Friday, September 28, 2018

R-Lipoic Acid - A Panacea For Health & Anti-Aging?

R-Lipoic Acid:  A Panacea For Health & Anti-Aging?

R-Lipoic Acid is a form of Lipoic Acid. Lipoic Acid has three forms that you can buy:

R-lipoiC (the form the body produces and is found in nature)
S-Lipoic (the form created in manufacturing Lipoic Acid)
Racemic Lipoic Acid (a combination of R & S).

R Lipoic is also referred to as the "natural form," while S is considered the "Unnatural form."

While these two forms are "mirror" images of each other if you look at their molecules. They actually have different effects inside the body. Both forms are anti-oxidants. However, R-Lipoic Acid is apparently the form that possesses all the magic that alpha lipoic acid has.



S-lipoic acid has some of the beneficial properties.  It is an anti-oxidant and when mixed with R-Lipoic Acid seems to increase R-lipoic's bio-availability.   But, S-lipoic Acid does not activate many of the enzymes that R-Lipoic Acid does AND it also blocks the effects of R-lipoic Acid.

We've been using alpha lipoic acid on and off for asthma and food allergies.  In fact, we consider it to be one of our go to supplements for lowering IgE for asthma and food allergies.  That being said we have not seen the results that we've anticipated.  But after discovering that we were taking the wrong form of Alpha Lipoic Acid, we're now going to switch to R-lipoic.

Before you go out and order just any R-lipoic acid, please read and view my thinking process and reasons as to why R-lipoic is the best form of alpha lipoic acid.  In addition to that, R-lipoic has one central problem - it is not very bio-available when you take it on its own.  So in my article I walk you through my decision process and which brands are the most bio-available and deliver the biggest bang for your buck.

Read which is the best brand of r-lipoic acid here.

Read my article on the Best Wedge Pillow for Acid Reflux.


Wednesday, November 16, 2016


This article is a copy of the article that I published on my website www.healinghacker.com
I don't post often. It's a tug of war between limited time along with self-doubts as to what I offer that is different than the rest of the web and a compulsion to keep searching and sharing. So here it goes, the result of months of spinning my wheels. In fact, this research will help me construct a protocol for our allergies and asthma. If you've read any of my other posts, you know that I obsess over allergies (with good reason, we have multiple life threatening food allergies and asthma). The obsession with allergies has lead me to a deeper understanding, appreciation, and awe of the immune system.

My Quest For the Best Vitamins for Asthma and Allergies

In my research for supplements, I looked for a couple things that are associated with reducing Th2 skewing, aka asthma and allergies. I searched out vitamins and supplements that were shown to reduce IgE, increase IFN-y, increase IL-12, increase NK cell activity (natural killer cells), and/or reduce IL-10 (IL-10 tends to be associated with the Th2 arm of the immune system). And just a brief note, if you don't already know this, Th1 is humoral immunity known to "fight viruses and other intracellular pathogens, eliminate cancerous cells, and stimulate delayed-type hypersensitivity (DTH) skin reactions" while Th2 is adaptive immunity via production of antibodies. Being skewed too heavily in either direction can result in diseases. Allergic problems and asthma tend to be invoked by an immune system that is Th2 skewed. I spent several months laboring over this list, but here are supplements that have been found to reduce allergies - along with some supplements you'll want to avoid because they increase allergies.

1. Aged Black Garlic Extracts

It has been found to Increase Interferon Gamma (IFN-y). In a mouse model it reduced IgE associated skin inflammation. Source Articles: "Immunomodulation and Anti-Inflammatory Effects of Garlic Compounds." "The Antioxidant Mechanisms Underlying the Aged Garlic Extract- and S-Allylcysteine-Induced Protection"
Buy Aged Black Garlic, Aged Garlic with Mushroom Extracts

2. Active Hexose Correlated Compound (AHCC)

This is a propreitary extract produced from specially cultivated and hybridized mushrooms. It has been found to skew towards Th17, enhance NK cells, increase IL-6 and IFN-γ. Source Articles: "Active Hexose Correlated Compound promotes T helper (Th) 17 and 1 cell responses via inducing IL-1β production from monocytes in humans"
Buy Active Hexose Correlated Compound (AHCC)

3. Alpha Lipoic Acid (ALA)

Alpha Lipoic Acid is becoming a sung hero in the world of anti-oxidants. It has been found to chelate heavy metals, restore blood glutathione levels, act as a free radical scavenger... The key here to me is that it can enhance blood glutathione levels. Additionally, in mouse model of asthma it was found to lower lung hyper responsiveness, eosinophils, and IgE. Source Articles:
"Alpha-Lipoic acid inhibits airway inflammation and hyperresponsiveness in a mouse model of asthma"
Buy Alpha Lipoic Acid (ALA)

4. Apigenin

Apigenin is flavone found in many fruits and vegetables. The highest sources include parsley, celery, celeriac and chamomile. It was found to reduce IgE, suppress Th2 cytokines. Source Articles: "Dietary apigenin suppresses IgE and inflammatory cytokines production in C57BL/6N mice"
Buy Apigenin

5. D-pinitol

According to Wikipedia, pinitol is a cyclitol, a cyclic polyol. It is a known anti-diabetic agent isolated from Sutherlandia frutescens leaves.[1][2] Gall plant tannins can be differentiated by their content of pinitol.[3] It was first identified in the sugar pine (Pinus lambertiana). It's also apparently in leafy greens - and a component of inositol. In one mouse model study d-pinitol inhibited allergic asthma in sensitized mice. In another it impaired Th1 polarization. Source Articles: "d-pinitol regulates Th1/Th2 balance via suppressing Th2 immune response in ovalbumin-induced asthma" "D-pinitol inhibits Th1 polarization via the suppression of dendritic cells"
Buy D-pinitol

6. Drumming

Obviously this isn't a supplement. I contacted the person associated with this study about further details about the type of drumming that was done. He was unavailable for further questions. There was apparently an increase in NK cell activity post drumming. Source Articles: "Composite Effects of Group Drumming Music Therapy on Modulation of Neuroendocrine-Immune Parameters in Normal Subjects."

7. Magnesium

Magnesium is sometimes delivered intravenously in the hospital for acute asthma attacks. It can "can induce bronchial smooth muscle relaxation..." I've heard from others who suffer from asthma, as well as read, that oral supplementation can also help reduce asthma symptoms as well as the amounts of emergency meds needed. Here is study done in children with asthma and oral magnesium supplementation. You'd need to purchase the study to see dosages, but another study that I read (which of course I cannot find now) had dosages of 340mg (given 2x day at 170 mg) for adults. What they found in the group of children was that the magnesium acted as an antioxidant and increase glutathione levels. Whether or not magnesium will help with allergic conditions is unclear to me. Although it has been found to decrease histamine levels, and would therefore be a valid supplement to experiment with. Source Articles:
Buy magnesium

8. Magnolia Flower and Gypsum Combination (Shin'iseihaito)

This is a mouse model. As several people have been quick to remind me, what works in mice doesn't necessarily work in humans. At any rate they found that this Kampo (Japanese) or TCM (Traditional Chinese Medicine) herbal extract was able to reduce the eosinophil, serum IgE and interleukin (IL)-4 levels, while increased the interferon (IFN)-γ levels in allergic mice. Source Articles: "Effect of Shin'iseihaito on murine allergic reaction induced by nasal sensitization." As far as buying this herbal remedy goes, I would recommend going to a reputable herbalist. You can find different sources on the internet, but for this one I personally would like to meet and see the person making/recommending this combination. There aren't any reputable supplement companies that I can find that make this.

9. Melatonin

Melatonin is acts as an antioxidant, immune stimulant and sleep regulator. As a supplement, it's a hormone that is either synthesized in a lab or derived from pig and cow brains (I of course steer clear of the later version). Melatonin is a mixed bag, so it demands some research and experimentation. Melatonin has been found in atopic dermatitis and allergic asthma to be associated with reduced IgE and IL-4. However, there was a study that found elevated blood melatonin levels associated with worsening nocturnal symptoms in people with asthma. So if asthma is part of the package, it seems to make sense to tread slowly with melatonin. Source articles:
Melatonin and Atopy: Role in Atopic Dermatitis and Asthma
Elevated serum melatonin is associated with the nocturnal worsening of asthma
Buy Melatonin (synthesized in lab - not animal brain derived).

