on glucose (instead of fat) which your body has limited storage for. Additionally, insulin is the master hormone for fattening and if it’s always high then you are always accumulating fat rather than burning it. Of course, this has some truth to it but the picture is a bit more complicated than this and I’ve been looking for a way to reconcile this with some more nuanced descriptions of how fattening actually works.

Insulin is not the only hormone implicated in this process. There are, at the very least, two others: leptin and ASP. But anyway, that isn’t exactly my point. CarbSane mentions often how the one thing that bothers her the most about low carb is that it is necessarily a high fat diet and that elevated NEFAs in the blood appear connected to sudden cardiac death (SCD) as well as diabetes (that is, elevated NEFAs are supposed to happen before the elevated blood sugar happens). But looking more at her posts, it seems that the likely mechanism of fattening and eventually diabetes works something like this:

-One goes into caloric surplus in some way (for now, it is my belief that nutrient poor foods like most grain carbs combined with liquid calories and food toxins like fructose or those found in grain carbs induce hyperphagia over time either as a function of form (such as the difficulty of the body recognizing liquid calories) or damage to the leptin receptor (the possibility of wheat lectin binding leptin has been hypothesized by Stephan)).

-Now that you are in caloric surplus, you begin to store more and more fat. You begin to have chronically high levels of insulin to inhibit lipolysis of all that fat which is necessary to avoid elevated NEFAs and lipotoxicity in the body.

-Eventually, however, fat cells become insulin resistant and this leads to elevated NEFAs which continues to exasperate production of insulin in the body. Over time, the rest of you becomes insulin resistant and now you are diabetic.

-To summarize, it appears the problem is pathological overeating caused by some damage to leptin which eventually leads to fattening and chronically elevated insulin through insulin’s attempt to inhibit the lipolysis of all that fat tissue and this eventually leads to insulin resistance in fat cells, elevated NEFAs and, eventually, elevated blood sugar and diabetes.

The reason Paleo diets work, I believe, is because calorie intake is spontaneously reduced through the consumption of nutrient dense foods. This caloric deficit combined with the removal of the bulk of food toxins and the change from glucose to fat as the main fuel source makes it so that now those fats can actually be burned and used for energy and the hormonal system has a chance to heal. Hence, no macronutrient in particular is the culprit but food toxins and low-grade macronutrients (which are usually grain carbs) that lead to the initial caloric excess that changes the body’s fat setpoint. This is why this sort of thing doesn’t happen to the Kitavans. For someone who is metabolically healthy, it would seem that as long as the foods you eat are whole foods, macronutrient ratios don’t really matter that much.

In relation to NEFAs there is another issue of interest. CarbSane is worried about the elevated NEFAs that seem to be produced in those on very low carb (VLC) diets, however, I believe this worry may be misplaced. The reason I believe it may be misplaced is because the phenomena of elevated NEFAs seems to be caused by very different things in diabetes than in a VLC diet and I do not believe elevated NEFAs are sufficient to produce diabetes in an individual outside of the context of elevated NEFAs in the pathogenesis of diabetes described above. On a VLC diet, insulin is being minimized and so lipolysis is encouraged and since virtually no carbs are being eaten this makes sense as lipids are the main fuel source. A normal person on the SAD would have a lower level of NEFAs but they are also running on a combination of lipids and glucose so this makes sense. On a VLC diet, the elevated NEFAs are also not occurring in defiance of insulin but because the diet is designed to produce little insulin in the body. Hormones are thus not being disturbed in the same way. Also, I wonder how rigorously “elevated” is being applied which is to say that if people on a VLC diet have elevated NEFAs relative to those on the SAD, I’m not sure if that really means anything. In the pathogenesis of diabetes it does since a diabetic on the SAD versus a “normal” person on the SAD can be compared to one another to see what difference the pathological state is having on that person. VLC is designed to elevate NEFAs so unless your body is trying to kill you, I find it hard to believe that elevated NEFAs in the context of normal functioning are a problem or that we would be designed in such a way that would put our lives in mortal danger if we were forced to survive on a VLC diet. Once again, I must say that I believe that any macronutrient ratio is perfectly fine so long as food toxins are not consumed and whole foods are consumed.

Looking through some posts at hyperlipid (this one in particular) it would seem that VLC produces a temporary physiological insulin resistance since the body is getting adapted to low carb intake but that this is not pathological and if one were to change to high carb the next day, the body would adapt to it and become insulin sensitive within a week. Thus, the carb loading that low carbers due before blood sugar tests are done because those tests are attempting to measure how insulin sensitive your tissues are in the context of a moderate to high carb diet. The low carbers thus make their diets temporarily moderate to high carb in order to get an accurate reading of insulin sensitivity.

In summary, I am coming to believe that this physiological insulin resistance and elevated NEFAs are nothing to worry about so long as they are not in a context that suggests that they are markers of a pathological state which I believe they are not in the context of a VLC diet. Now, I do not advocate a VLC diet for other reasons and if you do believe these things are to be worried about, the solution is simple. Instead of a very low carb, high fat diet eat a low to moderate carb, high fat diet and there you have it.

Filed under: ASP, Diabetes, Diet, Hormones, Insulin, Macronutrients, NEFAs, Obesity, Pathogenesis, VLC