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Natural and time-honored Natural and time-honored paths to the best health paths to the best health possible: An overviewpossible: An overview

Dr. Sharum Sharif, N.D.Dr. Sharum Sharif, N.D.

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Agenda:Agenda:

• Talk for 50 minutes. (This includes a Talk for 50 minutes. (This includes a few patient videos.)few patient videos.)

• Questions/answers for last 10 Questions/answers for last 10 minutes. minutes. – Please hold your questions until the end. Please hold your questions until the end. – Can email me your questions as well. Can email me your questions as well.

Email will be provided at end of talk. Email will be provided at end of talk.

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Biography:Biography:

• Received doctorate in Naturopathic Medicine Received doctorate in Naturopathic Medicine from Bastyr University in 2003. from Bastyr University in 2003.

• Graduated from the New England School of Graduated from the New England School of Homeopathy in 2007.Homeopathy in 2007.

• Have been practicing in Kent since 2003.Have been practicing in Kent since 2003.• Received bachelor’s in EE (electrical Received bachelor’s in EE (electrical

engineering) from U.W. in 1992. Specialized engineering) from U.W. in 1992. Specialized in Bio-medical instrumentation. Prior to in Bio-medical instrumentation. Prior to pursuing medicine, worked as an engineer for pursuing medicine, worked as an engineer for Microsoft. Microsoft.

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Biography:Biography:

• An Affiliate Clinical Faculty at Bastyr An Affiliate Clinical Faculty at Bastyr University, mentoring numerous University, mentoring numerous students at my clinic. students at my clinic.

• Teach a class on “Biotherapeutic Teach a class on “Biotherapeutic Drainage” at Bastyr University. Drainage” at Bastyr University.

• Area of interest: Autoimmune Area of interest: Autoimmune diseasedisease

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Who are NDs (Naturopathic Who are NDs (Naturopathic Doctors)?Doctors)?

NDs (naturopathic doctors) are NDs (naturopathic doctors) are licensed PCPs (primary care licensed PCPs (primary care physicians) who use mostly natural physicians) who use mostly natural therapies instead of pharmaceutical therapies instead of pharmaceutical drugs.drugs.

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Disclaimer:Disclaimer:

• This material is intended for This material is intended for information only and is not medical information only and is not medical advice. advice.

• Please consult with your ND Please consult with your ND (naturopathic doctor) about specific (naturopathic doctor) about specific supplements you might be taking. supplements you might be taking.

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Research articles used for this Research articles used for this talk:talk:• Most of the research articles used in this presentation were Most of the research articles used in this presentation were

obtained from PubMed- One of the largest medical obtained from PubMed- One of the largest medical databases in the world. You can google “pubmed” to find databases in the world. You can google “pubmed” to find the exact website address of this incredible database. the exact website address of this incredible database. Once in Pubmed, you can enter the subject you are Once in Pubmed, you can enter the subject you are interested in, and press the “search” button. For example, I interested in, and press the “search” button. For example, I entered “Myositis and Vitamins” or “Myositis and minerals”, entered “Myositis and Vitamins” or “Myositis and minerals”, “Myositis and viruses”, “myositis 2007”, “myositis and “Myositis and viruses”, “myositis 2007”, “myositis and cancer” (“myositis and cancer” gave the largest number of cancer” (“myositis and cancer” gave the largest number of articles amongst the topics above, 1859 as of Sept 4, 07), articles amongst the topics above, 1859 as of Sept 4, 07), etc., to find the majority of the articles sited here. Most etc., to find the majority of the articles sited here. Most articles is this database make their abstract available. The articles is this database make their abstract available. The abstract is the summary of the article. For all practical abstract is the summary of the article. For all practical purposes, you do not actually need the article itself, just the purposes, you do not actually need the article itself, just the abstract will give you the overview of the research. abstract will give you the overview of the research.

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Research articles used for this Research articles used for this talk:talk:

• I might have reviewed close to 1000 I might have reviewed close to 1000 research articles through the research articles through the Pubmed to prepare for this talk. Pubmed to prepare for this talk.

• There were numerous on myositis There were numerous on myositis and vitamins/minerals. and vitamins/minerals. Unfortunately, of all these articles, Unfortunately, of all these articles, there was only one article on there was only one article on myositis and herbs. myositis and herbs.

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Other sources:Other sources:

• ““Treatment of Cancer, Dysbiosis and Treatment of Cancer, Dysbiosis and Autoimmune Diseases” by Dr. Autoimmune Diseases” by Dr. MiKhael Adams, ND.MiKhael Adams, ND.This book can not be obtained This book can not be obtained through bookstores. It was a through bookstores. It was a seminar book.seminar book.I use Dr. Adams’ protocol for treating I use Dr. Adams’ protocol for treating dysbiosis, but have not actually used dysbiosis, but have not actually used his book for preparation of this talk. his book for preparation of this talk.

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Definition of medical terms Definition of medical terms used in this talk:used in this talk:• Autoimmune disease: Your own immune system attacks Autoimmune disease: Your own immune system attacks

yourself. yourself. • Dysbiosis: Imbalance of microorganisms (or microbes) or Dysbiosis: Imbalance of microorganisms (or microbes) or

unhealthy composition of microbes in the intestine (too unhealthy composition of microbes in the intestine (too many unfriendly organisms and not enough friendly ones- many unfriendly organisms and not enough friendly ones- acidophilus)acidophilus)

• Germs: Germs (or microbes) are various types of micro-Germs: Germs (or microbes) are various types of micro-organisms such as bacteria, viruses, parasites, and yeasts. organisms such as bacteria, viruses, parasites, and yeasts. Germs are also known as infectious agents because they Germs are also known as infectious agents because they can cause infection. can cause infection.

• GALT (or gut-associated lymphoid tissue): Lymphoid tissue GALT (or gut-associated lymphoid tissue): Lymphoid tissue in the gut.in the gut.

• Lymphocytes: A particular type of WBCs. There are two Lymphocytes: A particular type of WBCs. There are two types of lymphocytes: types of lymphocytes: – B cells and T cells. B cells and T cells.

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Definitions- Continued:Definitions- Continued:

• Lysosomes: Small organelles (structures within the Lysosomes: Small organelles (structures within the cell) that help digest “things” inside the cell.cell) that help digest “things” inside the cell.

• Oxidative stress (by free radicals). Free radicals Oxidative stress (by free radicals). Free radicals damage our tissues, and anti-oxidants are required to damage our tissues, and anti-oxidants are required to help with damage secondary to these free radicals. help with damage secondary to these free radicals.

• Mitochondria: Small structures in every cell in the Mitochondria: Small structures in every cell in the body. Mitochondria give us energy (or ATP). body. Mitochondria give us energy (or ATP).

• Probiotics: Friendly bacteria such as Lactobacillus Probiotics: Friendly bacteria such as Lactobacillus acidophilus which reside in the small intestine.acidophilus which reside in the small intestine.

• TNF-alpha: TNF-alpha is a type of cytokine (which are TNF-alpha: TNF-alpha is a type of cytokine (which are for signaling between cells)for signaling between cells)

• WBC (white blood cells): The cells of the immune WBC (white blood cells): The cells of the immune system system

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What is Autoimmune What is Autoimmune disease?disease?• Autoimmune diseases are characterized Autoimmune diseases are characterized

by an alteration of the body's defense by an alteration of the body's defense mechanism, designed for protection mechanism, designed for protection against infections and toxic injuries, against infections and toxic injuries, which attacks and destroys normal tissue. which attacks and destroys normal tissue.

• There are numerous types of There are numerous types of autoimmune diseases. Myositis is only autoimmune diseases. Myositis is only one type of autoimmune disease. one type of autoimmune disease.

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What are B cells? What are B cells?

• B cells are a type of white blood cells B cells are a type of white blood cells that are born in the bone marrow. that are born in the bone marrow.

• We need to make 100 million We need to make 100 million different B cells that can be selected, different B cells that can be selected, when needed, to protect us against when needed, to protect us against all possible invaders.all possible invaders.

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What is GALT?What is GALT?

• GALT is “gut-associated lymphoid GALT is “gut-associated lymphoid tissue”, and is located in the small tissue”, and is located in the small intestine. intestine.

• The GALT is comprised of several The GALT is comprised of several times more times more immune cell elementsimmune cell elements than the bone marrow, spleen, and than the bone marrow, spleen, and lymph nodes combined. lymph nodes combined.

• Therefore, your small intestine plays Therefore, your small intestine plays an incredibly significant role in your an incredibly significant role in your immunity. This is KEY to today’s talk. immunity. This is KEY to today’s talk.

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Examples of AI diseases:Examples of AI diseases:• AI CONDITION AI CONDITION Target tissueTarget tissue• Hashimoto’s thyroiditis Hashimoto’s thyroiditis ThyroidThyroid• Diabetes type IDiabetes type I PancreasPancreas• Grave’s diseaseGrave’s disease ThyroidThyroid• RA (rheumatoid arthritis)RA (rheumatoid arthritis) JointsJoints• MyositisMyositis Muscles and skinMuscles and skin• Raynaud’s Disease or phenomenonRaynaud’s Disease or phenomenon FingersFingers• SclerodermaScleroderma Skin & organsSkin & organs• MS (Multiple sclerosis)MS (Multiple sclerosis) NervesNerves• Psoriasis Psoriasis SkinSkin• Psoriatic arthritis Psoriatic arthritis Joints and skinJoints and skin• Sarcoidosis Sarcoidosis Skin & organsSkin & organs• Sjogren’s Sjogren’s Tear & salivary glandsTear & salivary glands• Lupus Lupus Joints & organsJoints & organs• IgA kidney IgA kidney KidneysKidneys• IBD (Crohn’s disease and Ulcerative colitis) IBD (Crohn’s disease and Ulcerative colitis) IntestinesIntestines• Fibromyalgia Fibromyalgia MusclesMuscles

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Principles of natural Principles of natural medicine:medicine:• 1) First, Do No Harm1) First, Do No Harm

• 2) Work with the Healing Power of 2) Work with the Healing Power of NatureNature

• 3) 3) Treat the causeTreat the cause (versus symptom (versus symptom alleviation)alleviation)

• 4) Treat the 4) Treat the whole personwhole person

• 5) Doctor is Teacher5) Doctor is Teacher

• 6) Practice 6) Practice preventionprevention

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Treat the whole person…Treat the whole person…

• All “time-honored” paths to healing, be it All “time-honored” paths to healing, be it naturopathic medicine, homeopathy, Chinese naturopathic medicine, homeopathy, Chinese Medicine, Ayervedic Medicine, etc., believe in a Medicine, Ayervedic Medicine, etc., believe in a “wholistic approach” to healing. What does this “wholistic approach” to healing. What does this mean? mean?

• This means that in order to solve a person’s This means that in order to solve a person’s ailment(s), you must consider the entire body, not ailment(s), you must consider the entire body, not just on one or two parts. As a results, when you just on one or two parts. As a results, when you treat a person naturally, many (or all) of their treat a person naturally, many (or all) of their symptoms will be treated at the same time. It is symptoms will be treated at the same time. It is rather difficult (sometimes impossible) in natural rather difficult (sometimes impossible) in natural medicine to treat just one or two symptoms- you medicine to treat just one or two symptoms- you treat the whole person. treat the whole person.

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Treat the cause- The main Treat the cause- The main principle in natural medicine…principle in natural medicine…

• Another principle in all time-honored paths Another principle in all time-honored paths to healing is the idea of finding and treating to healing is the idea of finding and treating the “cause(s)”, not just the superficial the “cause(s)”, not just the superficial symptoms. For example, the root cause of symptoms. For example, the root cause of all AI (autoimmune) diseases appears to be all AI (autoimmune) diseases appears to be centered in the intestines. Therefore, in centered in the intestines. Therefore, in order to eliminate the symptoms of AI order to eliminate the symptoms of AI diseases, you logically have to address the diseases, you logically have to address the problem at the root- in the intestines. (More problem at the root- in the intestines. (More on this later…)on this later…)

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Treat the cause….Treat the cause….

• The main idea in natural medicine is The main idea in natural medicine is NOT in using supplements (vitamins & NOT in using supplements (vitamins & minerals, or herbs, etc.) versus drugs. minerals, or herbs, etc.) versus drugs. The main idea is in The main idea is in treating the treating the CAUSECAUSE of disease and healing it of disease and healing it instead of only focusing on and instead of only focusing on and eliminating the by-products (otherwise eliminating the by-products (otherwise known as symptoms) of the disease. known as symptoms) of the disease.

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Example of “treat the Example of “treat the cause”:cause”:

• Based on a research article: “Our results suggest Based on a research article: “Our results suggest that mitochondrial dysfunction may be present in that mitochondrial dysfunction may be present in patients with inflammatory myositis.” Some of patients with inflammatory myositis.” Some of these “patients had these “patients had defectsdefects of respiratory chain of respiratory chain enzyme complexesenzyme complexes.”*.”*

• But WHY are the mitochondria in myositis But WHY are the mitochondria in myositis patients getting damaged? (Remember the main patients getting damaged? (Remember the main principle in natural medicine- find the cause…)principle in natural medicine- find the cause…)

*: Respiratory chain enzyme defects in patients with idiopathic inflammatory *: Respiratory chain enzyme defects in patients with idiopathic inflammatory myopathy. Ann Rheum Dis. 1995 Jun;54(6):491-3.myopathy. Ann Rheum Dis. 1995 Jun;54(6):491-3.Research Unit, Hospital Doce de Octubre, Madrid, Spain. Research Unit, Hospital Doce de Octubre, Madrid, Spain.