10. Plant sterols, stanols, and sterolins

Naturally occurring substances in and produced by plants. Found in fuits, vegetables, legumes, nuts, and seeds. However the amounts you'd get when you consume plants is lower than if you take supplements containing sterols, stanols, and sterolins. Plant sterols, stanols, and sterolins are known to lower cholesterol and modulate the immune system. One study in particular tracked asthma sufferers and vaccine titres vs a control group. Both groups consumed a soy based yogurt. The study group had added plant sterols, while the control group ate the yogurt without added sterols. And while the differences between the groups was not notable, the study group during the study time experienced decreased IgE and IL-13 indicating a shift from Th2 type immunity to Th1. Interesting bonus on this supplement is that it supposedly has been found to increase hair health. Source articles:
This articles is a review that was done by scientists working for Thorne supplements. However, that doesn't mean that it's not valid.
Dietary plant stanol ester consumption improves immune function in asthma patients: results of a randomized, double-blind clinical trial.
Beneficial Effects of Sitostanol on the Attenuated Immune Function in Asthma Patients: Results of an In Vitro Approach
Buy Plant Sterol and Sterolin Supplement
Buy Beta-sitosterol

11. Probiotic: HKLP-137 (Heat Killed Lactobacillus Plantarum 137) aka Immuno-LP 20

You'll find lots of studies on pubmed.org citing it's ability to stimulate Th1 type immunity in healthy subjects and mice via increased IFN-y and IL-12. We tried this supplement for awhile, I can't say that it worked for us. We were, however, trying a bunch of stuff at once so it's hard to tell. It's also difficult to determine if we were taking a high enough dose. The other thing is that most of the studies done on HKLP-137 seem to be on non-atopic individuals and mice. Reading these articles makes me want to give this supplement a try again. Source Articles: "Daily intake of heat-killed Lactobacillus plantarum L-137 enhances type I interferon production in healthy humans and pigs" "Daily intake of heat-killed Lactobacillus plantarum L-137 augments acquired immunity in healthy adults"
Buy Immuno-LP 20

12. Probiotic: Lactobacillus Casei Shirota (in the states only found in Yakult)

Yakult is a dairy drink that is made from powdered milk and sugar. It's available in stores around the US. Apparently, in Japan you can just buy the bacteria as a probiotic without the dairy and sugar that accompany the drink. At any rate, it has been found in an HIV infected population to lower IL-10, IL-12, IgE but raise IL-4. Source Articles: "Effect of Probiotic Supplement on Cytokine Levels in HIV-Infected Individuals: A Preliminary Study."

13. Probiotic: Bifidobacterium Lactis HN019

I am somewhat on the fence on probiotics. I think that they, of all supplements demand massive organized experimentation. What do I mean by that? Well firstly, probiotics are extremely specific. If you read about a probiotic lactobacillus acidophilus 123 and desire similar effects, you must find that exact strain down to the 123. Also, for those suffering allergies and asthma, the probiotics could have a different effect than in non-allergic individuals AND heat killed probiotics may be more effective than live (again from memory of a study that I now cannot find). However, we still use probiotics. Although, we are not as organized as I would like to be. Ideally, we'd use single strains and track blood before and after. We don't. So our approach is very hodge podge. Also, I personally tend to steer clear of most bifidobacteria probiotics. From what I've read and retained, it seems that bifidobacteria are usually associated with increasing IL-10 levels. IL-10, while not totally Th2 skewing, is nonetheless a Th2 cytokine. However, this Bifidobacterium Lactis HN019 is associated with increasing NK (natural killer) cell activity. So, it's on my list. And, we've taken these strains. I can't say that we saw an improvement, we did not do blood tests, but we also didn't see a worsening of any symptoms. Also, you cannot find either this strain or the L. Rhamnosus HN001 as single strains. Therefore, you can't really see the effect of the single strain. Source Articles: Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019
Buy B. Lactis HN019 mixed with L. Rhamnosus HN001

14. Probiotic: Lactobacillus Rhamnosus HN001

Increased NK cell activity in non-allergic individuals. Source Articles: Systemic Immunity-Enhancing Effects in Healthy Subjects Following Dietary Consumption of the Lactic Acid Bacterium Lactobacillus rhamnosus HN001
Buy B. Lactis HN019 mixed with L. Rhamnosus HN001

15. Rice Bran Exo-biopolymer, RBEP - known to contain arabinoxylan

In vivo study in humans, found to raise IFN-y levels. Interestingly, it did not effect any other cytokine levels. I've included "known to contain arabinoxylan" because I could not find this exact product. I've found other products that claim to activate NK-cell activity. Source Articles: Dietary supplementation with rice bran fermented with Lentinus edodes increases interferon-γ activity without causing adverse effects: a randomized, double-blind, placebo-controlled, parallel-group study.
Buy Enzymatically Modified Rice Bran
Buy Rice Bran Arabinoxylan Compound (We've taken this one. Again, we did not take blood work. So it's hard to tell if it had an effect. We are considering returning to this supplement.)

16. Selenium

Selenium is a potent anti-oxidant. It's been found to enhance the Th1 side of the immune system: with increased viral immunity, NK activity and IFN-y. We regularly take it along with other trace minerals. Source Articles:
Selenium and asthma
Buy Selenium
Buy the Selenium we take in trace minerals

17. Sodium Ascorbate (a form of Vitamin C)

I have written about vitamin C, especially in sodium ascorbate form, several times. It is a tent pole supplement in our routines. This study which followed three siblings over two years is the original study that turned me onto vitamin C. The study tracked a reduction in IgE using sodium ascorbate at 1000mg daily for two years. In our experience, we've found a similar IgE reducing effect. In fact, of all the supplements we've tried, sodium ascorbate made a huge and obvious impact that preceded confirmation via blood test. Basically my son's asthma and seasonal allergy symptoms pretty much disappeared. We stopped using it daily for several months. When we returned to vitamin C, we were not using sodium ascorbate because he hates the taste and texture. We have not had as amazing results using ascorbic acid. We do get some effect, but nothing as drastic as the 30% drop in IgE and essentially no asthma and seasonal allergy symptoms. Also, a second issue with the sodium ascorbate that we were taking, I'm not in love with the nano-particle facet of it. I feel that that is something that has not been researched enough. So while we took it for about two years, we now take it much less. Source Article:
Buy Sodium Ascorbate as lypo-spheric
Read about our experience using vitamin C for asthma and allergies. Currently, we're not using sodium ascorbate, but are in the process of trying yet another vitamin C. It's a fine balance between efficacy and taste/texture.

18. Sulforaphane

Sulforaphane is "a compound within the isothiocyanate group of organosulfur compounds. It is obtained from cruciferous vegetables such as broccoli, Brussels sprouts or cabbages. It is produced when the enzyme myrosinase transforms glucoraphanin, a glucosinolate, into sulforaphane upon damage to the plant (such as from chewing), which allows the two compounds to mix and react. " Wikipedia It's been found that the highest levels of sulforaphane can be obtained from 3 day old broccoli sprouts. You can either buy sulphoraphane as a broccoli sprout extract supplement or grow your own sprouts. The key with sulphoraphane is that it's created when glucoraphanin and myrosinase come together, as in chewing. So I prefer to eat the sprouts myself, because I doubt supplement efficacy for this compound for some reason. Although, keep in mind they are very strong tasting. Source Article: Sulforaphane inhibits the Th2 immune response in ovalbumin-induced asthma.
Buy broccoli sprout extract
Buy seeds to sprout

19. Vitamin D

Vitamin D is one of the most widely discussed vitamins. Most recently a study found that it reduces asthma attack severity. But I have a hard time completely getting on the Vitamin D bandwagon. It's not to say that it's not valuable. Clearly it is, however there appears to be a sweet spot for Vitamin D. Levels above and below a certain threshold are linked to elevating IgE, while the sweet spot is in the middle. Another study found, that serum vitamin D was positively associated with logarithmic transformed total IgE with base of 10 (LogTIgE) (coefficient (B), 0.011; 95% confidence interval, 0.001-0.021). I think the best approach with Vitamin D is to do a blood test and see the level. Then if you supplement track symptoms, and/or retest IgE levels along with Vitamin D level.

