Unraveling the Truth About Antioxidants: ROS and disease: finding the right balance. https://www.ncbi.nlm.nih.gov/pubmed/24999942

Antioxidant Therapies Address Common Underpinnings of These Chronic Conditions

There is not a day that goes by that healthcare practitioners don’t face challenges. Attending to many complex patients stacked back-to-back, communicating bad news to a patient, working with insurance to cover labs—most physicians encounter at least one of these, if not all three, each and every day. One of the additional challenges we face with complex patients is addressing a long list of diagnoses; as integrative providers, we often find ourselves trying to treat not just one, but often three or four health concerns in a single visit. With our broad education and tolle totum (treat the whole person) vision, it is difficult to avoid this tendency.

Fortunately, there are many nutritional therapies that address conditions we commonly see coexisting. Here, we look at factors in a set of conditions that commonly overlap: chronic fatigue syndrome, depression, and insomnia. More importantly, we discuss some shared solutions that will help the integrative practitioner support patients with these difficulties.

Common Underpinnings

https://science.sciencemag.org/content/360/6391/eaan5931

Research Suggests Bile Acids Have Potential as a Therapy for Dysbiosis, Constipation, and Inflammatory Bowel Disease

Generally, when we think of bile, we first think of the role it plays in digestion. Produced by the liver and expelled into the digestive tract by the gallbladder, bile is the substance that serves to emulsify and break down dietary fats so that they can be absorbed in the small intestine. Thus, supplemental bile acids with meals may be important for individuals post-cholecystectomy or with fat malabsorption for other reasons. However, the effects and potential therapeutic benefits of bile acids in the body go far beyond this.

In the digestive tract, bile acids also affect the balance of flora and gut motility.^[1],[2] Outside of the gut, they regulate many critical facets of physiology, including glucose and cholesterol metabolism; activating farnesoid X receptor (FXR), pregnane X receptor, the vitamin D receptor, and various G-protein-coupled receptors.[5] Evidence also suggests that bile acids affect neurological function, as well as the response of the hypothalamic–pituitary–adrenal axis.[6] Bile acids have even been suggested to be “novel therapeutic modalities in inflammation, obesity, and diabetes.”[7]

https://www.sciencedirect.com/science/article/pii/S1369527416301813

Passé? Or Something to Consider?

Nowadays, with any mention of digestive symptoms of constipation, diarrhoea, gas, or bloating, and a history of antibiotic or proton-pump inhibitor use, one of the first things most integrative healthcare practitioners will consider in the differential diagnosis list is gastrointestinal dysbiosis with testing for small intestinal bacterial overgrowth (SIBO).[1] SIBO has a lot of hype—and how can it not, with so many conferences, practitioners, and clinics focused on its treatment? Given that the lactulose breath test (LBT), commonly used for the diagnosis of SIBO, has a low sensitivity and frequently gives false-positive results (although sensitivity can be improved via three-hour methane and hydrogen testing), it can be overused for the ease of diagnosing, well, something.[2]^,[3]

The first retrospective cohort study of the #functional #medicine model has recently been published in the Journal of American Medical Association Network Open (#JAMA). The study saw researchers from the Cleveland Clinic’s Center for Functional Medicine examine 1,595 patients they had treated there, as well as 5,657 patients seen in primary care at a family health centre. All patients had their health-related quality of life (#QoL) assessed using a patient-reported outcomes measurement information system (#PROMIS). The National Institute of Health (#NIH) validated questionnaires, measured patients physical and mental health across a period of 12 months.

Preliminary research presented at the American Heart Association’s Scientific Sessions 2019 has shown that women who consume a higher proportion of their daily calorie intake in the evening had a greater risk of developing #cardiovascular disease. Previous studies have suggested that eating meals earlier in the day can aid weight loss, eating later may slow down #metabolism, and that later mealtimes can raise #inflammatory markers usually associated with #diabetes and #heart disease. This new research adds weight to the idea that eating more calories in the evening may negatively affect our health.

Whilst studies have previously been conducted on mice linking processed foods to #obesity and #intestinal #inflammation, human studies have been lacking. Associations have already been made regarding humans and the consumption of ultra-processed foods increasing the risks of developing obesity, #cancer, #autoimmune conditions and even premature mortality, human clinical trials have been needed to prove this link. Scientists from the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland, have carried out the first study of this kind and the results showed a weight gain in as little as two weeks.

The department of Immunology from the University of Toronto have recently completed research into the origins and causes behind inflammation of the heart (#myocarditis). Whilst many other studies have been conducted, resulting in a variety of theories, there has not yet been a conclusive definition of how risk factors and environmental exposures intersect. The Toronto team have shown in their results that genetic predisposition, production of a commensal #gut #microbial #autoantigen, and systemic #inflammation combine to trigger the generation of autoreactive CD4+ T cells that cause autoimmune myocarditis and #cardiac dysfunction.

Many theories have been developed to explain why animals exhibit certain social behaviours, the impact of the #microbiota, however, has rarely been considered.  In a review published in Science Mag this month, scientists have examined several pre-clinical and clinical trials investigating the effect of the microbiota on the social brain. It has been discovered that through a diverse set of pathways the gastrointestinal microbiota is able to send signals to the brain, this is known as the #microbiota-gut-brain axis. The microbiota plays a key role in neurodevelopment from early life into adulthood influencing processes such as #neurotransmission and #neuroinflammation as well as behaviour throughout lifespan. With animals having evolved in a microbial world, these signals may have influenced the animal brain throughout evolution.

By Nathan S. Bryan, PhD, on Nitric Oxide, the Peroxynitrite Issue, and Nutritional Tools That May Help Improve Nitric Oxide Production

 Nathan S. Bryan, PhD, is an international leader in molecular medicine and nitric oxide biochemistry. Specifically, Dr. Bryan was the first to describe nitrite and nitrate as indispensable nutrients required for optimal cardiovascular health. He was the first to demonstrate and discover an endocrine function of nitric oxide via the formation of S-nitrosoglutathione and inorganic nitrite.

Dr. Bryan has been involved in nitric oxide research for the past 18 years, and he has made many seminal discoveries in the field. Many of these discoveries and findings have transformed the development of new therapeutic agents for the treatment and prevention of human disease.

Dr. Bryan has published a number of highly cited papers and authored or edited five books. More about his work can be found at www.drnathansbryan.com.

Experts from the University of Science and technology in Wuhan, China, have reviewed 26 studies, compiling data from 1610 participants, all investigating the efficacy of anti-inflammatory agents on major depressive disorders. The #anti-inflammatories included in the studies were non-steroidal anti-inflammatory drugs (#NSAIDs) such as #ibuprofen and #aspirin, #omega 3 fatty acids, #cytokine inhibitors, #steroids, #statins, #antibiotics, #modafinil and #N-acetyl cysteine.