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Example of “treat the Example of “treat the cause”:cause”:

•And, WHY should the enzyme And, WHY should the enzyme systems be dysfunctional? Is the systems be dysfunctional? Is the defect genetically inherited, or is defect genetically inherited, or is it induced by some outside it induced by some outside influences? So, let’s see if we influences? So, let’s see if we can find the cause(s) for these can find the cause(s) for these problems. problems.

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One proposed mechanism for One proposed mechanism for mitochondrial damage in AI:mitochondrial damage in AI:• ““TNF-alpha induces TNF-alpha induces oxidative stress which oxidative stress which

can cause mitochondrial damage and can cause mitochondrial damage and deathdeath.” *.” *

• So TNF-alpha (a cytokine) appears to have So TNF-alpha (a cytokine) appears to have something to do with mitochondrial damage something to do with mitochondrial damage in myositis patients. But WHY do we even in myositis patients. But WHY do we even get TNF-alpha? Where does IT come from?get TNF-alpha? Where does IT come from?

*: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” *: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-by Mitchell Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-C. Journal: “Alternative Medicine Review”, Volume 3, Number 1. Publisher, C. Journal: “Alternative Medicine Review”, Volume 3, Number 1. Publisher, Thorne Research, Inc. 1998. Thorne Research, Inc. 1998.

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One proposed mechanism for One proposed mechanism for mitochondrial damage in AI:mitochondrial damage in AI:• ““When the body is invaded by a When the body is invaded by a foreign foreign

organism (such as bacteria or yeasts in the organism (such as bacteria or yeasts in the gut)gut), an immune response is activated which, in , an immune response is activated which, in turn, is mediated by turn, is mediated by cytokines cytokines (such as (such as Interleukin-1 and TNF-alpha (tumor necrosis Interleukin-1 and TNF-alpha (tumor necrosis factor-alpha). factor-alpha).

• TNF-alphaTNF-alpha has a prominent role in initiating the has a prominent role in initiating the immune response. While it is normally beneficial immune response. While it is normally beneficial to the host (person), in situations of to the host (person), in situations of overproduction , TNF-alpha itself can kill the overproduction , TNF-alpha itself can kill the host.” * host.” *

*: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; *: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-C. Journal: “Alternative Medicine Review”, Volume 3, Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-C. Journal: “Alternative Medicine Review”, Volume 3, Number 1. Publisher, Thorne Research, Inc. 1998. Number 1. Publisher, Thorne Research, Inc. 1998.

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TNF-alpha and myositis:TNF-alpha and myositis:

• ““TNF-alpha (specifically TNF-308A TNF-alpha (specifically TNF-308A and -1031T alleles) is a significant and -1031T alleles) is a significant risk factor in the IIMs (idiopathic risk factor in the IIMs (idiopathic inflammatory myopathies).”inflammatory myopathies).”

Tumour necrosis factor-{alpha} single nucleotide polymorphisms are not Tumour necrosis factor-{alpha} single nucleotide polymorphisms are not independent of HLA class I in UK Caucasians with adult onset idiopathic inflammatory independent of HLA class I in UK Caucasians with adult onset idiopathic inflammatory myopathies.myopathies.Rheumatology (Oxford). 2007 Sep;46(9):1411-6. Epub 2007 Jun 22. Rheumatology (Oxford). 2007 Sep;46(9):1411-6. Epub 2007 Jun 22. The University of Manchester, Rheumatic Diseases Centre, Hope Hospital, Salford, M6 The University of Manchester, Rheumatic Diseases Centre, Hope Hospital, Salford, M6 8HD. robert.g.cooper@manchester.ac.uk.8HD. robert.g.cooper@manchester.ac.uk.

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TNF-alphaTNF-alpha

• ““The concept of biological therapy arises from the The concept of biological therapy arises from the specific targeting of a factor, e.g. a cytokine, specific targeting of a factor, e.g. a cytokine, involved in the inflammatory cascade. Thus, involved in the inflammatory cascade. Thus, biologicals disrupt the complex network of biologicals disrupt the complex network of autoimmune-inflammatory events.”autoimmune-inflammatory events.”

• ““Anti-tumor necrosis factor-alpha (TNF-alpha) Anti-tumor necrosis factor-alpha (TNF-alpha) agents play a central role in biological therapy as agents play a central role in biological therapy as these agents have been successfully tried in most these agents have been successfully tried in most of these diseases.”of these diseases.”

Biological therapy of arthritis and systemic autoimmune diseasesBiological therapy of arthritis and systemic autoimmune diseasesOrv Hetil. 2007 Apr 8;148 Suppl 1:63-70. Review. Hungarian. Orv Hetil. 2007 Apr 8;148 Suppl 1:63-70. Review. Hungarian.

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Anti-T cell versus Anti-B cell Anti-T cell versus Anti-B cell biological agents for treatment biological agents for treatment of AI diseases:of AI diseases:• ““Some mostly T-cell mediated diseases, Some mostly T-cell mediated diseases,

such as rheumatoid arthritis, ankylosing such as rheumatoid arthritis, ankylosing spondylitis, psoriasis, polymyositis, spondylitis, psoriasis, polymyositis, polyarticular juvenile arthritis respond well polyarticular juvenile arthritis respond well to to anti-TNF agents and T cell targetinganti-TNF agents and T cell targeting, , while others, such as lupus, Sjogren's while others, such as lupus, Sjogren's syndrome, dermatomyositis may rather syndrome, dermatomyositis may rather respond to respond to anti-B cellanti-B cell biologicals.” * biologicals.” *

Biological therapy of arthritis and systemic autoimmune diseasesBiological therapy of arthritis and systemic autoimmune diseasesOrv Hetil. 2007 Apr 8;148 Suppl 1:63-70. Review. Hungarian. Orv Hetil. 2007 Apr 8;148 Suppl 1:63-70. Review. Hungarian.

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So, address the root cause of So, address the root cause of mitochondrial damage…mitochondrial damage…

• So, in order to stop the mitochondrial So, in order to stop the mitochondrial damage, doesn’t it make sense to go damage, doesn’t it make sense to go back to the root cause which is the back to the root cause which is the foreign organisms (germs) in the foreign organisms (germs) in the gut? (More on this later…)gut? (More on this later…)

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Natural treatment approach to Natural treatment approach to ALL autoimmune diseases is ALL autoimmune diseases is similar…similar…

• Various natural therapies for myositis Various natural therapies for myositis are discussed in this presentation. are discussed in this presentation. However, the fundamental approach However, the fundamental approach to treatment of all AI (autoimmune to treatment of all AI (autoimmune diseases) is the same because the diseases) is the same because the root cause of all AI diseases is the root cause of all AI diseases is the same. same.

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Testimonial Videos from Testimonial Videos from patients with various AI patients with various AI conditions:conditions:• DermatomyositisDermatomyositis

• SarcoidosisSarcoidosis

• Hashimoto’s thyroiditisHashimoto’s thyroiditis

• LupusLupus

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Common Natural Therapies Common Natural Therapies available for Myositis:available for Myositis:• Diet:Diet:

– Food and spices (such as turmeric) that reduce Food and spices (such as turmeric) that reduce inflammationinflammation

• Nutritional supplementations such as Nutritional supplementations such as Vitamin D, Creatine, anti-oxidants Vitamin D, Creatine, anti-oxidants (including Vitamins C, E, and Selenium) (including Vitamins C, E, and Selenium) and minerals (including oligotherapies or and minerals (including oligotherapies or gammadyns)gammadyns)

• HerbsHerbs• Mind-body or “energy” medicine Mind-body or “energy” medicine

(meditation, relaxation, homeopathy, etc.)(meditation, relaxation, homeopathy, etc.)

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Optimal Diet for Myositis family Optimal Diet for Myositis family of disorders:of disorders:

• Dysbiosis diet (or the “candida” diet)Dysbiosis diet (or the “candida” diet)– This diet mainly emphasizes the avoidance of This diet mainly emphasizes the avoidance of

sugar, sweet foods (including natural sweet sugar, sweet foods (including natural sweet foods such as fruit juices, honey, maple syrup, foods such as fruit juices, honey, maple syrup, etc.), avoidance of alcohol and eating plenty of etc.), avoidance of alcohol and eating plenty of vegetables instead. Meats of various kinds are vegetables instead. Meats of various kinds are allowed. Whole grains are fine as well. allowed. Whole grains are fine as well.

– Avoidance or at least reduction of coffee (even Avoidance or at least reduction of coffee (even decaf, and ideally all caffeinated beverages) is decaf, and ideally all caffeinated beverages) is highly recommended. highly recommended.

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Optimal Diet for Myositis family Optimal Diet for Myositis family of disorders:of disorders:• Fish is great for you due to the EFA (essential fatty Fish is great for you due to the EFA (essential fatty

acid) content. However, due to mercury toxicity in acid) content. However, due to mercury toxicity in fish, I would not recommend frequent consumption fish, I would not recommend frequent consumption of fish. I am not certain what a “safe” limit of of fish. I am not certain what a “safe” limit of mercury in the body is. However, I would suspect a mercury in the body is. However, I would suspect a healthy person might be OK eating fish once a healthy person might be OK eating fish once a week, but not much more frequently than that. week, but not much more frequently than that. Avoid farm-raised fish at all costs- eat wild fish. Avoid farm-raised fish at all costs- eat wild fish. Avoid bottom eating fish as mercury is heavy and Avoid bottom eating fish as mercury is heavy and can sink to the bottom of the ocean/sea. Best can sink to the bottom of the ocean/sea. Best solution is to supplement with high quality fish oil, solution is to supplement with high quality fish oil, and eat wild fish (such as salmon) infrequently.and eat wild fish (such as salmon) infrequently.

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Caffeine Caffeine IMB? IMB?

A random research article I found on caffeine and myositis:A random research article I found on caffeine and myositis:• ““Caffeine stimulates amyloid beta-peptide release from Caffeine stimulates amyloid beta-peptide release from

beta-amyloid precursor protein-transfected HEK293 cells. beta-amyloid precursor protein-transfected HEK293 cells. • Extracellular amyloid beta-peptide (A beta) deposition is a Extracellular amyloid beta-peptide (A beta) deposition is a

pathological feature of Alzheimer's disease and the aging pathological feature of Alzheimer's disease and the aging brain. Intracellular A beta accumulation is observed in the brain. Intracellular A beta accumulation is observed in the human muscle disease, IBM (inclusion body myositis).”human muscle disease, IBM (inclusion body myositis).”

• I recommend that patients avoid drinking coffee (even I recommend that patients avoid drinking coffee (even decaf) all together, and consume no more than 1-2 cups of decaf) all together, and consume no more than 1-2 cups of caffeinated tea (black or green). Non-caffeinated herbal caffeinated tea (black or green). Non-caffeinated herbal teas (such as mint tea, chamomile, etc.) are safe to drink.teas (such as mint tea, chamomile, etc.) are safe to drink.

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““Possibly” helpful supplements Possibly” helpful supplements for Myositis:for Myositis:

Why “Possibly”? Because not everyone will respond to Why “Possibly”? Because not everyone will respond to these natural therapies.these natural therapies.

• Vitamin DVitamin D• Vitamin EVitamin E• Vitamin CVitamin C• SeleniumSelenium• Minerals, such as calciumMinerals, such as calcium• EFA’s (or Essential Fatty Acids): Fish oil or Flax oilEFA’s (or Essential Fatty Acids): Fish oil or Flax oil• L-carnitineL-carnitine• CreatinCreatin• Acidophilus (Probiotics): “Friendly” bacteria in the gut.Acidophilus (Probiotics): “Friendly” bacteria in the gut.

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Vitamin D (a fat-soluble Vitamin D (a fat-soluble vitamin)vitamin)

• ““Vitamin D inadequacy is pandemic Vitamin D inadequacy is pandemic among rehabilitation patients in both among rehabilitation patients in both inpatient and outpatient settings.”*inpatient and outpatient settings.”*

*: Vitamin d and rehabilitation: improving functional outcomes. Nutr Clin Pract. 2007 *: Vitamin d and rehabilitation: improving functional outcomes. Nutr Clin Pract. 2007 Jun;22(3):297-304. Jun;22(3):297-304.

Spaulding Rehabilitation Hospital, Boston, MA, USA. Spaulding Rehabilitation Hospital, Boston, MA, USA.

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Vitamin DVitamin D

• ““Vitamin D deficiency and osteomalacia Vitamin D deficiency and osteomalacia should be considered in the differential should be considered in the differential diagnosis of patients with musculoskeletal diagnosis of patients with musculoskeletal pain, fibromyalgia, chronic fatigue pain, fibromyalgia, chronic fatigue syndrome, or syndrome, or myositismyositis. There is a need for . There is a need for better education of health professionals better education of health professionals and the general public regarding the and the general public regarding the optimization of vitamin D status in the care optimization of vitamin D status in the care of rehabilitation patients.”*of rehabilitation patients.”*

*: *: Vitamin d and rehabilitation: improving functional outcomes. Nutr Clin Pract. 2007 Vitamin d and rehabilitation: improving functional outcomes. Nutr Clin Pract. 2007 Jun;22(3):297-304. Jun;22(3):297-304. Spaulding Rehabilitation Hospital, Boston, MA, USA. Spaulding Rehabilitation Hospital, Boston, MA, USA.

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Vitamin D and cancer:Vitamin D and cancer:

• ““Thousands of cases of breast and colon cancers might be Thousands of cases of breast and colon cancers might be averted each year if people in colder climates raised their averted each year if people in colder climates raised their vitamin D levels, researchers estimate in a new report. A vitamin D levels, researchers estimate in a new report. A number of studies have suggested that vitamin D may be number of studies have suggested that vitamin D may be important in cancer risk. Much of this research is based on important in cancer risk. Much of this research is based on cancer rates at different latitudes of the globe; rates of cancer rates at different latitudes of the globe; rates of breast, colon and ovarian cancer, for example, are lower in breast, colon and ovarian cancer, for example, are lower in sunnier regions of the world than in Northern climates sunnier regions of the world than in Northern climates where cold winters limit people's sun exposure.”*where cold winters limit people's sun exposure.”*

• And, since myositis, being an AI disease, may And, since myositis, being an AI disease, may predispose to cancer, it is wise to at least have your predispose to cancer, it is wise to at least have your Vitamin D levels tested. Vitamin D levels tested.