20. Whey

Whey supplementation is known to increase glutathione. What interests me the most though is the study that found that a month long whey supplementation protocol was able to reduce total IgE levels by 30%. For anyone who tracks IgE levels for allergies, you realize how amazing this is. We managed to reduce IgE levels by 30% over several months with daily sodium ascorbate - but that was several months vs one month. Source Articles: Effect of whey protein to modulate immune response in children with atopic asthma. Oral supplementation with whey proteins increases plasma glutathione levels of HIV-infected patients. Buy the whey from the study (Immunocal)

Further reading for the interested

Proinflammatory cytokines (IL-17, IL-6, IL-18 and IL-12) and Th cytokines (IFN-γ, IL-4, IL-10 and IL-13) in patients with allergic asthma
This s a great article that details the different cytokines and allergic asthma. This article informed my search for supplements: supplements that increase IL-12, IFN-y, NK cell activity... vs supplements that increase cytokines associated with skewing Th2 immunity via things like IL-10.
IgE Versus IgG4 Production Can Be Differentially Regulated by IL-10
IL-10, a Th2 associated cytokine is a bit more complicated than simply being a Th2 cytokine and therefore something that allergic individuals want to avoid. While it can illicit differentiation between either IgE or IgG 4, that switch is timing based. This read if for the truly nerdy - and it's a discussion of in vitro studies as opposed to in vivo.
Amazing free 23 page pdf for those who are truly on a quest to hack their bodies and make positive change.
I hope this list is helpful. Please comment below with any additions or experiences experimenting with the above mentioned or others that should be added.
Thank you for reading.
Also please note that I do use affiliate links in this post and throughout the site. However, I only recommend supplements we've used and researched.

Thursday, May 21, 2015

Chinese Herbs: Asthma & Food Allergies (Q&A with Dr Xiu-Min Li)



This interview was conducted with the world renowned immunologist and Chinese Herbalist Dr. Xiu-Min Li via phone and email discussing the latest in her proprietary Chinese Herbal Formulas for asthma and food allergies. Dr Li is the originator of FAHF-2 (food allergy herbal formula) and ASHMI (anti-asthma herbal medicine intervention).

If you have questions - or want to contact me - please go to my site (healinghacker.com).

This is a relatively in depth article and takes about 20 minutes to read (longer if you want to really digest). If you don't have time (or patience), here are the distilled takeaways:
  • Herbs work, but there's a high level of commitment necessary - time (several years) & dosage (prepare to swallow more than one pill a day). If you can't bring it (commitment that is), herbs may not be for you.
  • IgE is not necessarily be-all/end-all of allergic reaction - on herbal protocol IgE may remain constant or not, and yet tolerance can occur. Basophil activation measured via blood draw is strongly correlated with tolerance/reactivity. Dr Li discusses this blood test as a safe prelude to food challenge. We've made inroads in reducing our IgE levels, but I am now even more aware that this as a singular strategy isn't a "cure." Other immune cells need to be addressed as well. I think Chinese herbs can really shine in addressing a spectrum of immune cells - quieting reactions.
  • Herbs switch the immune system from allergic to non-allergic by rebalancing the immune system. As mentioned above, the IgE levels may or may not change, but previously reactive individual may be able to tolerate foods/pollens..., because other parts of immune system are mediating.
  • Results are totally individual. Some people can do treatment and then be off completely; others will need to pulse on and off (6 months on, 6 months off).
If you want the full-on details from which the above has been distilled, pull up a chair, grab a snack, and READ ON!

amd_xiu-minHealing Hacker: Can you discuss the results of the human efficacy trials with Food Allergy Herbal Formula-2 (FAHF-2)? Does it work if compliance is good? How do you know it works? Can you talk about the clinical trials of FAHF-2? What results are forthcoming?

Dr. Li: I can only discuss the published studies. We published a study in annals of Allergy Asthma and Immunology that showed FAHF-2 is a very safe treatment that modulates the immune system. We found it had immune-modulating effects on Th1, and T- regulatory cells that inhibit allergic immune response as well as Th-2 cells, which are associated with allergies. We actually saw the immune system response switch from allergic to non-allergic. This is promising. If you can modulate the T-cells so that they don’t produce IgE, the allergic antibody, you will eventually see a clinical improvement.

We did a 6-month open-label study (not a control study) but much shorter than the mouse study, which required two years to produce results. Our second six-month trial found similar high safety profile; and this time we had an opportunity to look at the immunological response of the basophils, which produce histamine. We were able to suppress the histamine production of these cells, which produced a favorable clinical effect. So that was the second trial.

The third trial we finished in 2014. The results were mixed. We did see consistent safety data and some immunomodulatory effects. However, we have not demonstrated efficacy yet with the protocol used. The compliance level was a big issue. You know this as well as everyone else. (HH: my son took herbs with Dr. Li for about a year and compliance was difficult for us - swallowing between 30-40 pills a day because I was crushing them and putting into small capsules for him to swallow.)

There are still a lot of things to learn from this trial. We think the product itself needs to be improved - if we can reduce the number of pills we can increase compliance and optimize the product.

This is an obstacle for traditional herbal medicine - we know it’s safe, it has potential benefits, but it’s very difficult to conduct a trial because the amount of pills is an issue. And also the protocol design is not where after a couple weeks you see the effect. This protocol requires quite a long time and much effort. In private practice when we treat things like eczema and asthma, patients can see and feel improvements, which gives them an incentive to continue treatment for the “invisible” problem, food allergies.

Interestingly, the preliminary data showed that if the individual had high enough blood concentration of the bioactive compound marker, they had positive clinical outcomes. This supports our in vitro study data that showed that human immune cells directly exposed to FAHF-2 extract experienced beneficial immunomodulatory effects. There are gaps of knowledge between TCM human use experience, in vivo animal model study, human in vitro study, and then finally to human in vivo study trials. Our continued work will help us fill in the gaps.



The good news is that we have developed a purified product which requires just 1/5 of the previous dosage that has successfully combatted peanut allergy in mice.
HH: This is B-FAHF-2?
Dr. Li: Yes, B for butanol, a form of alcohol. We’ve achieved FDA approval and received funds for the clinical trials but we haven’t started yet. We’re updating the protocol and preparing the refined version of B-FAHF-2 that will be used for the trial.

The design of this trial is different than the previous trials. Treatment time will be 26 months – closer to a real timeframe where you can see strong results. Previous study times were too short to allow the full immunological changes to occur. Persistent allergy is associated with abnormal memory immune cells--T cells, B cells and mast cells/basophils--which are very stubborn. Taking IgE production as an example - as you’ve seen in your life, you’ve been avoiding peanut, but still the peanut specific IgE is more than 100.
HH: It’s more than 100 still, yes.

Dr. Li: Why is that? It’s because of the memory B cells. Once those cells form, they have longevity and continue to reproduce. Knocking them out takes a long time.

“We actually saw the immune system response switch from allergic to non-allergic. This is promising.”

HH: How do the herbs operate? What are the herbs doing that are affecting the immunological markers?

Dr. Li: We started to look at which herb compounds affect IgE. We just published in 2014 but the work has been done over many years. We demonstrated that human memory B-cell lines that produce IgE could remain very high, even if they are not stimulated. You just put them in a good nutrition medium and they will grow and produce IgE.

In that study we compared effects of FAHF-2 and B-FAHF-2 on IgE production. Both significantly reduced IgE, but B-FAHF-2 requires nearly 9 times less concentration.

We screened nine herbs from B-FAHF-2 and found three of them directly suppressed IgE. Other herbs have no direct effect on IgE, but some of them suppress inflammation and histamine release while others enhance protective immune responses such as IgG. But this study only focused on identifying the constituents in vitro (in a test tube, Petri dish, outside the body - as opposed to in vivo, which means given to a living animal or human).

We focused on one of the IgE inhibitory herbs, identified and isolated the active compounds, and published. The mechanism operates thusly: memory cells do not need a strong stimulus, sometimes none at all. They settle in the bone marrow where they wait until they’re ready to produce IgE. We discovered the compound that regulates IgE does so through the modulation of one of the critical transcription factors that control IgE synthesis from memory cells.

HH: It suppresses that transcription factor?

Dr. Li: Yes, that’s the key - antibody production – that’s where we use the term ‘switch.’ The antibody producing B-cells can be switched in a different direction. The same cells can produce IgG or IgE, controlled by these transcription factors. They tell this cell what to produce. And so therefore, you don’t have to kill the cells; you just have to initiate the signals to control what they produce.

HH: So you’re not killing those cells, you are switching what they are producing.

Dr. Li: Right. That is a unique finding for a natural product. They are not killing the cells. The cells can still be there, but just not produce the IgE. Also, sometimes with immunomodulation, the IgE levels are still there, only they’re dormant. Then when the body needs them, they can reactivate, when you encounter an intestinal parasite, for example.

Normally the immune system can distinguish between the different proteins - food protein is very different from bacteria. Bacteria pathogens are very different from other microbes. The cells can tell. So therefore when you get a bacterial infection, your B-cells automatically start to produce IgG. Most of the time probiotics stimulate your immune system to produce IgG. Once your immune system encounters this type of stimulus, it has the capability to produce IgG to protect the individual. But with allergies, the allergen stimulates production of IgE by B cells.

HH: Why do allergic individuals have this? Are they missing some key windows of immune education? Are they missing nutrients? Is there toxicity? I understand that the herbs are working on the cellular level, but why - why does it exist at all? I don’t know if you know the answer to this…

Dr. Li: (Laughs) - Some kids have asked me why do we need allergy. We are not absolutely certain yet. But you can summarize it as several things - perhaps it’s a single factor or combination but it has to do with exposure to microbials. There is a short window when the fetus is in the mom’s uterus when the immune system is skewed towards Th2 - but then after birth they need to gain quickly and switch to Th1 dominance through exposure to the microbials. So microbials or a type of microbial exposure is a major factor. Another theory holds that the mother or the post-natal infant is exposed to food too early or too late. This was the prevailing theory for 10 - 15 years, but has been recently rejected. See we avoided the peanut early and the prevalence of peanut allergy has doubled. So that has not been the peanut. So now there is no peanut restriction on mothers- but now the peanut prevalence allergy has tripled. We still have no consensus.

Another thing is the allergic march from when children are very little - they have a little eczema or allergy but as they grow they develop asthma or persistent food allergy. We are just beginning epigenetic studies. The genes are switched on and off by certain triggers such as chemicals in the environment. The environment is important, food is important, microbials and pathogens are important, antibiotics are important because they wipe out good microbes as well as bad.

So we are studying epigenetics - the genes are all normal and present. It’s how they are regulated that may cause a baby to be born with a pre-existing, allergy-prone condition. We just had a publication in a very important journal using the mouse model. We induced an allergy in some of the mothers and their babies had a very strong tendency to develop allergies, an allergy bias. But conditions still must be favorable for allergies to develop. So both factors play a role: susceptibility (active allergen genes) and environment.

With this epigenetic mechanism - the good thing is that it’s dynamic. So, you can modify it.

That’s why we are working hard to develop a treatment. We believe that this epigenetic mechanism not only underlies why it’s easier for some people to develop allergies, but it also provides an opportunity for treatment and dietary modification. For example, taking vitamin C and other things - may reprogram these genes from allergy to non-allergy. But these epigenetic changes in vivo (in body) take quite a long time. In vitro studies, through exposing the cells, provide good information about product efficacy. When working in vivo it’s crucial to have a sufficient dose – the more bioactive ingredients the better the treatment at the expected concentration range.

HH: In vitro is the herb exposed to the cells - but in vivo the herbs have been processed and digested - can you talk about that?

Dr. Li: That is why I now tell the patients, if you want to start the herbal protocol, you need to use a good dose over a long period of time. Otherwise I don’t think it will work.

HH: It sounds like what you’re talking about is achieving a certain level of cellular saturation. 

Dr. Li: Yes, you’re right. This all has science behind it.

“…sometimes with immunomodulation, the IgE levels are still there, only they’re dormant.”

HH: And so, let me go back to - you’re talking about this next round of trials that will be 26 months and the mouse models - and in a perfect world if what you’ve seen in the mouse models translates to humans - what does someone’s path to reprogramming their genes from allergic to tolerogenic look like? What does the path to heal through B-FAHF-2 look like - how long does it take? Are we on it for our entire lives? What is the dosage? 

Dr. Li: It still depends on the individual. So that’s why parents are very supportive of us. We’re moving in a more practical direction, but with minimum expenditures, as opposed to the millions spent on the earlier trial. This new study will require $2-3 million but it can only take 17 patients in active and 17 patients in placebo. Why? Because when you want to do a double blind placebo trial with the challenges, it’s extremely expensive – medicines, nurses, doctors, tests, managing reactions.

But then another new study we are setting up will be a small practice-based study. That is, it will be done through day-to day practice under “real world” conditions instead of intensely controlled clinical trial conditions. I want to use biomarkers - IgE as well as basophils—to see if we can measure progress without challenges.

In mice, basophils activation shows a very strong correlation with clinical reaction. And then I’ll use epigenetics to look at the T-cells and determine whether they are switched or not switched, and how long they take to make the transition (Additional information: The epigenetic biomarker becomes more important now. For example, some of my patients passed a peanut or treenut challenges. If their tolerogenic epigenetic biomarker maintains even after reduction and discontinuation of treatment, plus normalized basophil activity, their tolerance will highly likely be sustained.)

I cannot stress strongly enough - these trials - no one has done them but us. We are pioneers. It’s not perfect yet. There are several knowledge gaps. In addition to continuing double blind placebo controlled trials, we will also conduct the practice based-study, which is more cost effective, so that we can design an even better trial in the near future. (Additional Information: Although randomized controlled trials (RCT) are the gold standard in assessing treatment efficacy and safety of newly developed drugs, their results can be limited when applied to real-world clinical settings. Practice based evidence (PBE) studies are an alternative to RCT, and well suited to determine what works best for specific patient types in day-to-day clinical practice. They provide a holistic picture of patients, treatments, and outcomes seen in real-world clinical settings. PBE studies can uncover better practices more quickly than randomized controlled trials, while achieving many of the same advantages. TCM is inherently an individualized approach to Chinese herbal medicines as well as acupuncture and acupressure; PBE studies are well suited for the preliminary TCM therapy to define what TCM therapies will be the best for the specific group of patients with food allergies.

There are three requirements for the individuals in the study. They have to have a history of reactions and their peanut specific IgE has to be over 100. Or, if the peanut IgE is not over one hundred, but the two-year IgE figures are very high and increasing, those patients can also qualify. The third group will be made up of people who have a history and very frequent reactions. You know sometimes children are so sensitive they don’t even have to eat the offending food, they just smell it or touch it and they have a reaction. They will also qualify. This is a patient friendly protocol.

You know I’ve really learned a lot from mothers. I started to work on my case reports because a mother said, “You know you have so many good results, why don’t you publish them? Do a small study not a big trial study and publish it.” I’ve got medical students helping me organize the data. One case report was just accepted for publication that shows positive effects of an herbal treatment combination. We don’t know which one is essential. I think that each one made some contribution – therefore making the combination better. I used cream and internal tea and it really quieted the patient’s reactions and lowered the IgE.