*: Reuters; Sept 4, 2007. *: Reuters; Sept 4, 2007.

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Biochemistry of Vitamin D:Biochemistry of Vitamin D:

Vit D2/D3 from food and sun gets into Vit D2/D3 from food and sun gets into the blood (from skin and intestines). the blood (from skin and intestines). The liver has to convert these to Vit D, The liver has to convert these to Vit D, 25-hydroxy, and then the kidneys have 25-hydroxy, and then the kidneys have to convert this to Vit D, 1-25 dihydroxy.to convert this to Vit D, 1-25 dihydroxy.

• Can test for:Can test for:– Vit D, 25-hydroxy (inactive form of Vit D)Vit D, 25-hydroxy (inactive form of Vit D)– Vit D, 1-25 dihydroxy (active form of Vit D )Vit D, 1-25 dihydroxy (active form of Vit D )

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Can you have too much or too Can you have too much or too little Vit D?little Vit D?

• Yes. You can have too little or too Yes. You can have too little or too much Vit D, 25-hydroxy, while having much Vit D, 25-hydroxy, while having too much or too little of the other too much or too little of the other form, Vit D, 1-25 dihydroxy. form, Vit D, 1-25 dihydroxy.

• So, if you have too little Vit D, 25-So, if you have too little Vit D, 25-hydroxy, but too much Vit D, 1-25 hydroxy, but too much Vit D, 1-25 dihydroxy, what should you do? dihydroxy, what should you do? What about the reverse situation?What about the reverse situation?

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Dr. Marshall Protocol on Vit Dr. Marshall Protocol on Vit D:D:• To illustrate the intricate balance of To illustrate the intricate balance of

vitamins in the body, let’s discuss Dr. vitamins in the body, let’s discuss Dr. Marshall Protocol. Marshall Protocol.

• Dr. Marshall has developed a Dr. Marshall has developed a treatment protocol for patients with treatment protocol for patients with low Vit D called the 'Marshall Protocol' low Vit D called the 'Marshall Protocol' (MP), which is being implemented by (MP), which is being implemented by physicians around the world. physicians around the world.

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Dr. Marshall Protocol on Vit Dr. Marshall Protocol on Vit D:D:• ““There has been a lot of confusion in recent years There has been a lot of confusion in recent years

as to how much vitamin D should be taken, as to how much vitamin D should be taken, particularly since many studies have based their particularly since many studies have based their recommendations on measuring levels of the recommendations on measuring levels of the inactive precursor form of vitamin D (25 D). This inactive precursor form of vitamin D (25 D). This may be seriously misleading, because recent data may be seriously misleading, because recent data shows that one may have a low inactive vitamin D shows that one may have a low inactive vitamin D and still have elevated levels of the active vitamin and still have elevated levels of the active vitamin D hormone (1,25 D; for example, see Issue 7 of D hormone (1,25 D; for example, see Issue 7 of CISRA’s Synergy Health NewsletterCISRA’s Synergy Health Newsletter).”*).”*

*: Issue 8, 2005 -- Marshall Protocol: Conference, Update, Corrections; by J. C. *: Issue 8, 2005 -- Marshall Protocol: Conference, Update, Corrections; by J. C. Waterhouse, Ph.D.Waterhouse, Ph.D.

4343

Dr. Marshall Protocol on Vit Dr. Marshall Protocol on Vit D:D:• ““There are also differences in the subjective experience of There are also differences in the subjective experience of

the effect of vitamin D level increase or decrease. the effect of vitamin D level increase or decrease. According to Dr. Trevor Marshall’s work on TH1 diseases, According to Dr. Trevor Marshall’s work on TH1 diseases, some people may feel temporarily better with higher levels some people may feel temporarily better with higher levels of vitamin D and sunlight, despite it doing them harm in the of vitamin D and sunlight, despite it doing them harm in the long run. In this view, those with sarcoidosis and certain long run. In this view, those with sarcoidosis and certain other inflammatory diseases may feel temporarily better other inflammatory diseases may feel temporarily better with higher vitamin D from sun exposure or supplements with higher vitamin D from sun exposure or supplements because an elevated level of active vitamin D may inhibit because an elevated level of active vitamin D may inhibit the immune system from killing cell wall deficient (CWD) the immune system from killing cell wall deficient (CWD) bacteria. In a sense, the high bacteria. In a sense, the high vitamin D may be acting in an vitamin D may be acting in an immune suppressing manner somewhat analogous to immune suppressing manner somewhat analogous to steroid drugssteroid drugs. In other words, the elevated active vitamin D . In other words, the elevated active vitamin D hormone serves to inhibit the symptom-provoking hormone serves to inhibit the symptom-provoking Herxheimer reactions that occurs when antibiotics or the Herxheimer reactions that occurs when antibiotics or the immune system kill bacteria.”immune system kill bacteria.”

4444

Dr. Marshall Protocol on Vit Dr. Marshall Protocol on Vit D:D:• ““Dr. Marshall finds that some people even Dr. Marshall finds that some people even

report being on vitamin D for months or even report being on vitamin D for months or even a year or two and they may think they are a year or two and they may think they are improving from taking the vitamin D. But, in improving from taking the vitamin D. But, in the long run, the the long run, the experience with sarcoidosis experience with sarcoidosis patients is that this elevated vitamin D will patients is that this elevated vitamin D will allow the bacteria to continue to increaseallow the bacteria to continue to increase and eventually the patient will relapse. and eventually the patient will relapse. According to Dr. Marshall, evidence suggests According to Dr. Marshall, evidence suggests that this is likely to be the case with other that this is likely to be the case with other TH1 diseases with similar vitamin D patterns, TH1 diseases with similar vitamin D patterns, like CFS and Chronic Lyme Disease.”like CFS and Chronic Lyme Disease.”

4545

Dr. Marshall Protocol on Vit Dr. Marshall Protocol on Vit D:D:• ““In contrast, Dr. Marshall finds that In contrast, Dr. Marshall finds that other other

patients will feel significantly better when patients will feel significantly better when they lower vitamin Dthey lower vitamin D and sunlight due to and sunlight due to lower symptoms of hypervitaminosis D lower symptoms of hypervitaminosis D (which means elevated vit D levels in the (which means elevated vit D levels in the blood). So, the overall message is that it blood). So, the overall message is that it appears to be better to base one’s appears to be better to base one’s judgments on the vitamin D test results, judgments on the vitamin D test results, done and interpreted properly, and done and interpreted properly, and including both inactive (25 D) and active including both inactive (25 D) and active (1,25 D).”(1,25 D).”

4646

More on Marshall Protocol…More on Marshall Protocol…

• ““It also should be noted that in some cases, It also should be noted that in some cases, the vitamin D levels in the serum may not the vitamin D levels in the serum may not adequately reflect the levels in the adequately reflect the levels in the local local tissuestissues, if the most inflamed areas do not , if the most inflamed areas do not get as much blood flow (e.g., the skin, the get as much blood flow (e.g., the skin, the nervous system and the joints). In these nervous system and the joints). In these cases, the total clinical picture can be used cases, the total clinical picture can be used to determine whether the Marshall Protocol to determine whether the Marshall Protocol (MP), which includes temporarily (MP), which includes temporarily minimizing vitamin Dminimizing vitamin D, is appropriate.”, is appropriate.”

4747

Treat the root cause of vit D Treat the root cause of vit D abnormalities…abnormalities…

• Since the balance of Vit D appears to Since the balance of Vit D appears to be so intricate (and the small intestine, be so intricate (and the small intestine, liver and kidneys are all involved), isn’t liver and kidneys are all involved), isn’t it more reasonable to focus on it more reasonable to focus on correcting organ function (more on this correcting organ function (more on this later) versus taking Vit D in a blind-later) versus taking Vit D in a blind-folded fashion, or even minimizing Vit folded fashion, or even minimizing Vit D in your blood by force?D in your blood by force?

4848

Vitamin C (an anti-oxidant)Vitamin C (an anti-oxidant)

• ““Based on our findings, high-dose Based on our findings, high-dose vitamin C therapy is considered to be vitamin C therapy is considered to be effective in some cases of IBM effective in some cases of IBM (Inclusion body myositis).”*(Inclusion body myositis).”*

*: *: High-dose vitamin C therapy for inclusion body myositis. Fukuoka Igaku Zasshi. High-dose vitamin C therapy for inclusion body myositis. Fukuoka Igaku Zasshi. 2001 Apr;92(4):99-104. 2001 Apr;92(4):99-104. Department of Neurology, Neurological Institute, Graduate School of Medical Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. yamada@neuro.med.kyushu-Sciences, Kyushu University, Fukuoka 812-8582, Japan. yamada@neuro.med.kyushu-u.ac.jp u.ac.jp

4949

Vitamin CVitamin C

• ““This acute human inflammatory This acute human inflammatory model strongly suggests that vitamin model strongly suggests that vitamin C and NAC supplementation C and NAC supplementation immediately post-injury, transiently immediately post-injury, transiently increases tissue damage and increases tissue damage and oxidative stress.”*oxidative stress.”*

*: Supplementation with vitamin C and N-acetyl-cysteine increases oxidative stress *: Supplementation with vitamin C and N-acetyl-cysteine increases oxidative stress in humans after an acute muscle injury induced by eccentric exercise.in humans after an acute muscle injury induced by eccentric exercise.Free Radic Biol Med. 2001 Sep 15;31(6):745-53. Free Radic Biol Med. 2001 Sep 15;31(6):745-53. Biochemistry of Aging Laboratory, Center for Exercice Science, College of Human Biochemistry of Aging Laboratory, Center for Exercice Science, College of Human Performance, University of Florida, Gainesville, FL 32611, USA. Performance, University of Florida, Gainesville, FL 32611, USA.

5050

Vitamin E (an anti-oxidant)Vitamin E (an anti-oxidant)

• ““Since vitamin E is a physiologic Since vitamin E is a physiologic stabilizer of cellular and lysosomal stabilizer of cellular and lysosomal membranes, and since some membranes, and since some autoimmune diseases respond to autoimmune diseases respond to vitamin E, we suggest that a relative vitamin E, we suggest that a relative deficiency of vitamin E damages deficiency of vitamin E damages lysosomal membranes, thus initiating lysosomal membranes, thus initiating the autoimmune process.”*the autoimmune process.”**: Is vitamin E involved in the autoimmune mechanism?*: Is vitamin E involved in the autoimmune mechanism?Cutis. 1978 Mar;21(3):321-5. Cutis. 1978 Mar;21(3):321-5.

5151

Vitamin EVitamin E

• ““It was concluded that treatment It was concluded that treatment with high doses of vitamin E (3200 with high doses of vitamin E (3200 IUs) was responsible for the arrest of IUs) was responsible for the arrest of the usually progressive neuropathy the usually progressive neuropathy and myopathy.”and myopathy.”Arrest of neuropathy and myopathy in abetalipoproteinemia with high-dose vitamin E Arrest of neuropathy and myopathy in abetalipoproteinemia with high-dose vitamin E therapy.therapy.Can Med Assoc J. 1985 Jan 1;132(1):41-4. Can Med Assoc J. 1985 Jan 1;132(1):41-4.

5252

Vitamin EVitamin E

• ““A 70-year-old woman with polymyositis A 70-year-old woman with polymyositis was treated with three different was treated with three different immunosuppressive drugs. Her condition immunosuppressive drugs. Her condition deteriorated over a three-month period deteriorated over a three-month period until she became totally helpless. She then until she became totally helpless. She then made a dramatic improvement when large made a dramatic improvement when large doses of vitamin E (d, alpha-tocopheryl doses of vitamin E (d, alpha-tocopheryl acetate) were administered.”acetate) were administered.”

Polymyositis: response to vitamin E.Polymyositis: response to vitamin E.South Med J. 1976 Oct;69(10):1372-4. South Med J. 1976 Oct;69(10):1372-4.

5353

EFAs (Essential fatty acids) and EFAs (Essential fatty acids) and L-Carnitine:L-Carnitine:

• ““In contrast with the reported clinical In contrast with the reported clinical improvement with high doses of improvement with high doses of essential fatty acids, our patients' essential fatty acids, our patients' clinical condition did not improve clinical condition did not improve after three months of L-carnitine after three months of L-carnitine therapy.”therapy.”Chronic fatigue syndrome: studies on skeletal muscle. Clin Neuropathol. 1992 Nov-Chronic fatigue syndrome: studies on skeletal muscle. Clin Neuropathol. 1992 Nov-Dec;11(6):329-32. Dec;11(6):329-32. Department of Internal Medicine, Hospital Clínic i Provincial, Barcelona, Spain.Department of Internal Medicine, Hospital Clínic i Provincial, Barcelona, Spain.

5454

L-Carnitine:L-Carnitine:

• ““Abnormal distribution of muscle carnitine is Abnormal distribution of muscle carnitine is present in patients with inflammatory present in patients with inflammatory myopathies and could impair muscle function. myopathies and could impair muscle function. Coexistent mitochondrial dysfunction may Coexistent mitochondrial dysfunction may contribute to carnitine insufficiency. “contribute to carnitine insufficiency. “

• So, should you supplement with L-carnitine, or So, should you supplement with L-carnitine, or should you help the mitochondrial should you help the mitochondrial dysfunction? Why mitochondrial dysfunction? dysfunction? Why mitochondrial dysfunction? Abnormal carnitine distribution in the muscles of patients with idiopathic inflammatory Abnormal carnitine distribution in the muscles of patients with idiopathic inflammatory myopathy.myopathy.Arthritis Rheum. 1996 Nov;39(11):1869-74. Arthritis Rheum. 1996 Nov;39(11):1869-74. Hospital Doce de Octubre, Madrid, Spain. Hospital Doce de Octubre, Madrid, Spain.