But back to this practice-based study, which will answer your question. We’ll do three courses of treatment; one course of treatment is one year. I believe we’ll see changes in biomarkers in the first year for some such as reduction of basophil activity. But for others it may take two or three years. Maybe someone after one year will see effects. If the IgE is more than 100, in one or two years you’ll start to see it drop - but it may not drop to the level where it’s so low that they can go for a challenge. Other biomarkers will help to monitor progress. You have to separate when the effects are first visible and there is tolerance from the child “outgrowing” the allergy – which may take longer.

HH: That makes sense. It’s about adjusting expectations to the time frames you’re talking about. Even though, when we took the herbs, you told us to have a vision spread out over 3 years - it was still a lot to wrap my mind around. I think now I have a little bit more time stamina.

Dr. Li: I know. I sometimes tell the patients if you are seeking an immediate cure, I cannot help you. But if you have a long-term effort really concentrating - you will see, given time, gradually it will help your son’s or daughter’s immune system. But some respond sooner. That’s why I said it depends on the individual. We give a choice - you can do one course and then two or three courses. After one course of treatment we can also combine with other therapies. I am collaborating with other allergists to combine the therapies such as SLIT provided by Dr. Mary Morris.

“From this we know that tolerance has increased.”
HH: For that practice-based study are you doing it multi-center or only out of New York?

Dr. Li: First we will just start in New York collaborating with a mainstream allergy practice. Since it’s practice based, the regulation level is different than for a placebo-controlled trial. It’s not called a trial - it’s a study. Everyone gets treated. We will use the individuals that come to the clinic and get an annual check up but they don’t want to get treated as controls (sometimes this is also called community study). We’ll just collect their blood samples. Since they are checking their blood levels anyway we just use that as a control, but they don’t take a placebo. And then no one will get a challenge. I have a team working with two other allergists that are helping me evaluate. I’ll provide the treatment and then they will evaluate. This will make it more objective not just my opinion.

And then after two or three years we will most likely see the epigenetics change - the basophils reduced, and/or the IgE changed. However, even if the IgE remains high - but we may be able to predict that they have built up a new level of tolerance. Sometimes people will still have a high IgE, it cannot be reduced to the baseline normal, but they can tolerate the foods to which they used to have reactions.

For example, we’ve taken blood and mixed it with peanut protein - two nanograms – a very low dosage. Before treatment the cells produce 60-90% activation, meaning 60-90% of the cells released histamine. This shows that the patient is very sensitive. Then after treatment, we’ve done the same blood sample mixed with two nanograms of peanut protein, and seen 20% of the basophil cells release histamine. From this we know that tolerance has increased (non-allergic people also have basophil activation, about 10-20%). So that gives us a quantitative measurement, but the individual does not have to go for a challenge. We use the cell level to predict the individual’s sensitivity If patients’ biomarkers are dramatically improved compared to baseline, and if the family is interested in introducing certain foods, allergists will determine clinical tolerability by oral challenge based on the clinical practice standard for assessing food allergy outgrowth.

All these methods for biomarkers are being used in my lab. We don’t require a food challenge at baseline for this highly sensitive group of patients. But if you don’t do a challenge sometimes people think that you don’t have an allergy. So we want to use biomarkers to predict sensitivity. As I’ve said before, there is a strong correlation between the biomarkers and clinical reactivity. If you look at the cells, instead of the clinical endpoints, you can get critical information about allergic vs. tolerogenic status. But many times we separate the clinical symptoms and the immunological basis. We see the clinical symptoms and forget that everything has an immunological and physiological foundation. What we observe in clinic originates in the cells. And so predictive information, not necessarily diagnostic information, can be drawn without the dangers of challenges.

HH: Challenges can be traumatic. I think that clinicians see a reaction from the outside. But our children experience these reactions – and so while challenges can be life changing if you get a new food – they can also be extremely terrifying for the children especially if they’ve failed challenges in the past. 

Dr. Li: Yes. That’s why many kids are very, very careful. And some kids can still be careful, but avoidance is not enough for them. There’s about 10-14% of the allergic children who react to inhaled allergens and/or skin contact. In fact, my recent publication of three cases in one instance focuses on skin contact and inhalation causing severe reactions.

HH: Skin contact causing systemic anaphylactic reactions?

Dr. Li: Yes. Well skin contact-induced reactions don’t happen with everyone, only a small portion of allergic individuals.

HH: With the mouse model - the mice were 100% compliant - so how many of the mice were successfully protected from anaphylaxis? Did it protect all the mice that took it?

Dr. Li: Yes. That’s what was so impressive. Since I started working on the food allergy research we tested many novel therapies that we thought would be effective against food allergies. The first time we used the herbal treatment we saw that the mice were protected. They were all protected. It was beautiful. If we can reach the dose and duration of the mice (100%), we have a good chance. It’s just that persuading our patients to use a full dose over an extended period of time is a big job. We are hoping that the refined product will make our and their efforts easier. In my practice-based study we are going to use the refined product that I’m working on.

HH: I understand that you’re preparing to publish the data of the most recent FAHF-2 study - and with the practice-based study you’re hoping to perfect the protocol and process - and so talking about what things look like is difficult. But if you look at the mouse model and translate to the human model, what kind of projections can you make? Do we take the herbs at a full dose for three years? … And then what happens?

Dr. Li: Then you’ll get protection, even if your IgE may not be at a normal level. That is my prediction. Reactions don’t only involve IgE, but also additional types of cells such as mast cells and basophils. The protection is not only due to reduction of IgE, but also induction of other antibodies such as IgA and IgG.

In the animal study, before treatment, the mice had a similar IgE level as post treatment. But in the middle, before treatment with the herbs commenced, we gave a boosting dose to drive their IgE levels very high. In mice, we don’t do “More than 100” we do a real level - for example, 2500 or 2000 - to ensure at that time of the challenge they have a reaction. Following the boosting, their IgE levels can reach 5000 or more. But after the herbal treatment, the IgE level of 5000 can drop to around 2000. And even with that level at the time of the challenge… they don’t have any reactions. So, after treatment the IgE level is lower than the post-boost level. But it never gets as low as normal, sometimes not even to the level before we boosted them.

With very high IgE levels, if you are able to drop it to a certain level, I think you do not need it to be normal. After treatment, you may build up a new level of tolerance. In Chinese medicine, they talk about balance - so I think - the treatment just brings a new level of balance. You cannot go back to baseline, like a new baby before they’ve been exposed to the allergens. But, you can affect a switch that starts to build up a good protective immune response and bring new balance… The children are still healthy. They don’t have reactions. But their IgE level is not zero.

HH: IgE becomes less an indicator at that point, because the whole system has realigned itself.

Dr. Li: Right. You can still have IgE. But you also have lots of IgG, IgA, and many other protective antibodies. That is very good. These antibodies circulate. And for example, if you have peanut protein that gets in, they grab the protein and don’t give it a chance to bind to IgE. These other antibodies are also specific so they can do that. This protects the individual from having a reaction. The protection happens in many ways, not just dropping the IgE.

HH: And then after the three years - there is protection - there is a new balance. How do the next 10 years look? Are there periods of time where we’re back on herbs for a month, a year? Is it half the year? Not at all?

 
Dr. Li: That is a very good question. Many allergists who do research don’t believe that food allergies, particularly persistent food allergies, can be cured. That’s because they see how stubborn the cells are. Everything involves cellular memory - memory basophils cells, memory B-cells, memory T-cells…

That’s why the new study is around the effect of polysensitization (sensitization to more than one allergen family). You can lower this sensitization. You can build up a higher level of tolerance. You can bring a new balance. This is an epigenetic concept (relating to or arising from nongenetic influences on gene expression) - you can reprogram. You still have the potential to have good protection.