5555

L-carnitine:L-carnitine:

• Carnitine deficiency syndromes can be classified Carnitine deficiency syndromes can be classified into two groups: primary carnitine deficiency and into two groups: primary carnitine deficiency and secondary carnitine deficiency syndromes. A lipid secondary carnitine deficiency syndromes. A lipid storage myopathy with carnitine deficiency storage myopathy with carnitine deficiency following an immunosuppressive therapy is following an immunosuppressive therapy is described in a young man suffering from a described in a young man suffering from a possible polymyositis. After treatment with L-possible polymyositis. After treatment with L-carnitine both biochemical and morphological carnitine both biochemical and morphological features recovered. A secondary carnitine features recovered. A secondary carnitine deficiency syndrome due to an deficiency syndrome due to an immunosuppressive therapy is supposed.immunosuppressive therapy is supposed.Secondary muscular carnitine deficiency following immunosuppressive Secondary muscular carnitine deficiency following immunosuppressive treatment]treatment]Psychiatr Neurol Med Psychol (Leipz). 1989 Oct;41(10):614-20. German. Psychiatr Neurol Med Psychol (Leipz). 1989 Oct;41(10):614-20. German.

5656

CreatinCreatin

• ““Oral creatine supplements combined Oral creatine supplements combined with home exercises improve with home exercises improve functional performance without functional performance without significant adverse effects in patients significant adverse effects in patients with polymyositis or dermatomyositis. with polymyositis or dermatomyositis. They appear safe, effective, and They appear safe, effective, and inexpensive.”inexpensive.”Creatine supplements in patients with idiopathic inflammatory myopathies who are Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six-month, double-blind, clinically weak after conventional pharmacologic treatment: Six-month, double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2007 May 15;57(4):694-702. randomized, placebo-controlled trial. Arthritis Rheum. 2007 May 15;57(4):694-702.

5757

Selenium (an anti-oxidant)Selenium (an anti-oxidant)

• ““Subsequent evaluations revealed undetectable (less Subsequent evaluations revealed undetectable (less than 0.02 microgram/ml) serum and urine Se levels in than 0.02 microgram/ml) serum and urine Se levels in this patient. In addition, electromyographic evidence this patient. In addition, electromyographic evidence of of myositismyositis and nonspecific membrane irritability and nonspecific membrane irritability was documented. Therapy with oral was documented. Therapy with oral Selenium rapidly Selenium rapidly reversed her symptoms and normalized with serum reversed her symptoms and normalized with serum creatine kinase creatine kinase values over a 10-day period. values over a 10-day period. Prolonged treatment with Se was required to achieve Prolonged treatment with Se was required to achieve normal values of Se in the serum.” normal values of Se in the serum.”

Selenium responsive myositis during prolonged home Selenium responsive myositis during prolonged home total parenteral nutrition in cystic fibrosis.total parenteral nutrition in cystic fibrosis.JPEN J Parenter Enteral Nutr. 1985 Jan-Feb;9(1):58-60. JPEN J Parenter Enteral Nutr. 1985 Jan-Feb;9(1):58-60.

5858

Selenium…Selenium…

• This study was done on a 19 year old cystic This study was done on a 19 year old cystic fibrosis patient who was dependent on total fibrosis patient who was dependent on total parenteral nutrition solutions. Therefore, a parenteral nutrition solutions. Therefore, a logical conclusion to draw here is to at least logical conclusion to draw here is to at least test selenium levels in a myositis patient, test selenium levels in a myositis patient, and rule out selenium deficiency. and rule out selenium deficiency. Regardless of the results, it might be helpful Regardless of the results, it might be helpful to supplement with selenium for at least to supplement with selenium for at least some time.some time.

• Note: Selenium helps the liver. Note: Selenium helps the liver.

5959

Calcium (a mineral, not Calcium (a mineral, not vitamin)vitamin)• ““Patients with JDM may be at risk for significant Patients with JDM may be at risk for significant

loss of bone mineral associated with decreased loss of bone mineral associated with decreased calcium absorption.”calcium absorption.”Mineral metabolism in children with dermatomyositis. J Rheumatol. 1994 Mineral metabolism in children with dermatomyositis. J Rheumatol. 1994

Dec;21(12):2364-9. Dec;21(12):2364-9. Section of Pediatric Rheumatology, Baylor College of Medicine, Houston, TX. Section of Pediatric Rheumatology, Baylor College of Medicine, Houston, TX.

• Why do IDM have decreased calcium absorption? Why do IDM have decreased calcium absorption? Supplementation with calcium would probably be Supplementation with calcium would probably be helpful, but more importantly we should find out helpful, but more importantly we should find out why JDM patients have decreased calcium why JDM patients have decreased calcium absorption? The answer is most likely due to absorption? The answer is most likely due to dysbiosis dysbiosis (Refer to the “gut hypothesis section.) (Refer to the “gut hypothesis section.)

6060

What about other minerals What about other minerals (besides calcium)?(besides calcium)?

• Minerals are a fundamental Minerals are a fundamental component of nearly every biological component of nearly every biological enzyme reaction, and can be used to enzyme reaction, and can be used to activate/stimulate these enzyme activate/stimulate these enzyme reactions. Therefore, they play a reactions. Therefore, they play a critical role in health/disease. critical role in health/disease.

6161

How to activate How to activate enzymeenzyme systems in the body? Use systems in the body? Use mineralsminerals• Some of these minerals are considered Some of these minerals are considered

trace minerals, and some of these trace minerals, and some of these trace minerals can not be obtained in a trace minerals can not be obtained in a multivitamin/mineral supplement. multivitamin/mineral supplement. Example: Gold, aluminum, cobalt, etc. Example: Gold, aluminum, cobalt, etc. These rare minerals can be obtained in These rare minerals can be obtained in oligotherapy form. (Refer to future oligotherapy form. (Refer to future slides.)slides.)

6262

Various forms of minerals…Various forms of minerals…

• Four forms of mineral dosing:Four forms of mineral dosing:– Pharmacological dosesPharmacological doses– Mineral supplementation (milligrams)Mineral supplementation (milligrams)– Homeopathic doses such as ferrum Homeopathic doses such as ferrum

metallicummetallicum– Oligotherapies (or oligo elements, or Oligotherapies (or oligo elements, or

gammadyns)gammadyns)

6363

Why oligotherapy?Why oligotherapy?

• Oligotherapy can be used in Oligotherapy can be used in normalization of enzyme function. normalization of enzyme function.

• Oligotherapy uses small Oligotherapy uses small concentrations of minerals as concentrations of minerals as opposed to the more common macro opposed to the more common macro doses commonly used in nutritional doses commonly used in nutritional supplements.supplements.

6464

Why oligotherapy?Why oligotherapy?

• The concentrations are exactly equal to The concentrations are exactly equal to the level required for enzymatic activity. the level required for enzymatic activity.

• The distribution of these elements in an The distribution of these elements in an ionic solution (~12x dilution) allows ionic solution (~12x dilution) allows them to be absorbed directly into the them to be absorbed directly into the bloodstream (sublingually), and to be bloodstream (sublingually), and to be used immediately for used immediately for enzymatic/catalytic activity.enzymatic/catalytic activity.

6565

Why oligotherapy?Why oligotherapy?

• If minerals are bound to a substrate If minerals are bound to a substrate upon entering the body, as with upon entering the body, as with mineral supplementation, these mineral supplementation, these reactions occur with much more reactions occur with much more difficulty. difficulty.

6666

CAUTION:CAUTION:

• Oligotherapies can cause side effects Oligotherapies can cause side effects if you are not “prepared” to take if you are not “prepared” to take them… them…

• The preparation process involves The preparation process involves many steps that only few NDs many steps that only few NDs (naturopathic doctors) in the are (naturopathic doctors) in the are might be familiar with.might be familiar with.

6767

Why can oligotherapies cause Why can oligotherapies cause side effects?side effects?• One possible explanation: Since numerous One possible explanation: Since numerous

chemical reactions in the body can be chemical reactions in the body can be stimulated by these oligo-elements, your stimulated by these oligo-elements, your organs of elimination (liver and kidneys) organs of elimination (liver and kidneys) can become overwhelmed even if your can become overwhelmed even if your blood test for liver and kidneys are blood test for liver and kidneys are perfectly normal. Therefore, as significant perfectly normal. Therefore, as significant as this therapy might be, you need to be as this therapy might be, you need to be under the supervision of a practitioner who under the supervision of a practitioner who is well versed in prescribing oligo-is well versed in prescribing oligo-elements. Oligo-elements are widely used elements. Oligo-elements are widely used in Europe, but rarely prescribed in the U.S.in Europe, but rarely prescribed in the U.S.

6868

How much vitamins/minerals is How much vitamins/minerals is not too much? not too much?

• Try to not use a much higher dose of any of Try to not use a much higher dose of any of the vitamins/minerals than the the vitamins/minerals than the recommended daily allowances for each recommended daily allowances for each one. one.

• If you ever try a high dose of any If you ever try a high dose of any vitamin/mineral, make certain it is under a vitamin/mineral, make certain it is under a doctor’s supervision. Your physician might doctor’s supervision. Your physician might recommend a high dose regiment of various recommend a high dose regiment of various nutritional supplements, but these nutritional supplements, but these regiments are typically for a short-period of regiments are typically for a short-period of time, followed by a break. time, followed by a break.

6969

How significant are the diet How significant are the diet and supplements?and supplements?

•Very significant. However, in many Very significant. However, in many cases (in my experience), unless cases (in my experience), unless the person “optimizes” (I will the person “optimizes” (I will discuss this later in this discuss this later in this presentation) the health of the presentation) the health of the internal organs (liver, kidneys and internal organs (liver, kidneys and intestines), nutritional intestines), nutritional supplementation and dietary supplementation and dietary changes might be of limited use, if changes might be of limited use, if any. any.

7070

How significant are the diet How significant are the diet and supplements? and supplements? Continued…Continued…• In my experience, without any other In my experience, without any other

natural therapies such as herbs, natural therapies such as herbs, homeopathic medicines and homeopathic medicines and oligotherapies, diet and nutritional oligotherapies, diet and nutritional supplementation (vitamins, minerals, supplementation (vitamins, minerals, and fish oil, etc.) are often of limited and fish oil, etc.) are often of limited use (or at least very slow) in treating use (or at least very slow) in treating autoimmune conditions (especially in autoimmune conditions (especially in the more advanced cases). the more advanced cases).

7171

Is AI “caused” by poor Is AI “caused” by poor nutritional status?nutritional status?• Based on the above research, it appears that AI Based on the above research, it appears that AI

patients (myositis patients in particular) may patients (myositis patients in particular) may benefit from certain nutritional supplementations. benefit from certain nutritional supplementations. However, it does not appear that it is the low However, it does not appear that it is the low status of these nutrients that are “causing” AI. status of these nutrients that are “causing” AI. We have just found a “correlation”, versus a We have just found a “correlation”, versus a “cause and effect”. Therefore, supplementing “cause and effect”. Therefore, supplementing with these nutrients, although perhaps helpful in with these nutrients, although perhaps helpful in some cases, is most likely not going to address some cases, is most likely not going to address the underlying cause of the imbalance. To cure the underlying cause of the imbalance. To cure AI, you need to look into AND beyond nutrition. AI, you need to look into AND beyond nutrition.

7272

7373

Beyond vitamins and Beyond vitamins and minerals…minerals…

• To obtain more profound results in To obtain more profound results in the treatment of myositis (as well as the treatment of myositis (as well as other AI patients), one needs to look other AI patients), one needs to look at the underlying (or root) cause(s) of at the underlying (or root) cause(s) of the condition(s) under question. the condition(s) under question.

7474

Other “causes” of myositis?Other “causes” of myositis?

• So far we have discussed So far we have discussed mitochondrial damage in myositis. mitochondrial damage in myositis. So, is that the cause? No, that’s only So, is that the cause? No, that’s only one event in a chain of events. So, one event in a chain of events. So, are there other “causes” or are there other “causes” or “contributing factors”?“contributing factors”?

7575

NSAIDS (or NSAI) drugs NSAIDS (or NSAI) drugs causing myositis-like causing myositis-like symptoms?symptoms?• ““A dermatomyositis-like syndrome A dermatomyositis-like syndrome

developed in a patient treated with a developed in a patient treated with a nonsteroidal anti-inflammatory agent nonsteroidal anti-inflammatory agent (NSAI), niflumic acid, and regressed after (NSAI), niflumic acid, and regressed after the cessation of treatment. Previously an the cessation of treatment. Previously an eruption had occurred under treatment eruption had occurred under treatment with another NSAI, diclofenac. Our report with another NSAI, diclofenac. Our report shows that NSAI can induce not only lupus-shows that NSAI can induce not only lupus-like syndromes but also other connective like syndromes but also other connective tissue disorders.”tissue disorders.”Dermatomyositis-like syndrome induced by nonsteroidal anti-inflammatory agents.Dermatomyositis-like syndrome induced by nonsteroidal anti-inflammatory agents.Dermatologica. 1989;178(1):58-9. Dermatologica. 1989;178(1):58-9. Hôpital Ste Marguerite, Marseille, France. Hôpital Ste Marguerite, Marseille, France.