Many children have multiple food allergies: 30-50% of them. Another part that is so scary, from the literature, is the growing number of children with multiple food allergies and multiple allergic diseases. In my patient population, almost 100% have many things - food allergies, asthma, and eczema. Many of them had been on daily anti-histamine for many years for their allergies in addition to other medications. They have several foods with IgE levels that are over 100. Other people have come to me and they don’t write down how many foods they are allergic to – as one mother told me, “Let me tell you how many foods we can eat. Maybe that’s simpler.” (Additional information: I just had a phone consultation last week with this mother, this child started to add back some foods already. We added the foods back to his diet first from the foods that he lost the latest).

So what does life look like after 3 years of treatment? It depends on how severe the individual’s food allergies were to start. For the most severe, with many IgE counts more than 100 - maybe we can help introduce some new foods. With treatment, plus lifestyle changes, plus other dietary modifications - when the IgE level is low - they get a chance to introduce new foods. And many patients are cured. But for others we still need to work. In these groups of children who have multiple allergic conditions, their asthma and eczema will be improved first and environmental allergy can also be improved so some of them can wean off the steroids and daily anti-histamine. They are healthier as individuals (including both physical and mental health). But their IgE sensitization improvement may be seen later. That is why the clinical phenotype and IgE levels are not always correlated. However, it is not easy to establish this concept/practice because these are no other in vitro immunological measures available yet at routine practice, most of the new biomarker measures are still in research status.

"This is an epigenetic concept (relating to or arising from non-genetic influences on gene expression) - you can reprogram."
I helped several mothers; they started to introduce one food after another after another…. I don’t claim this is all my success, because the patients are children. Children have a strong natural capacity to outgrow…. The treatment just helps them to develop that capacity. If they have 20 or 30 or 10 even (food allergies) to outgrow, that may take a longer time. And it seems that after they outgrow certain foods, it’s quite stable, the allergies don’t return. I’m not saying 20-30 foods all of a sudden are all cured. It’s different levels. Some are more stubborn. Some are easier. But once you can introduce more foods, the idea is to improve this individual’s quality of life.

HH: Now going back to the mouse model - for some people they might need to do intermittent periods of herbs and for others they just go off and they are done. 

Dr. Li: You’re right. In the mouse model, we stopped treatment after six months. But in human time, that is a quarter of their life (HH NOTE: because mice live an average 2 years). If ten mice are used, you stop once they build up full protection. Then about two or three mice will start to show some symptoms after you stop treatment for six months. Then we give another course of treatment and they are fully protected again. But the other seven or eight mice continue to be fully protected even without further herb courses.

I think it is still a good protocol even if the individual passes the challenge - maybe each year or every two years they do the herbal treatment for three months or six months. I use this protocol for asthma patients.

I have asthma patients who were chronically steroid dependent. When they were on steroids they still had symptoms. They got better on the herbs and eventually they were off all inhaled steroids. In these cases they stop the herbs for six months and go back on herbs for six months – that’s the protocol (Most of time I start with a one-month alternating protocol). Maybe eventually they will only need three months per year treatment. I’m happy when they’re able to wean off the steroids; I’m also very happy that they can stop TCM as well, AND their conditions are still very well controlled.

HH: And what percentage of the patients were able to do that?
Dr. Li: Asthma patients?

HH: Yes

Dr. Li: Asthma patients are very interesting. When they come to me, most of the time, they are very chronic. They are the extremely tough asthma cases. I have quite a few, but I don’t have a percentage. Computing percentages doesn’t mean as much in one practice as it does with a bigger study base. Since this work involves clinical practice, not a study population, I would be very reluctant to use percentages routinely.



HH: The one thing we didn’t cover, which I’m curious about. You noticed similarity between parasite infection and allergy at the start of your research. How do Chinese medicine principles enter into the herbal tinctures that you are working with?

Dr. Li: It would take a while to connect the TCM principles to the research. You know TCM to the U.S. is a new concept. Many people don’t know about it. For many years I haven’t used TCM interpretation or language to connect to our medicine because it’s very difficult to have a common language. It’s very hard to talk about that.

When I started my off-site clinic, I didn’t start with people with food allergies. I started with patients with eczema. They were so bad - and the standard therapy couldn’t help them. They were dubbed “give up patients” by the referring physicians. These doctors sent their patients to me, and I helped their eczema. And then when the eczema was better they wanted me to help their food allergies.

Additionally, patients with asthma also began to come to me for help. I had many who couldn’t continue the steroids because they developed terrible adverse effects from having been on them so many years. This led me to present the idea of establishing an alternative medicine or integrative medicine center to Mount Sinai in order to help the patients. That way if the patients wanted to use the alternative medicine at least they would have reliable sources. I’m not saying that other TCM practitioners are not reliable. But we focus on food allergies, allergies, asthma… We started to build. We’re half way. There are a lot of things that need to be worked on that are difficult.

Seeing the patients with the multiple food allergies spurred me to understand this more using the TCM concept. I read and researched intensively. The symptoms described in the formula for parasites are very much like a food allergy reaction.

Now in my practice, I do incorporate the TCM concept. For example, a particular group of patients, children who when they were little, only had a few allergies; but, as they grow, they acquire more and more food allergies. They develop environmental allergies as well. For them, I see that the digestive system is not functioning properly - in addition to the immune system and IgE. For these patients, I’ve begun to deepen the treatment with great TCM principles – not simply using a formula that matches the symptoms.

Sometimes we forget the physiological function of digestion. So that’s why I developed a treatment called digestive tea. To help the kids rebuild their GI system. That’s really a TCM concept. They have this concept that they focus for children on enhancing the GI system.

Normally I don’t want to interpret anything with TCM terminology. It’s not necessary to use the same language and terminology. Some mothers read the TCM books. Some don’t. And if you say, “you have a spleen Qi deficiency,” they get very scared.

HH: Yes, I’ve read about TCM and if I heard that, I’d get scared.

Dr. Li: Right. If you say, you have a kidney Qi deficiency. They say, “What’s that?”

That’s why I don’t use that terminology. Patients and families rarely ask about the TCM terminology/mechanisms and I don’t offer them. Interestingly, some of allergists and clinical fellows who work with me began to use TCM terminology even in their presentations. I think in the future, more people will be willing or interested in the TCM terminologies.

HH: Yes. And I have a bare bones understanding - yes it can be frightening to hear that.

Is there anything that I’ve missed?

Dr. Li: Yes. I feel that the conditions of food allergies, asthma, eczema, environmental allergies that can occur in one individual make the situation very difficult. They are different conditions, but they can and do occur together in one individual.

So the vision of the treatment should be different depending on the individual. And herbal medicines give us a promising, safe starting point, to retrain the immune system either before it goes wrong, or after. If we expose the memory B cells to the bioactive compounds at sufficient concentrations…we can basically shut down the memory cells from producing IgE. That means you have to expose as many memory cells to these ingredients as possible through many routes.

Now since memory cells, as I said, usually settle in the bone marrow, it is a real challenge to reach them in vivo. Which will be most effective? Through the skin or through ingestion? Probably a combination. We understand which molecules may be the key for IgE, key for basophils, key for good T-cells.... The active compounds can switch the epigenetics from allergic to tolerogenic - so we’ll use this knowledge to also help us to advance the TCM products. That is my immediate goal.

The clinical trial is a long way off. There is a huge effort needed. It requires a good design for the patients and the investigators - and then the funding is an issue. You can have great ideas, but if you don’t have solid funding, you won’t reach your goal. That’s the difference when you are a pharmaceutical company. We have to struggle. This is a critical factor that you can’t ignore in the success of clinical trials.

Then in line with that the practice-based biomarker study of TCM… that is the beginning of new methodology to help TCM clinical studies move forwards. If we gain more information, it will help us to advance the science before spending millions of dollars, and design bigger studies with more precision

Susan Weisman and another mother, Selena Bluntzer, worked through the Icahn Medical School at Mount Sinai school to set up a crowd funding website. That site discusses the practice-based biomarker study. This is not a substitute for government or big institutional funding—the heavy lifting—but it allows concerned parents and patients to contribute to science on behalf of their own children’s future. I would also like to thank Winston Wolkoff Integrative Medicine for Allergies and Wellness, and our supporters, the Winston, Wolkoff, Sherbakova, and Pichugov families for their contributions.