7676

NSAIDS…NSAIDS…

• Based on this study, if you take OTC (over-Based on this study, if you take OTC (over-the-counter) NSAIDS (non-steroidal anti-the-counter) NSAIDS (non-steroidal anti-inflammatory agents), such as tylenol, etc., inflammatory agents), such as tylenol, etc., for recurrent or chronic headaches and/or for recurrent or chronic headaches and/or any other type of pain, fever, etc., you might any other type of pain, fever, etc., you might develop develop symptomssymptoms of myositis or other of myositis or other connective tissue disorders. connective tissue disorders. But why? But why? Later on, we will discuss how NSAIDs can Later on, we will discuss how NSAIDs can cause “dysbiosis” (and dysbiosis can cause cause “dysbiosis” (and dysbiosis can cause AI), and that may be how NSAISDs can play a AI), and that may be how NSAISDs can play a role in causing myositis. role in causing myositis.

7777

Do not casually stop a fever Do not casually stop a fever unless it is life-threatening…unless it is life-threatening…• Taking Tylenol can lower your fever. Sometimes, that Taking Tylenol can lower your fever. Sometimes, that

is definitely necessary. However, lowering a fever can is definitely necessary. However, lowering a fever can interfere with your immune system. Fever is your interfere with your immune system. Fever is your immune system’s way of fighting with these infectious immune system’s way of fighting with these infectious agents. You suppress the fever, and these infectious agents. You suppress the fever, and these infectious agents may stay in your muscles. All natural medicines agents may stay in your muscles. All natural medicines healing modalities (modern naturopathic medicine, healing modalities (modern naturopathic medicine, Chinese medicine, ayervedic (Indian) medicine, unani Chinese medicine, ayervedic (Indian) medicine, unani medicine, etc) welcome a fever! Be careful in infants, medicine, etc) welcome a fever! Be careful in infants, of course, due to possibility of febrile seizures. of course, due to possibility of febrile seizures.

• How high is considered high fever? This varies case by How high is considered high fever? This varies case by case. Consult with your physician. The adult body case. Consult with your physician. The adult body temperature can safely go up to 103 without causing temperature can safely go up to 103 without causing any problems. Children can safely go up to 102 without any problems. Children can safely go up to 102 without causing any problems.causing any problems.

7878

Fever…Fever…

• You can hold a fever from going up by You can hold a fever from going up by applying cold water onto the legs or the rest of applying cold water onto the legs or the rest of the body- that would be OK. Just don’t the body- that would be OK. Just don’t eliminate a fever, or try to reduce it eliminate a fever, or try to reduce it significantly by over-the-counter drugs unless significantly by over-the-counter drugs unless the fever is “too” high. the fever is “too” high.

• Remember that a high fever can be dangerous Remember that a high fever can be dangerous by itself, therefore, refer to a physician if you by itself, therefore, refer to a physician if you ever have a fever. Share your desire to want ever have a fever. Share your desire to want to avoid fever drugs, and find out if it is safe to avoid fever drugs, and find out if it is safe for you (or your children) to avoid the anti-for you (or your children) to avoid the anti-fever drugs at the time you are being seen. fever drugs at the time you are being seen.

7979

Other “causes”?Other “causes”?Statin drugs and myositis?Statin drugs and myositis?• ““Statin-related skeletal muscle disorders Statin-related skeletal muscle disorders

range from benign myalgias--such as non-range from benign myalgias--such as non-specific muscle aches or joint pains specific muscle aches or joint pains without elevated serum creatinine kinase without elevated serum creatinine kinase (CK) concentration--to true myositis with (CK) concentration--to true myositis with >10-fold elevation of serum CK, to >10-fold elevation of serum CK, to rhabdomyolysis and myoglobinuria.”rhabdomyolysis and myoglobinuria.”

Genetic determinants of statin intolerance. Genetic determinants of statin intolerance. Lipids Health Dis. 2007 Mar 21;6:7 Lipids Health Dis. 2007 Mar 21;6:7 Schulich School of Medicine and Dentistry, University of Western Ontario Schulich School of Medicine and Dentistry, University of Western Ontario and Vascular Biology Research Group, Robarts Research Institute, London, and Vascular Biology Research Group, Robarts Research Institute, London, Ontario, Canada. jisun.oh@utoronto.caOntario, Canada. jisun.oh@utoronto.ca

8080

Rhabdomyolysis versus Rhabdomyolysis versus myositis:myositis:

• Rhabdomyolysis is a known potential Rhabdomyolysis is a known potential side effect of statin drugs. side effect of statin drugs. Rhabdomyolysis is a serious type of Rhabdomyolysis is a serious type of myotoxicity (muscular toxicity), and myotoxicity (muscular toxicity), and should not be confused with should not be confused with “myositis”. “myositis”.

8181

Statin drugs Statin drugs myositis? myositis?

• ““Statins, with or without fibrates, and Statins, with or without fibrates, and liverliver and and renal diseaserenal disease were were significantly associated with significantly associated with increased myositis risk in an MCO increased myositis risk in an MCO (managed care organization) (managed care organization) population.”population.”

Statin and statin-fibrate use was significantly associated with increased myositis risk Statin and statin-fibrate use was significantly associated with increased myositis risk in a managed care population.in a managed care population.J Clin Epidemiol. 2007 Aug;60(8):812-8. Epub 2007 Mar 26. J Clin Epidemiol. 2007 Aug;60(8):812-8. Epub 2007 Mar 26. Clinical Research Unit, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA. Clinical Research Unit, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA. david.1.mcclure@kp.orgdavid.1.mcclure@kp.org

8282

Prevention is the key!Prevention is the key!

• Prevention is one of the most important Prevention is one of the most important fundamentals of natural and time-honored fundamentals of natural and time-honored paths. paths.

• Statin drugs are incredibly helpful in Statin drugs are incredibly helpful in reducing cholesterol levels in the blood, reducing cholesterol levels in the blood, thereby potentially reducing risk of thereby potentially reducing risk of cardiovascular events. However, if statin cardiovascular events. However, if statin drugs are potentially dangerous for the drugs are potentially dangerous for the health of the muscles, then perhaps we health of the muscles, then perhaps we should explore alternative therapies for should explore alternative therapies for cholesterol management and control. cholesterol management and control.

8383

8484

Another “cause”?Another “cause”?Infections (germs or microbes) Infections (germs or microbes) myositis? myositis?

““The study of animal models has The study of animal models has clearly shown that infections may clearly shown that infections may trigger autoimmune diseases.”trigger autoimmune diseases.”

Infections and autoimmune diseases.Infections and autoimmune diseases.J Autoimmun. 2005;25 Suppl:74-80. Epub 2005 Nov 8. Review. J Autoimmun. 2005;25 Suppl:74-80. Epub 2005 Nov 8. Review. Laboratoire d'Immunologie, Hôpital Necker, 161 rue de Sèvres, 75743 Paris Cedex Laboratoire d'Immunologie, Hôpital Necker, 161 rue de Sèvres, 75743 Paris Cedex 15, France. bach@necker.fr15, France. bach@necker.fr

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What are the various types of What are the various types of germs that can cause germs that can cause myositis? And, where do they myositis? And, where do they cause havoc?cause havoc?

• These germs can be bacteria, yeasts, These germs can be bacteria, yeasts, viruses, and parasites. viruses, and parasites.

• It is proposed that these germs reside It is proposed that these germs reside in the small intestine, and it in the gut in the small intestine, and it in the gut that they start a series of undesirable that they start a series of undesirable events leading to AI disease. (Refer to events leading to AI disease. (Refer to the section on “the Gut Hypothesis”.)the section on “the Gut Hypothesis”.)

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How are these germs (or their How are these germs (or their toxic by-products) getting into toxic by-products) getting into our blood?our blood?

• Through the lining in our small Through the lining in our small intestine. (Refer to the slides on intestine. (Refer to the slides on Dysbiosis, coming up later.)Dysbiosis, coming up later.)

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Germs Germs myositis? myositis?

• ““Although direct evidence for this association is still lacking, Although direct evidence for this association is still lacking, numerous data from animal models as well as from humans numerous data from animal models as well as from humans support the hypothesis of a direct contribution of pathogens support the hypothesis of a direct contribution of pathogens to the induction of several autoimmune diseases. This to the induction of several autoimmune diseases. This review focused on the possible role of infectious agents as review focused on the possible role of infectious agents as triggers of autoimmunity in polymyositis (PM) and triggers of autoimmunity in polymyositis (PM) and dermatomyositis (DM).”dermatomyositis (DM).”

Polymyositis-dermatomyositis and infections.Polymyositis-dermatomyositis and infections.Autoimmunity. 2006 May;39(3):191-6. Review. Autoimmunity. 2006 May;39(3):191-6. Review. University of Padova, Division of Rheumatology, Department of Clinical and University of Padova, Division of Rheumatology, Department of Clinical and Experimental Medicine, Italy.Experimental Medicine, Italy.

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Germs Germs myositis? But, what myositis? But, what about “infectious myositis”?about “infectious myositis”?

• Various germs in the gut can disturb Various germs in the gut can disturb the immune system, and result in the immune system, and result in inflammation in the gut and AI (Refer inflammation in the gut and AI (Refer to the section in this presentation on to the section in this presentation on “the Gut Hypothesis”.) However, this “the Gut Hypothesis”.) However, this is is notnot to be confused with to be confused with ““infectious myositisinfectious myositis” where often ” where often the infectious agents are localized in the infectious agents are localized in the tissue- this can be very serious. the tissue- this can be very serious.

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Germs Germs myositis? myositis?

• ““Parasites and bacteria are associated Parasites and bacteria are associated with polymyositis. These include parasitic with polymyositis. These include parasitic protozoa, cystodes and nematodes.”protozoa, cystodes and nematodes.”

• ““Some viruses have been proposed to be Some viruses have been proposed to be associated with various forms of associated with various forms of myositis.”myositis.”

– Source is unknown. Source is unknown.

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Viruses Viruses myositis? myositis?

• Viruses are a type of germ.Viruses are a type of germ.

• ““We report a case of profound subacute We report a case of profound subacute polymyositis following serologically confirmed polymyositis following serologically confirmed infection by respiratory syncytial virus (RSV).”infection by respiratory syncytial virus (RSV).”

Steroid-responsive subacute polymyositis in an adult following respiratory syncytial virus Steroid-responsive subacute polymyositis in an adult following respiratory syncytial virus infection.infection.Int J Clin Pract. 2006 Jan;60(1):93-4. Int J Clin Pract. 2006 Jan;60(1):93-4. Department of Medicine, Poole Hospital, Dorset, UK. Department of Medicine, Poole Hospital, Dorset, UK.

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Problems with the “germs Problems with the “germs leading to myositis” theory:leading to myositis” theory:

• Sometimes it is years after being Sometimes it is years after being exposed to an infectious agent that exposed to an infectious agent that the person develops symptoms the person develops symptoms and/or gets diagnosed with myositis. and/or gets diagnosed with myositis.

• A lot of these germs (infectious A lot of these germs (infectious agents) are not totally known yet. agents) are not totally known yet.

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The Gut Hypothesis- The Gut Hypothesis- DysbiosisDysbiosis•Based on research, we are finding Based on research, we are finding

out that AI disease is considered an out that AI disease is considered an Entero-Metabolic disorder Entero-Metabolic disorder (otherwise known as “dysbiosis” or (otherwise known as “dysbiosis” or “leaky gut”). “leaky gut”).

• In other words, an In other words, an “immunocompromised” gut is “immunocompromised” gut is thought to be at the root of the thought to be at the root of the suppressed immune system in AI suppressed immune system in AI patients. patients.

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Dysbiosis- An imbalanced Dysbiosis- An imbalanced gut…gut…

• Lack of proper intestinal health, Lack of proper intestinal health, meaning not having enough good & meaning not having enough good & friendly bacteria (acidophilus or friendly bacteria (acidophilus or probiotics) and, instead, having too probiotics) and, instead, having too many unfriendly organisms many unfriendly organisms (unfriendly and harmful bacteria, (unfriendly and harmful bacteria, yeasts (candida), parasites and yeasts (candida), parasites and viruses). viruses).

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Who is Dr. Russell Jaffe, MD, Who is Dr. Russell Jaffe, MD, PhD?PhD?• Dr. Russell Jaffe, MD, PhD, was named an Dr. Russell Jaffe, MD, PhD, was named an

International Scientist of the YearInternational Scientist of the Year (2003) by the International Biographical (2003) by the International Biographical Commission (IBC) of Cambridge, England. Commission (IBC) of Cambridge, England. The IBC is the world’s oldest and The IBC is the world’s oldest and acclaimed “who’s who” scientist acclaimed “who’s who” scientist recognition society. Dr. Jaffe is one of just recognition society. Dr. Jaffe is one of just 200 scientists in the world to receive this 200 scientists in the world to receive this honor. honor.

• Dr. Jaffe’s work focuses on addressing the Dr. Jaffe’s work focuses on addressing the underlying, individual underlying, individual CAUSESCAUSES rather than rather than symptomatic relief. symptomatic relief.

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More on Dr. Jaffe…More on Dr. Jaffe…

• ““Russell Jaffe’s visionary advances in the Russell Jaffe’s visionary advances in the fields of biochemistry and clinical fields of biochemistry and clinical immunology have revolutionized how immunology have revolutionized how physicians and health care professionals physicians and health care professionals successfully treat autoimmune and immune successfully treat autoimmune and immune dysfunction conditions,” said Dr. Robert dysfunction conditions,” said Dr. Robert Pumphrey, MD, Associate Clinical Lab Pumphrey, MD, Associate Clinical Lab Director of ELISA/ACT Biotechnologies LLC. Director of ELISA/ACT Biotechnologies LLC.

• Let’s examine Dr. Jaffe’s article. Let’s examine Dr. Jaffe’s article.