To read and donate to “Chinese Medicine for Food Allergy” go HERE.

Thank you to Henry Ehrlich author of Asthma Allergies Children: A Parent's Guide and "Food Allergies: Traditional Chinese Medicine, Western Science, and the Search for a Cure." Henry also runs asthmaallergieschildren.com, a site devoted to ideas that are within the guidelines set by accredited medical authorities for treatment of asthma and allergies.

If you have questions - or want to contact me - please go to my site (healinghacker.com).

Thursday, October 30, 2014

Traditional Chinese Medicine For Food Allergies: Kicking Allergy's Ass With Ancient Herbs



FAHF-2 could be the closest thing to a cure for food allergies out there.

What is a cure?

In my opinion: tolerance.

Being able to savor what was once a mouthful of death. I recently read "Food Allergies: Traditional Chinese Medicine." The book chronicles the work of Dr. Xiu-Min Li – known by anyone who is anyone in food allergy circles as the originator of FAHF and FAHF-2 (Food Allergy Herbal Formulas 1 &2), as well as ASHMI (Anti-Asthma Simplified Herbal Medicine Intervention). I can safely say that anyone with food allergies would benefit from reading "Food Allergies: Traditional Chinese Medicine." While I've read many an article and infographic on the immune process behind an allergic reaction, Henry Ehrlich (the author) goes through it more comprehensibly.... introducing concepts such as IgG and IgE competing for room on mast cells. He also covers things I've found in other readings (it was nice to have it reaffirmed) that IFN-gamma and IgE seems to be inversely coorelated.

If you are seeing Dr. Li, you should definitely read it. Understanding the dynamics of the process and the studies will enable you to keep your eyes on the prize when day, after day, after day, you are coaxing your child into swallowing 20-40 pills before school, then another 20-40 in the evening. Luckily my son has learned to swallow larger capsules, bringing his pill number down to 1/3 or 1/4 that number. But, you get my point. In this book, Henry Ehrlich covers Dr Li's arc from interest in immunology to where she is today - on the cusp of releasing the multi-location phase 2 efficacy studies in humans. He also dives into the results of the studies, even discussing the process for inducing allergies in the lab mice. Overall - if you're in the food allergy, allergy, and/or asthma sphere - this book is a must read. I've already returned to it several times to reference things that have lingered in my mind.

Food Allergies: Traditional Chinese Medicine is short - but dense with info.

 

This book took me longer to read than I expected, for two reasons. First, I couldn't see through the tears and had to put it down. We've been so worn and ground down by our allergy and asthma regimen, that to just ponder life without it... well it made me cry. He also speaks with some other food allergy parents and, for me, there was a sense of comaraderie. Additionally, I was re-inspired in the belief that my crazed quest would actually beget a cure. OUR cure. The second reason for my unusually long reading time was Henry Ehrlich's incisive explanations of the allergic immune response function – Greek letters and all. Though I consider myself relatively knowledgeable about a wide range of cytokines, I still had to ratchet my brain to the max and search the net before I could fully grasp all his invaluable information.

Our Time on Chinese Herbs

 

I've always known, and continue to spread the word, that one of the greatest medical systems in the world is the Traditional Chinese Medical System. I'm not speaking about the structure of the system - but the herbal remedies, the understanding and defining of the body systems, and the holistic approach which targets the cause of the illness (or imbalance.) This is a fundamentally different approach than allopathic medicine, which provides phenomenal emergency care, but appears to address and alleviate symptoms only, and views each organ or system as a discreet silo'd piece unto itself....

 I was first introduced to Traditional Chinese Medicine back when my son was about 2 years old. At the time I had been having abnormal pap smears for the past 5 or so years. I also had tested positive for the HPV virus. The diagnosis, after a sampling, was atypical cervial desplasia. My gyne recommended cryo-therapy to freeze off the part that was abnormal, and that my body was not clearing on its own. The thing was that the sampling was so intensely painful I was terrified of the potential pain the cryotherapy would cause, and decided to try something else first. A friend of my mother's told me about her TCM in Chinatown. I felt like I had nothing to lose - if it worked , great, if not, I knew what to do next.

 The TCM doctor practiced in the back of what looked like a gift shop. The walls were wrapped in tiny drawers with Chinese figures scribbled on them. She sat with me for about 15 minutes, felt my pulse, checked my tongue, and then said "You drink my tea for 2 months, you go back to doctor and it will be gone." That was it. I left with a two week supply of tea (a bag of twigs, leaves, rocks, unidentifiable plant and mineral matter) and was told to return for a follow up and refills. And so I did. Now the taste of the tea was indescribably awful. Bitter, sour, muddy... thick and lasting. But I slugged it down as told. And when I returned to the gyne for a follow up months later - it was gone! I would say that prior to this experience, I was much more of a pill popping, medicine- loving traditional patient. But this experience really shifted my perspective. It gave me an alternative treatment option when the MD had no answers to offer. Then it hit me: what about...

Herbs for food allergies and asthma

 

I tried Chinatown herbalists' herbs with my son shortly thereafter. He was about 2 or so at the time. We drank the herbs very briefly, but then stopped because I read articles and such that warned of potential contamination with the herbs - heavy metals, pesticides, etc... My son was so young and I really believed, and still do, that your first rule should be: do no harm. I wasn't convinced the herbs were safe. And while I felt OK taking a risk with myself, I didn't feel OK doing the same with my two-year-old. We then sought to find herbal practitioners that tested the quality of their herbs. We ran through a number of different practitioners - TCM and Ayurvedic - before totally stopping again because nothing seemed to shift my son's immune system. We didn't experience a reduction of symptoms, an increase in tolerated foods, or drop in IgE. But I still believed the answer lay in the world of herbs - and specifically TCM herbs. In 2010 we discovered Dr Li through an Accupuncture Today article. I googled and emailed her directly after reading. In the winter of 2010, we had our first consultation with her. Our goal - to diminish the food allergies - was complicated and delayed by my son's eczema and asthma. We were on and off topical steroids to control the eczema; inhalers to help with the asthma. During our first 6 months we were able to clear the eczema and discontinue topical steroids. Next, we tackled his immune system with Dr. Li's herbs. The goal was to prevent colds and thereby, cold-exacerbated asthma attacks. We achieved this as well. As we moved on to food allergies, we were continually in flux, taking different herbs depending on whether or not he had a cold or asthma issue. In hindsight, I realize that my expectations were too high (I wanted faster results), the protocol was difficult to swallow (around 40-50 pills for my six-year-old daily), and I didn't quite understand the end goal. Thinking through it now I realize that we accomplished a lot, only we weren't progressing at the pace I expected, not driving the IgE down fast enough for this anxious mother.

What is so great about Food Allergies: Traditional Chinese Medicine is that it's helped me reset my expectations by walking me through the mice studies. The initial mice studies of FAHF-1&2 kept the mice on the herbs for 7 weeks. The human equivalent of the two year mouse life span comes out to about 4.8 years. So when Dr. Li advised me to expect a three year time line, she wasn't kidding. (Of course she wasn't, but if I'm famous for anything, it's for missing the obvious and needing to hear information multiple times before allowing my mind to assimilate it.) And so, our herb regimen for food allergies – following the successful regimens for eczema, asthma and colds – was too brief. I now understand that. I've always had a passion for the Eastern way. I've ingested herbal concoctions from my local TCM herbalist for all ailments that have plagued me. Still, to my Western-raised mind, three years seemed so long to be on the same herbs. This book delivered more than a lesson on food allergy, it reminded me that curing food allergies and asthma is about patience and perseverance. I'm convinced we should return to Dr. Li for round two. There's no doubt that she is the best game in town for food allergy.


The real eye openers for me out about FAHF-2 & food allergies were:

  • That IgG and IgE battle for room on mast cells. Fascinating. I've read that desensitization increases the IgG levels for the specific foods.
 