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Dr. Jaffe’s article on Dr. Jaffe’s article on Dysbiosis:Dysbiosis:• ““Maldigestion (incomplete of breakdown of food Maldigestion (incomplete of breakdown of food

ingested) and dysbiosis (unhealthy composition of ingested) and dysbiosis (unhealthy composition of microorganisms in the intestine) can generate microorganisms in the intestine) can generate appreciable quantities of immune reactive and appreciable quantities of immune reactive and health-diminishing digestive remnants and health-diminishing digestive remnants and pathogen products. These products can pathogen products. These products can penetrate the intestinal mucosal barrier, penetrate the intestinal mucosal barrier, particularly if it is more permeable due to particularly if it is more permeable due to cumulative repair deficits.” cumulative repair deficits.” Next slide…Next slide…

*: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management *: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD. by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD. (The references for this article are close to 200.)(The references for this article are close to 200.)

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Dr. Jaffe’s article on Dr. Jaffe’s article on Dysbiosis:Dysbiosis:• ““Immune reactive digestive remnants exceed the mucosal Immune reactive digestive remnants exceed the mucosal

lymphoid tissues ability to trap them. Digestive remnants, lymphoid tissues ability to trap them. Digestive remnants, as foreign (immune reactive) burdens, drain immune as foreign (immune reactive) burdens, drain immune reserves, increase immune defense work, and delay or reserves, increase immune defense work, and delay or defer needed repair from routine “wear and tear” or injury. defer needed repair from routine “wear and tear” or injury. These immune reactive foreign “invaders” can enter These immune reactive foreign “invaders” can enter systemic circulation where they provoke or make worse systemic circulation where they provoke or make worse symptoms of ill health because of compromise and symptoms of ill health because of compromise and impairment in innate immune defense and repair impairment in innate immune defense and repair mechanisms.”mechanisms.”

• ““This renders us open to autoimmune or immune This renders us open to autoimmune or immune dysfunction conditions.”dysfunction conditions.”

• Next slide…Next slide…

*: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management *: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD. by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD.

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Dr. Jaffe’s article on Dr. Jaffe’s article on Dysbiosis:Dysbiosis:• ““When our lines of defense are overwhelmed, When our lines of defense are overwhelmed,

excess immune reactive digestive debris or excess immune reactive digestive debris or infectious agents may gain access to the infectious agents may gain access to the lymphatic circulation. Subsequently, as the lymphatic circulation. Subsequently, as the lymph fluid is returned to the flowing blood lymph fluid is returned to the flowing blood through the thoracic duct, immunoreactive through the thoracic duct, immunoreactive materials may gain access to the systemic materials may gain access to the systemic circulation.” circulation.”

• Next slide… Next slide…

*: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management *: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD. by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD.

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Dysbiosis: (How does Dysbiosis: (How does dysbiosis affect so many dysbiosis affect so many different AI diseases?)different AI diseases?)• ““From there, a tissue or organ with From there, a tissue or organ with

increased permeabilityincreased permeability (repair deficit; (repair deficit; inflammation) may become the focus for inflammation) may become the focus for delayed immune reactions and delayed immune reactions and lymphocytic infiltrationlymphocytic infiltration. Consequences . Consequences of this include swelling, pain, and of this include swelling, pain, and autoimmune syndromesautoimmune syndromes.”.”

*: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease *: “First line Comprehensive Care. Part I: Chronic Autoimmune Disease Management by Causes Rather than Symptomatic Consequences”, by Dr. Management by Causes Rather than Symptomatic Consequences”, by Dr. Russell Jaffe, MD, PhD. Russell Jaffe, MD, PhD.

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Summary: Dysbiosis Summary: Dysbiosis All All AIAI• In other words, it appears that the root cause of AI In other words, it appears that the root cause of AI

disease (regardless of the site of disease- muscles disease (regardless of the site of disease- muscles and skin in myositis, nerves in MS, joints in arthritis, and skin in myositis, nerves in MS, joints in arthritis, etc.) is in the intestines. etc.) is in the intestines.

• Therefore, to cure AI disease, you must cure Therefore, to cure AI disease, you must cure the dysbiosis. (Remember, treat the cause…)the dysbiosis. (Remember, treat the cause…)

• There are potentially other factors that can cause AI There are potentially other factors that can cause AI disease, or at least contribute to worsening of the disease, or at least contribute to worsening of the symptoms. However, based on my experience, symptoms. However, based on my experience, treating the dysbiosis appears to be the most treating the dysbiosis appears to be the most critical step in stopping and, in most cases, critical step in stopping and, in most cases, reversing the AI disease. reversing the AI disease.

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Another article on Another article on Dysbiosis:Dysbiosis:

• The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; Jeffrey The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; Jeffrey Bland, PhD. Bland, PhD.

• Read on…Read on…

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Dr. Kaminski’s article on dysbiosis…Dr. Kaminski’s article on dysbiosis…

• ““It is in the It is in the small intestinesmall intestine that the that the majority of exchanges occur between majority of exchanges occur between intestinal contents, the mucoa, the lamina intestinal contents, the mucoa, the lamina propria, and the gut-associated lymphoid propria, and the gut-associated lymphoid tissue (tissue (GALTGALT). The GALT is comprised of ). The GALT is comprised of several times more immune cell elements several times more immune cell elements than the bone marrow, spleen, and lymph than the bone marrow, spleen, and lymph nodes combined.” *nodes combined.” *

*: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” by Mitchell *: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-C. Journal: “Alternative Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-C. Journal: “Alternative Medicine Review”, Volume 3, Number 1. Publisher, Thorne Research, Inc. 1998. Medicine Review”, Volume 3, Number 1. Publisher, Thorne Research, Inc. 1998.

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Dr. Kaminski’s article on dysbiosis…Dr. Kaminski’s article on dysbiosis…

• ““Intestinal microbes are sampled in the Peyer’s patch Intestinal microbes are sampled in the Peyer’s patch (lymphatic tissue in the intestinal wall) and (lymphatic tissue in the intestinal wall) and inactivated by macrophages (a type of immune cells). inactivated by macrophages (a type of immune cells).

• Next, T cells identify the foreign organisms (germs) in Next, T cells identify the foreign organisms (germs) in the gut. the gut.

• This information is then passed to the B-cell This information is then passed to the B-cell lymphocytes. lymphocytes.

• With this information for antibody (antibodies fight With this information for antibody (antibodies fight against foreign things in the body) production, the B-against foreign things in the body) production, the B-cells leave the Peyer’s patch, become plasma cells, cells leave the Peyer’s patch, become plasma cells, and migrate to various tissues throughout the body and migrate to various tissues throughout the body that have moist mucosal surfaces, and back to the that have moist mucosal surfaces, and back to the intestinal lymphoid tissue.” intestinal lymphoid tissue.”

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Dr. Kaminski’s article on dysbiosis…Dr. Kaminski’s article on dysbiosis…

• ““From here, sIgA is secreted onto the mucosal surface to From here, sIgA is secreted onto the mucosal surface to protect the mucosa from adhesion by specific microbes in protect the mucosa from adhesion by specific microbes in the gut. the gut.

• If there is no adhesion (if the germs do not adhere to the If there is no adhesion (if the germs do not adhere to the gut mucosal surfaces), then there is no inflammation, and gut mucosal surfaces), then there is no inflammation, and with no inflammation, there is no TNF (tumor necrosis with no inflammation, there is no TNF (tumor necrosis factor) production or subsequent “leaky gut”. (Therefore, factor) production or subsequent “leaky gut”. (Therefore, adhesion of germs or their toxic by-products onto the adhesion of germs or their toxic by-products onto the mucosal surfaces can cause inflammation in the gut, mucosal surfaces can cause inflammation in the gut, leading to “leaky gut”.)leading to “leaky gut”.)

• The antibody-antigen complex is eventually expelled from The antibody-antigen complex is eventually expelled from the GI tract. the GI tract.

• This precise immunologic activity is known as the specific This precise immunologic activity is known as the specific immunity of the gut.”immunity of the gut.”

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Dr. Kaminski’s article on dysbiosis…Dr. Kaminski’s article on dysbiosis…

• ““With the gut compromised, there is adhesion of With the gut compromised, there is adhesion of previously harmless but potentially toxic previously harmless but potentially toxic organisms to the mucosa with ensuing organisms to the mucosa with ensuing inflammation.” *inflammation.” *

• What happens to the foreign organisms (or their What happens to the foreign organisms (or their toxic by-products) in the gut if they happen to toxic by-products) in the gut if they happen to successfully adhere to the mucosal surfaces? successfully adhere to the mucosal surfaces?

• They cross into the circulation, and end up in They cross into the circulation, and end up in various tissues (muscles/skin, etc.) and liver- various tissues (muscles/skin, etc.) and liver- Thus, overloading the liver. Thus, overloading the liver.

*: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut *: to “AIDS Wasting Syndrome as an Entero-Metabolic Disorder: The Gut Hypothesis” by Mitchell Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; Hypothesis” by Mitchell Kaminski, Jr., MD; Steven Weil, DN, Jeffrey Bland, PhD; and Pat Jan, PA-C. Journal: “Alternative Medicine Review”, Volume 3, Number 1. and Pat Jan, PA-C. Journal: “Alternative Medicine Review”, Volume 3, Number 1. Publisher, Thorne Research, Inc. 1998. Publisher, Thorne Research, Inc. 1998.

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***Dysbiosis cascade******Dysbiosis cascade***

• Intestinal microbes Intestinal microbes T cells T cells B B cells cells plasma cells plasma cells sIgA (if not sIgA (if not sufficient sufficient adhesion of microbes to adhesion of microbes to the mucosal surfaces in gut the mucosal surfaces in gut Inflammation Inflammation TNF-Alpha TNF-Alpha production production Leaky gut (dysbiosis) Leaky gut (dysbiosis) AI disease AI disease

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Where do you want to Where do you want to intervene in this cascade?intervene in this cascade?• Therapies can be directed at various points in Therapies can be directed at various points in

this cascade of events. You can choose this cascade of events. You can choose amongst these therapies:amongst these therapies:

I)I) Anti-microbials to eliminate the germs in the intestines Anti-microbials to eliminate the germs in the intestines (There are a number of natural antimicrobials we (There are a number of natural antimicrobials we safely and effectively use for this purpose. There are safely and effectively use for this purpose. There are no known drugs for treatment of dysbiosis.)no known drugs for treatment of dysbiosis.)

II)II) Anti-B or T cell drugs (No natural medicines, to my Anti-B or T cell drugs (No natural medicines, to my knowledge, can do this.)knowledge, can do this.)

III)III) Anti-TNF drugs (No natural medicines, to my Anti-TNF drugs (No natural medicines, to my knowledge, can do this.)knowledge, can do this.)

IV)IV) Immunoglobulin therapies (No natural medicines for Immunoglobulin therapies (No natural medicines for this)this)

V)V) Anti-inflammatory drugs or herbs (Of course, the Anti-inflammatory drugs or herbs (Of course, the drugs- steroids- are more powerful)drugs- steroids- are more powerful)

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What are some other What are some other important potential important potential contributing factors to AI?contributing factors to AI?• Disease in liver and kidneys, OR evenDisease in liver and kidneys, OR even

• Lack of optimal functioning of liver Lack of optimal functioning of liver and kidneys (This is much more and kidneys (This is much more frequently the problem.) frequently the problem.)

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Autoimmune Disease- A disorder of Autoimmune Disease- A disorder of ““sub-optimalsub-optimal” functioning internal ” functioning internal organs?organs?

• Our internal organs simply need a Our internal organs simply need a “tune up” just like an automobile “tune up” just like an automobile does. We give a “tune up” to our does. We give a “tune up” to our automobile every three months or automobile every three months or every 3000 miles. How often do we every 3000 miles. How often do we give ourselves a tune up? What does give ourselves a tune up? What does that even mean? that even mean?

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Role of the liver in the Role of the liver in the body…body…• Intestinal toxins are detoxified by the Phase Intestinal toxins are detoxified by the Phase

I (cytochrome p450) and Phase II pathways I (cytochrome p450) and Phase II pathways of the liver. of the liver.

• The liver has several hundred functions in The liver has several hundred functions in the body, one of the main functions being the body, one of the main functions being “detoxification”, and the next most “detoxification”, and the next most important function is to process your important function is to process your digested foods (absorbed from your digested foods (absorbed from your intestines which end up in your liver for intestines which end up in your liver for processing). processing).

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A vicious cycle:A vicious cycle:

• Dysbiosis in the intestines can Dysbiosis in the intestines can overwhelm the liver. And, liver being overwhelm the liver. And, liver being overwhelmed will, in turn, not overwhelmed will, in turn, not support and can in fact harm a support and can in fact harm a dysbiotic small intestine.dysbiotic small intestine.

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More on the connection More on the connection between the liver and the gut:between the liver and the gut:• ““Leaky gut syndrome (dysbiosis) puts an extra burden on Leaky gut syndrome (dysbiosis) puts an extra burden on

the liver because it allows extra toxins to circulate through the liver because it allows extra toxins to circulate through the bloodstream. And when the liver is bombarded by the bloodstream. And when the liver is bombarded by inflammatory irritants from incomplete digestion, it has less inflammatory irritants from incomplete digestion, it has less energy to neutralize chemical substances. energy to neutralize chemical substances.

• Therefore, it is essential to help the liver in every way Therefore, it is essential to help the liver in every way possible to reduce the total body load of toxins so that it possible to reduce the total body load of toxins so that it can work efficiently and effectively.” *can work efficiently and effectively.” *

• There are numerous natural compounds/medicines that can There are numerous natural compounds/medicines that can help the liver with its day-to-day functions of detoxification help the liver with its day-to-day functions of detoxification and food processing. and food processing.

* “Leaky Gut Syndrome” , Elizabeth Lipski, M.S., C.C.N.* “Leaky Gut Syndrome” , Elizabeth Lipski, M.S., C.C.N.

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Liver/kidney involvement in Liver/kidney involvement in myositis?myositis?

• ““Statins, with or without fibrates, and Statins, with or without fibrates, and liverliver and and renal diseaserenal disease were were significantly associated with significantly associated with increased myositis risk in an MCO increased myositis risk in an MCO (managed care organization) (managed care organization) population.”population.”

Statin and statin-fibrate use was significantly associated with increased myositis risk Statin and statin-fibrate use was significantly associated with increased myositis risk in a managed care population.in a managed care population.J Clin Epidemiol. 2007 Aug;60(8):812-8. Epub 2007 Mar 26. J Clin Epidemiol. 2007 Aug;60(8):812-8. Epub 2007 Mar 26. Clinical Research Unit, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA. Clinical Research Unit, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA. david.1.mcclure@kp.orgdavid.1.mcclure@kp.org

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Renal involvement in Renal involvement in myositis?myositis?• In the past (article below is from 1987), we In the past (article below is from 1987), we

used to believe that “Renal involvement is used to believe that “Renal involvement is usually considered to be rare in usually considered to be rare in dermatomyositis and polymyositis.”* dermatomyositis and polymyositis.”* However, over time, research appears to be However, over time, research appears to be showing a relationship between the kidneys showing a relationship between the kidneys and myositis (Refer to next slide.)and myositis (Refer to next slide.)

*: *: Renal manifestations in dermatomyositis and polymyositis]Renal manifestations in dermatomyositis and polymyositis]

Ann Med Interne (Paris). 1987;138(2):109-13. French. Ann Med Interne (Paris). 1987;138(2):109-13. French.

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Renal involvement in Renal involvement in myositis?myositis?

• In 2005, researchers report:In 2005, researchers report:

• ““We, therefore, concluded that renal We, therefore, concluded that renal involvement in PM/DM patients is not involvement in PM/DM patients is not as uncommon as previously as uncommon as previously thought.”thought.”

Renal involvement in patients with polymyositis and dermatomyositis.Renal involvement in patients with polymyositis and dermatomyositis.Int J Clin Pract. 2005 Feb;59(2):188-93. Int J Clin Pract. 2005 Feb;59(2):188-93. Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.

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Renal involvement in Renal involvement in myositis?myositis?

• ““Dermatomyositis associated with Dermatomyositis associated with genitourinary malignancies is not genitourinary malignancies is not uncommon.”uncommon.”

Dermatomyositis associated with bilateral ureteral spontaneous rupture.Dermatomyositis associated with bilateral ureteral spontaneous rupture.J Formos Med Assoc. 2007 Mar;106(3):251-4. J Formos Med Assoc. 2007 Mar;106(3):251-4.

Department of Urology, National Taiwan University Hospital, Taipei, Taiwan. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.

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Renal involvement in Renal involvement in myositis?myositis?• ““Adult-onset dermatomyositis is often Adult-onset dermatomyositis is often

associated with internal malignancy. We associated with internal malignancy. We report a case of dermatomyositis report a case of dermatomyositis associated with an aggressive and fatal associated with an aggressive and fatal case of transitional cell carcinoma of the case of transitional cell carcinoma of the bladder.”bladder.”

Fatal bladder cancer and dermatomyositis.Fatal bladder cancer and dermatomyositis.South Med J. 2000 May;93(5):492-3. South Med J. 2000 May;93(5):492-3. Department of Dermatology, Yale University School of Medicine, New Haven, Conn, Department of Dermatology, Yale University School of Medicine, New Haven, Conn, USA.USA.

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Renal involvement in Renal involvement in myositis?myositis?

• ““The mechanism underlying the The mechanism underlying the association between myositis and association between myositis and glomerulonephritis remains to be glomerulonephritis remains to be elucidated.”elucidated.”

Polymyositis associated with focal mesangial proliferative glomerulonephritis with Polymyositis associated with focal mesangial proliferative glomerulonephritis with

depositions of immune complexes.depositions of immune complexes.Clin Rheumatol. 2007 May;26(5):792-6. Epub 2006 Mar 16. Clin Rheumatol. 2007 May;26(5):792-6. Epub 2006 Mar 16. Department of Allergy and Rheumatology, University of Tokyo, 7-3-1 Hongo, Tokyo, Department of Allergy and Rheumatology, University of Tokyo, 7-3-1 Hongo, Tokyo, 113-8655, Japan.113-8655, Japan.

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Specific tests for AI:Specific tests for AI:

A lot of AI diseases have a specific A lot of AI diseases have a specific marker in the blood that can be marker in the blood that can be tested for:tested for:

Examples:Examples:

Myositis: Myositis: CPKCPKRheumatoid Arthritis: RF Rheumatoid Arthritis: RF

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Important non-specific tests for Important non-specific tests for AI:AI:• Blood tests: CBC, liver and kidney function tests, lipid (cholesterol) Blood tests: CBC, liver and kidney function tests, lipid (cholesterol)

profile, vit D levels. profile, vit D levels. IgG food allergy testing. IgG food allergy testing. • Urine test: A U/A (urinanalysis) testUrine test: A U/A (urinanalysis) test• Salivary test: s-IgA (Secretory IgA) which is considered to be an Salivary test: s-IgA (Secretory IgA) which is considered to be an

indirect measurement of intestinal health. This is not a conventional indirect measurement of intestinal health. This is not a conventional test. test.

• Abdominal and kidney ultrasound (to look for abnormal benign Abdominal and kidney ultrasound (to look for abnormal benign masses and/or stones). Order CT/MRI if needed. Examples:masses and/or stones). Order CT/MRI if needed. Examples:

• A benign mass in the kidneys- This indicates poor kidney function.A benign mass in the kidneys- This indicates poor kidney function.• Papillary necrosis (in kidneys) is not normal, but not considered serious enough Papillary necrosis (in kidneys) is not normal, but not considered serious enough

to be treated, so “watch and wait” is recommended. to be treated, so “watch and wait” is recommended. • Kidney stones- This indicates poor kidney function.Kidney stones- This indicates poor kidney function.• ““sludge” or polyps in the gall bladder are usually considered insignificant and sludge” or polyps in the gall bladder are usually considered insignificant and

there is no drugs prescribed for these conditions, but these indicate poor liver there is no drugs prescribed for these conditions, but these indicate poor liver function. function.

• A benign mass in the liver- This indicates poor liver function. A benign mass in the liver- This indicates poor liver function. • Gall bladder stones- This indicates poor liver function. Gall bladder stones- This indicates poor liver function.

(I routinely order all the above tests for ALL patients.)(I routinely order all the above tests for ALL patients.)

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Specific tests I look for in the Specific tests I look for in the blood for cues:blood for cues:

• Indicators for abnormal liver function:Indicators for abnormal liver function:– Abnormal values for total protein, bilirubin, Abnormal values for total protein, bilirubin,

albumin, globulin, high or low cholesterol, high albumin, globulin, high or low cholesterol, high TGs, low Vit D levels, etc.TGs, low Vit D levels, etc.

• Indicators for abnormal kidney function:Indicators for abnormal kidney function:– Abnormal values for BUN, Creatinine, and GFR. Abnormal values for BUN, Creatinine, and GFR. – Abnormal urine test results, including Abnormal urine test results, including

extremely low or high specific gravity, bacteria extremely low or high specific gravity, bacteria and WBC in the urine, protein or glucose in the and WBC in the urine, protein or glucose in the urine, crystals/casts in the urine. urine, crystals/casts in the urine.

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Does suboptimal liver show up Does suboptimal liver show up on a blood test?on a blood test?

• Can the Can the liverliver overload be detected on a blood overload be detected on a blood test? Unless the patient has severe liver test? Unless the patient has severe liver disturbance as in the case of hepatitis, disturbance as in the case of hepatitis, alcoholism, etc, the blood liver function tests alcoholism, etc, the blood liver function tests do not become abnormal. Therefore, this do not become abnormal. Therefore, this phenomenon can go totally undetected. phenomenon can go totally undetected.

• There are times, when subtle abnormalities There are times, when subtle abnormalities can be detected, but there are typically no can be detected, but there are typically no drugs to address such issues. Example, drugs to address such issues. Example, slightly elevated bilirubin, albumin, liver slightly elevated bilirubin, albumin, liver enzymes, etc. enzymes, etc.

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Symptoms pointing to sub-Symptoms pointing to sub-optimal functioning LIVER:optimal functioning LIVER:

– Any and all GI symptoms, including:Any and all GI symptoms, including:• Acid reflux (burping)Acid reflux (burping)

• Abdominal discomfort/painAbdominal discomfort/pain

• Pain over liver/gall bladder areaPain over liver/gall bladder area

• Gas and bloatingGas and bloating

• Constipation or diarrheaConstipation or diarrhea

– Multiple chemical sensitivityMultiple chemical sensitivity– Easy bruisingEasy bruising– Too many food allergiesToo many food allergies– Itching, etc.Itching, etc.

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Symptoms pointing to sub-Symptoms pointing to sub-optimal functioning optimal functioning INTESTINES:INTESTINES:

– Sometimes, no immediate GI (gastrointestinal) Sometimes, no immediate GI (gastrointestinal) symptoms are present even in a suboptimally symptoms are present even in a suboptimally functioning intestinal tract. functioning intestinal tract.

– Any and all GI symptoms, including:Any and all GI symptoms, including:• Acid reflux (burping and/or sensation of acid in Acid reflux (burping and/or sensation of acid in

esophagus)esophagus)• Abdominal (intestinal) discomfort/painAbdominal (intestinal) discomfort/pain• Pain over liver/gall bladder areaPain over liver/gall bladder area

– Liver imbalance can lead to intestinal imbalance and vice Liver imbalance can lead to intestinal imbalance and vice versa.versa.

• Gas and bloatingGas and bloating• Constipation or diarrheaConstipation or diarrhea

– Too many food allergiesToo many food allergies

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Symptoms pointing to sub-Symptoms pointing to sub-optimal functioning KIDNEYS:optimal functioning KIDNEYS:

– Frequent urination and burning with urination Frequent urination and burning with urination WITHOUT actually having a UTI (urinary tract WITHOUT actually having a UTI (urinary tract infection)infection)

– Acute UTI, or low-grade chronic UTIAcute UTI, or low-grade chronic UTI– Active acute kidney stones, or history of it.Active acute kidney stones, or history of it.– Pain over kidneysPain over kidneys– ItchingItching– Abnormal skin colorAbnormal skin color– Edema (water retention)Edema (water retention)– Etc.Etc.

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Example on how to find the Example on how to find the suboptimal organs using a suboptimal organs using a regular blood &/or urine test…regular blood &/or urine test…

• Please refer to the notes on “Please refer to the notes on “how how lab values can lead us to the lab values can lead us to the suboptimal functioning organs?”suboptimal functioning organs?”. .

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How do we treat dysbiosis?How do we treat dysbiosis?

Eliminating various germs in the gut Eliminating various germs in the gut using natural medicines and using natural medicines and replacing them with probiotics replacing them with probiotics (acidophilus) is absolutely critical in (acidophilus) is absolutely critical in treating AI disease. treating AI disease.

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What else besides eradiation of What else besides eradiation of the intestinal bugs? Apply the intestinal bugs? Apply castor oil pack over abdomencastor oil pack over abdomen• Rubbing castor oil over the gut on a daily basis can help Rubbing castor oil over the gut on a daily basis can help

enhance the health of the lymphatic tissue that is housed in enhance the health of the lymphatic tissue that is housed in the intestines. This can improve the gut-associated the intestines. This can improve the gut-associated immunity, and thus help with the whole AI process. immunity, and thus help with the whole AI process.

• Castor oil is definitely a time-honored therapy. It has been Castor oil is definitely a time-honored therapy. It has been around for thousands of years, and used medicinally in around for thousands of years, and used medicinally in many cultures throughout the planet. many cultures throughout the planet.

• Beyond healthy nutrition and lifestyle, castor oil packs Beyond healthy nutrition and lifestyle, castor oil packs might be the single most important natural medicine there might be the single most important natural medicine there is in helping with AI disease. The reason is that it appears is in helping with AI disease. The reason is that it appears that castor oil (when absorbed through the abdominal wall) that castor oil (when absorbed through the abdominal wall) helps with the health of the lymphatic tissue (peyer’s patch) helps with the health of the lymphatic tissue (peyer’s patch) in the small intestine. This, in turn, appears to help in the in the small intestine. This, in turn, appears to help in the healing of the leaky gut, therefore, reduce AI activity. healing of the leaky gut, therefore, reduce AI activity.

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How to optimize liver How to optimize liver function?function?

• Numerous natural medicines are Numerous natural medicines are available to “help” with liver available to “help” with liver function. Example: Nebulized function. Example: Nebulized glutathione therapy which helps the glutathione therapy which helps the phase II detoxification pathways. phase II detoxification pathways. This is a prescription natural This is a prescription natural medicine which can greatly benefit medicine which can greatly benefit the liver. the liver.

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How to prepare for dysbiosis How to prepare for dysbiosis therapy?therapy?#1) Optimize liver and kidney health first. #1) Optimize liver and kidney health first.

Then, Then, #2) Address the dysbiosis in the intestines. #2) Address the dysbiosis in the intestines.

This process must be done in this order- This process must be done in this order- liver/kidneys first, THEN intestines. liver/kidneys first, THEN intestines.

Why in this order? Why in this order? Dysbiosis therapy can produce toxic Dysbiosis therapy can produce toxic byproducts which will end up in the liver and byproducts which will end up in the liver and potentially kidneys. Therefore, it is potentially kidneys. Therefore, it is important to optimize the health of your important to optimize the health of your liver and kidneys prior to eradicating germs liver and kidneys prior to eradicating germs in the intestine. in the intestine.