  • That when inducing food allergy in mice, the smaller amount of food administered initially, the stronger the allergy – ie. mice given 5mg of peanut had stronger food allergy than mice given 25mg. Seems counter intuitive – a smaller dose creating a stronger allergic reaction in the long run.
 
  • FAHF-2 works on two elements that appear to contribute to food allergy: gut permeability and the immune system. Although it is difficult to separate the gut and the immune system, given that the gut rolls in the immune system. Gut permeability sounds to me very much like "leaky gut." This too is fascinating. Gut permeability definitely plays a role in food allergy. This has always resonated with me. Not sure doctors would agree, but just a few years ago a chiropractor who heard about my son's food allergies said "Oh, he's got leaky gut." She then gave us the supplement glutamine. I don't recall how long we took it. Something to reconsider...
 
  • Dr. Li's three year timeline makes much more sense now. Mr. Erhlich cites FAHF-2 studies in which mice took the herbs for 7 weeks. Since mice life spans are about two years, 7 weeks in human time could be about three or more years. I wonder if the time off herbs during which the benefits persisted can also be translated into human years. The mice had protection for several months (sometimes they received a boosting dose of herbs - I'll have to reread) - this could potentially translate to human protection requiring several years. Which would mean one would not necessarily have to take herbs every day for life, one could potentially take them for a solid chunk of time (months/years), then take a break for a solid chunk of time (months/years) and maintain tolerance.
 
  • The immune system could be called a zero sum game. IFN-gamma goes up then IgE goes down. IFN-gamma is Th1 - IgE is Th2 - it's a seesaw. This is something that I've known for awhile. And I've used this to skim and drive the particular probiotic strains that I've selected. Not sure how the recently talked about Th17 arm factors into this - will need further reading.
     

Tuesday, December 31, 2013

How we started lypospheric vitamin C

Vitamin C

I posted some here about our use of lypospheric vitamin C here and here. But this post is about how we landed on lypospheric vitamin C to begin with. We wove our way to the lypospheric vitamin c.

Vitamin C and Seasonal Allergies

In the spring of last year (2012) I believe, my son started what had become usual for us each spring - intense nasal congestion. It was spring allergies. He would get so congested that he could not even breath through his nose at night - I spent weeks at a time sleeping with him the previous years and holding him up so that the congestion would drain and he could sleep peacefully. We'd finally succumb to nasal steroids - adding to our steroid burden.

And in 2012 - that is where we were headed. Bear in mind, we'd use the netti daily, zyrtec, stay indoors - but still he would spend about 3 months battling intense nasal congestion that could only be tamed with flonase. So here we were March-ish 2012 and my son was beginning the seasonal stuffies. I let it go for as long as I could and then ordered the nasal steroids. In the meantime, he caught a flu or something that was going around school - so he was out for a week. I decided to start the steroids once he was well again. Towards the end of the week, when I thought he was getting better - he spiked a fever and a really rich cough. This was Saturday night - I decided that we'd last out the weekend and then go into doc on Monday. He had pneumonia when he was 2 - and then some other quasi lung infection thing at 3 (all before asthma diagnosis) - so I was totally afraid he had gotten pneumonia. The cough was intense and the fever relatively high (hovering around 101.9 to 102.5 if I recall). Around 11ish at night, I spooned as much lypospheric c mixed with apple juice as my son would take. I would wake him periodically and give it to him. In the morning, I gave him a gram - and then throughout the day - I think it was every 4 hours or so I'd give him 1 gram.

Needless to say by Monday morning he was fine - fever had broken the day before never to return. The other thing that didn't return was the nasal congestion. So I continued giving my son 1 gram, sometimes 2 grams, daily of lypospheric vitamin C. About 5 months ago, I stopped giving my son a daily gram. He now only takes it when he is sick or sniffly. We'll see how the spring goes - whether or not we need to pulse back on, and what effect, if any, that has.

Vitamin C and IgE

Over the next year and a half we experienced an IgE reduction of 30% (the first 4-6 months) followed by a slow rise again, despite our daily dose. Our IgE experience seems similar to the findings of this article:

Assessment of oral ascorbate in three children with chronic granulomatous disease and defective neutrophil motility over a 2-year period.

 

This is a fascinating article. The children, all three of whom had elevated IgE levels, experienced an initial drop of IgE in first 6 months - followed by a gradual rise over the next year and a half that they were tracked.  

Why does vitamin C (sodium ascorbate in particular) initially reduce IgE? Why does it stop doing that after about 6 months? What organ does it initially effect, that grows tolerant to it?

More food for thought:

The Analysis of Vitamin C Concentration in Organs of Gulo-/- Mice Upon Vitamin C Withdrawal

 

An interesting study, keeping in mind that it is mice model. The mice are bred not to produce vitamin C (like humans). But it's interesting read - if only to get a clue to which organs it effects:
According to the report by Harrison et al. (14), vitamin C is preferentially deposited in brain (4~10 mM), adrenal gland (2~10 mM), liver (0.8~1 mM) and cerebrospinal fluids (CSF; 0.2~0.4 mM). However, the reason why such organs contain the high concentration of vitamin C is still largely unknown. Moreover, in vivo kinetics of vitamin C in organs under vitamin C insufficient condition has not been investigated yet.

Wednesday, November 13, 2013

Baked Milk Muffin 4 Months Out, Probiotics, & Chelation

Our daily muffin

So it's been a nearly 4 months since our baked milk challenge and up until about 3 weeks ago, getting my son to finish the muffin was a chore. Mainly, he complained that his stomach hurt or his lips itched. I backed all the way down to 1/4 muffin a day, then I would slowly build it back up. Presently, he's at 1 muffin a day. In all fairness I started giving him digestive enzymes with the muffin about 3 weeks ago, which seems to have been the reason I could escalate it back up to 1 whole muffin. I give him the muffin first thing in the morning with breakfast. But just before, I break open a digestive enzyme cap and pour enough out to fill 2 empty vegetarian capsules size number 3 (one of the smallest). He no longer complains of a stomach ache. In fact, he asks for seconds.

The other thing I've been doing lately is giving him a probiotic. I was experimenting with a lactobacillus mix, but stopped because he got eczema flare on inner elbows and backs of knees. I'm not sure if it was coincidence, since pollen was high as well. However, I temporarily stopped. Although, I have been giving him Gerber Soothe Colic Drops which contain l. reuteri. This is the same probiotic as the BioGai, but licensed to Gerber. (Side note, I have purchased online & via pharmacy - and even in pharmacy, they kept it on shelf, not in refrigerator). At any rate, you can read about the BioGaia research here. My son is not an infant, but a 7 year old - soon to be 8. I give him around 10-11 drops a day. The nutritionist at Gerber, with whom I spoke, said that 100 million would be the dosage for both infants and older. However, I've doubled the dose. We'll see because most of the studies are on infants - but I remain hopeful. And it seems to me completely benign.

Our hair test

A couple weeks back, I did a hair test on my son (the results posted here). I dropped the results with our nutritionist, who said she'd look them over and we'd discuss. Although, her first response - was what do these numbers mean? What do the hair results of the general population look like? Isn't everyone exposed and so wouldn't we all have elevated levels. This is something that I don't know the answer to - and if I get a chance, I'll do a follow up call to the lab.

But, the 2 things I've done & decided are - I've stopped getting our camel milk in plastic and instead been getting it in glass. The cost of the milk has gone up with the added shipping weight - but I feel better about it. Also, in preparation for doing the lose dose Andy Cutler low dose chelation, I've started introducing my son to DMSA. The dose has been approx 6mg that I give 1x a day. We are on 4th day today. While I understand this isn't the recommended process, I want to make sure he can tolerate before delivering around the clock. So far, so good. I'll do it 5 days, then this weekend probably start with DMSA.

What turned me onto chelation is 2 things - 1. there are some similarities in the immune issues in kids with autism and allergy - 2. I read a study that linked arsenic to elevated IgE and asthma. This was a study that was done in India or China - and they found with alpha lipoic acid chelation of arsenic, IgE levels dropped as did severity of asthma symptoms. I'll have to look for this abstract again and post link.