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Benefits of dysbiosis therapy:Benefits of dysbiosis therapy:

1)1)Most foundational method of Most foundational method of treating AI.treating AI.

2)2)Dysbiosis therapy will result in Dysbiosis therapy will result in better digestion/absorption of better digestion/absorption of nutrients/food. In fact, with nutrients/food. In fact, with healthier internal organs, nutritional healthier internal organs, nutritional supplementation will “work” much supplementation will “work” much better. better.

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Let’s go further… What Let’s go further… What causescauses dysbiosis (or leaky gut)?dysbiosis (or leaky gut)?

• The most common cause of dysbiosis is use The most common cause of dysbiosis is use of of antibiotics and over-the-counter pain antibiotics and over-the-counter pain medsmeds. Antibiotics change the balance of . Antibiotics change the balance of intestinal microbes. They simultaneously intestinal microbes. They simultaneously kill both harmful and helpful (“friendly”) kill both harmful and helpful (“friendly”) bacteria throughout our digestive system, bacteria throughout our digestive system, leaving the territory to bacteria, parasites, leaving the territory to bacteria, parasites, viruses and fungi (yeasts) that are viruses and fungi (yeasts) that are unaffected by the antibiotic. unaffected by the antibiotic.

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Does inflammation “cause” AI Does inflammation “cause” AI disease? disease?

• Inflammation is involved in AI Inflammation is involved in AI disease. However, the problem is disease. However, the problem is what CAUSES inflammation in the what CAUSES inflammation in the body? Dysbiosis. body? Dysbiosis.

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Do anti-inflammatory Do anti-inflammatory medicines help AI?medicines help AI?

• Yes. They help with the symptoms, but Yes. They help with the symptoms, but are not curative. Steroids are probably are not curative. Steroids are probably the most powerful anti-inflammatory the most powerful anti-inflammatory drugs, but can not cure the root cause drugs, but can not cure the root cause of AI. The same goes for anti-of AI. The same goes for anti-inflammatory herbs- they can help with inflammatory herbs- they can help with the inflammation, but the root cause of the inflammation, but the root cause of inflammation needs to be addressed. inflammation needs to be addressed.

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Anti-inflammatory herbs versus Anti-inflammatory herbs versus steroids?steroids?

• Steroids are definitely more powerful Steroids are definitely more powerful than anti-inflammatory herbs, but than anti-inflammatory herbs, but more likely to cause side effects. more likely to cause side effects.

• Do herbs have side effects? Usually Do herbs have side effects? Usually not, but can if the root cause of not, but can if the root cause of disease in the person is NOT disease in the person is NOT addressed. (We will discuss this addressed. (We will discuss this later.)later.)

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Case) RA patient who did not Case) RA patient who did not respond well to herbal anti-respond well to herbal anti-inflammatoriesinflammatories• 50 yr old woman with severe RA (rheumatoid arthritis)50 yr old woman with severe RA (rheumatoid arthritis)• S/S (signs and symptoms): Frequent urination (up to 20 per S/S (signs and symptoms): Frequent urination (up to 20 per

day) with normal blood tests. day) with normal blood tests. • Became bedridden with anti-inflammatory herbs (after two Became bedridden with anti-inflammatory herbs (after two

weeks of use)weeks of use)• Why?Why?• I had ignored to optimize the function of her kidneys (early I had ignored to optimize the function of her kidneys (early

in practice, and not learned the connection between the in practice, and not learned the connection between the internal organs and AI)internal organs and AI)

• Optimizing health of her kidneys helped significantly with Optimizing health of her kidneys helped significantly with her RA. (In retrospect, I should have tested her urine and her RA. (In retrospect, I should have tested her urine and looked for abnormalities in her urine test, blood kidney looked for abnormalities in her urine test, blood kidney function test, “kidney” ultrasound) even though she did not function test, “kidney” ultrasound) even though she did not have any UTI symptoms.)have any UTI symptoms.)

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Variety of practitioners in Variety of practitioners in natural medicine:natural medicine:• Some “natural” medicine practitioners (including Some “natural” medicine practitioners (including

a good number of Naturopathic Doctors) a good number of Naturopathic Doctors) prescribe anti-inflammatory herbs to help with prescribe anti-inflammatory herbs to help with symptoms of AI disease, and do not look for the symptoms of AI disease, and do not look for the “cause” of the AI – dysbiosis, and therefore, are “cause” of the AI – dysbiosis, and therefore, are not able to successfully treat AI. The idea of not able to successfully treat AI. The idea of prescribing only anti-inflammatory herbs does not prescribing only anti-inflammatory herbs does not embrace principles of wholistic medicine. As a embrace principles of wholistic medicine. As a myositis patient, seek out natural medicine myositis patient, seek out natural medicine practitioners who emphasize the critical practitioners who emphasize the critical significance of the health of internal organs significance of the health of internal organs (digestive system, liver and kidneys).(digestive system, liver and kidneys).

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Osteoporosis & myositis? Osteoporosis & myositis?

• Dysbiosis can cause mal-absorption of Dysbiosis can cause mal-absorption of nutrients. Therefore, AI patients are at nutrients. Therefore, AI patients are at risk for poor calcium status even if they do risk for poor calcium status even if they do not take steriods.not take steriods.

• So, myositis does not cause osteoporosis, So, myositis does not cause osteoporosis, but what causes myositis (dysbiosis) also but what causes myositis (dysbiosis) also puts you at risk for osteoporosis. puts you at risk for osteoporosis.

• If women, and post-menopausal, that is a If women, and post-menopausal, that is a secondary risk factor for low bone density.secondary risk factor for low bone density.

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Natural treatments for Natural treatments for osteoporosis:osteoporosis:

• Treat the dysbiosisTreat the dysbiosis- - maldigestion/malabsorption.maldigestion/malabsorption.

• Optimizing function of liver and kidneys since Optimizing function of liver and kidneys since Vit D2/D3 from food and the sun is converted Vit D2/D3 from food and the sun is converted into Vit D, 25-OH in the liver, and into Vit D, 25-OH in the liver, and subsequently into Vit D, 1-25 Dihydroxy in the subsequently into Vit D, 1-25 Dihydroxy in the kidneys. kidneys.

• Take calcium daily. 1000 mg daily for men Take calcium daily. 1000 mg daily for men and non-menopausal women, and 1500 for and non-menopausal women, and 1500 for menopausal women. menopausal women.

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Natural treatments for Natural treatments for osteoporosis:osteoporosis:• Vitamin D which helps absorption of calcium. Vitamin D which helps absorption of calcium.

(Cod liver oil is great because it contains (Cod liver oil is great because it contains essential fatty acids AND vit D. 1 Tbsp daily essential fatty acids AND vit D. 1 Tbsp daily of cod liver oil is sufficient.) But, remember, of cod liver oil is sufficient.) But, remember, some AI patients might do better without Vit some AI patients might do better without Vit D! D!

• Sometimes prescription Vit D (calcitriol) may Sometimes prescription Vit D (calcitriol) may be taken short-term to boost the Vit D status be taken short-term to boost the Vit D status in the blood, if it ever tests below the normal in the blood, if it ever tests below the normal levels. levels.

• Weight bearing exercise.Weight bearing exercise.• Many other natural therapies are available. Many other natural therapies are available.

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Mind-body Medicines and Mind-body Medicines and Approaches in treating Approaches in treating disease:disease:• Yoga and Tai-chiYoga and Tai-chi

• Relaxation techniques such as Relaxation techniques such as biofeedback, meditationbiofeedback, meditation

• HOMEOPATHY HOMEOPATHY

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Is the mind important?! Is the mind important?!

• ““You can not separate passion from You can not separate passion from pathology (study of diseases) any pathology (study of diseases) any more than you can separate a more than you can separate a person’s spirit from his body. The person’s spirit from his body. The flesh is the spirit thickened.”flesh is the spirit thickened.”

The book “Letters to a young doctor” by Richard Selzer. The book “Letters to a young doctor” by Richard Selzer.

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Homeopathy:Homeopathy:

• ““Homeopathy is a branch of medical Homeopathy is a branch of medical science based on the principle that disease science based on the principle that disease can be cured by strengthening the body’s can be cured by strengthening the body’s defense mechanism (immune system) with defense mechanism (immune system) with substances selected for their energy-giving substances selected for their energy-giving properties. properties.

• Homeopathic medicine aims to change the Homeopathic medicine aims to change the body’s energy levels which lie at the root of body’s energy levels which lie at the root of disease.” *disease.” *

The science of homeoapthy, by George Vithoulkas. The science of homeoapthy, by George Vithoulkas.

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““Constitutional” Homeopathic Constitutional” Homeopathic Remedy:Remedy:• Each person has a “constitutional” remedy which can Each person has a “constitutional” remedy which can

ultimately help them more than any other natural medicine ultimately help them more than any other natural medicine known. known.

• The “constitutional” homeopathic remedy is a perfect fit to The “constitutional” homeopathic remedy is a perfect fit to the person like a lock and a key. It can help a person on the person like a lock and a key. It can help a person on the physical as well as mental/emotional level. the physical as well as mental/emotional level.

• A person’s constitutional remedy is ultimately required for A person’s constitutional remedy is ultimately required for curing their chronic disease(s). curing their chronic disease(s).

• Constitutional remedies are in 200C or higher potencies Constitutional remedies are in 200C or higher potencies that are not available over-the-counter. that are not available over-the-counter.

• You need a professional homeopath in order to find this You need a professional homeopath in order to find this remedy for yourself. It is next to impossible to find this remedy for yourself. It is next to impossible to find this remedy on your own. remedy on your own.

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Example to illustrate the Example to illustrate the difference between difference between conventional medicine and conventional medicine and homeopathic medicinehomeopathic medicineTake sore throat as an example. Take sore throat as an example.

• The MD is more interested in which The MD is more interested in which organism is causing the sore throat in organism is causing the sore throat in order to select an antibiotic to kill it. order to select an antibiotic to kill it.

• The homeopath is looking for the The homeopath is looking for the substance in nature which can substance in nature which can stimulate the person to heal himself. stimulate the person to heal himself.

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Video testimonials for Video testimonials for homeopathy:homeopathy:

• M’s videoM’s video

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Can you mix conventional Can you mix conventional drugs and natural therapies to drugs and natural therapies to treat AI?treat AI?• Absolutely. You can do both at the same time. As Absolutely. You can do both at the same time. As

the patients feel healthier, they discuss the dose of the patients feel healthier, they discuss the dose of their drugs with their MD, and usually, over a their drugs with their MD, and usually, over a course of a few months to up to 1-2 years (or course of a few months to up to 1-2 years (or sometimes more), they will not need to continue sometimes more), they will not need to continue taking any drugs at all. This is a decision that taking any drugs at all. This is a decision that should be made under the MDs and my supervision. should be made under the MDs and my supervision.

• I work with medical doctors all the time in order to I work with medical doctors all the time in order to offer the best of what both systems of medicine can offer the best of what both systems of medicine can bring to the table. bring to the table.

• We can request records from you MDs office so that We can request records from you MDs office so that we do not have to repeat all the tests. we do not have to repeat all the tests.

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How long does it take to How long does it take to optimize the health of internal optimize the health of internal organs?organs?• Varies. This depends on how old the Varies. This depends on how old the

patient is, how long they have had their patient is, how long they have had their condition, what other conditions they condition, what other conditions they might have, etc. might have, etc.

• Typically, it takes at least a few weeks Typically, it takes at least a few weeks to notice improvements. Usually, to notice improvements. Usually, significant improvement in most (if not significant improvement in most (if not all) symptoms within a few (3-6) all) symptoms within a few (3-6) months. months.

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Natural treatment protocol for Natural treatment protocol for myositis- a summary:myositis- a summary:

• Healthy diet & lifestyleHealthy diet & lifestyle

• Optimize health of your emotions Optimize health of your emotions using homeopathic medicines using homeopathic medicines (“constitutional”)(“constitutional”)

• Optimize health of:Optimize health of:– LiverLiver– KidneysKidneys– Intestines (dysbiosis therapy)Intestines (dysbiosis therapy)

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Note to practitioners…Note to practitioners…

• ““Gaze long enough at your patients, and from even Gaze long enough at your patients, and from even the driest husk there will fly upward a shower of the driest husk there will fly upward a shower of sparks that, to him who gazes, will coalesce into a sparks that, to him who gazes, will coalesce into a little flame.” “In the beginning you will love their little flame.” “In the beginning you will love their wounds because they give you the occasion for wounds because they give you the occasion for virtue; later you will love the sick for their own virtue; later you will love the sick for their own sake. Rendered helpless by their afflictions, they sake. Rendered helpless by their afflictions, they cherish the memory of fertile lands and cool green cherish the memory of fertile lands and cool green glades and the company of love- all the stuff of glades and the company of love- all the stuff of their former selves. These people know something their former selves. These people know something you and I do not yet know- what it is to live with you and I do not yet know- what it is to live with the painful evidence of your mortality.”the painful evidence of your mortality.”

Excerpt from the book “Letters to a young doctor” by Richard Selzer. Excerpt from the book “Letters to a young doctor” by Richard Selzer.

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Bringing light into darkness Bringing light into darkness (optimizing health instead of (optimizing health instead of treating disease) is the key to treating disease) is the key to cure…cure…

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Contact Info:Contact Info:

• Sharum Sharif, N.D.Sharum Sharif, N.D.

Clinic Name: Whole Health ClinicClinic Name: Whole Health Clinic

Office phone: 425-656-0700Office phone: 425-656-0700

Email: Email: DrSSharif@WholeHealthClinic.Net.DrSSharif@WholeHealthClinic.Net.

Website: Website: www.WholeHealthClinic.Netwww.WholeHealthClinic.Net