Dr. John Gannage, MD, MCFP, DipHom
Notes from Orthomolecular Health talk March 20, 2013
Dr. John Gannage – Twitter @DrJGannageMD –www.integrative-medicine.com
On Wednesday March 20th, Rebecca and I attended the first of a series of talks on ‘MINDFUL’ – a network that provides education on the role that diet, lifestyle and nutrition plays on mental health. These wonderful lectures – organized by the International Schizophrenia Foundation (ISF), www.orthomed.org – are based on over 40 years of research and clinical practice into orthomolecular approaches for mental health and wellness.
Pioneered by Dr. Abram Hoffer and popularized by two-time Nobel Prize winner Linus Pauling, the term ‘Orthomolecular’ simply means ‘correct fit’. It’s about using the ‘correct’ nutritional molecule in the correct amount, to balance the body’s biochemistry.
The guest speaker this evening was Dr. John Gannage, an Integrative Medicine Doctor, whose main focus is on assisting children and families affected by developmental issues (including Autism). Although the toxicity angle he covered this evening was frightening – the main message we took away this evening was uplifting… the body and developing fetus can be supported if the gut and liver are supported and healed.
Overview and Introduction
•Tonight’s talk addresses brain-based conditions from the nutrition perspective only. We will be talking ‘functional malnourishment’ – you can be overweight and still be malnourished
•Between ages 12-17, one in five children will have a diagnosable mental health condition
•Neuro-developmental conditions affect one in every 6 children
•Included under this umbrella are Autism, Asperger’s, ADHD, learning disabilities, etc.
•Mental health conditions are not solely genetic; they are an expression of a child’s interaction with his or her environment, which include:
•Emotional/physiological issues, toxicity, malnourishment (vitamin and mineral deficiencies), neuro-inflammation, dysbiosis of gut (gut-brain connection), food intolerances.
•See study on dysbiosis, published today in the Journal of Medicine:
•Keep in mind, genetic susceptibility is NOT the end-all. Much can be done
Symptoms are a sign of altered chemistry and electrical activity in the brain related to diet, local brain nutrients, accumulated toxins, inflammation in the brain and other factors that have little to with a Ritalin or Prozac deficiency.
The Disease Sequence
•Well-established clinically and in research studies
•The brain is connected to the gut via the Vagus Nerve. When you feel ‘butterflies in your stomach’, that is the gut-brain axis or Vagus nerve being stimulated
•Nourishment is hindered by malabsorption in the gut and leaky gut
•Colic in babies – studies show there are gut imbalance and allergies at play.
Gut Ecosystem Disturbed by:
•Antibiotics (from food as well as pharmaceuticals), dietary chemicals, chlorinated tap water, other medications, food intolerance, birthing process
•See work of Derrick McFabe, University of Western Ontario . McFabe noticed that a subgroup of children with autism had gastrointestinal problems. Recent research has indicated immune changes and ‘interesting bacteria’ in these patients. For further reading on Dr. McFabe’s work, see: http://cogentbenger.com/autism/interviews/macfabe-interview/
Gut ecosystem responsible for:
· Immune regulation, remote inflammation, production of vitamins K, B and D, excitotoxins from unhealthy bacteria
·Provides precursors for neurotransmitters for brain chemistry, affects gene expression of brain cells, GI tract part of peripheral nervous system
· GABA, serotonin, melatonin all produced in gut
· See Scientific American, 2011 article on gut bacteria by Robert Martone, entitled, Neuroscience of Gut, http://www.scientificamerican.com/article.cfm?id=the-neuroscience-of-gut which points out how certain bacteria are implicated in the development of neurological behaviours.
•Gluten and dairy can impact gut and brain health
•Functional medicine emphasizes gut and liver support, including probiotics, for optimal brain protection and development
•Link between GI disorders and Autism [research 1999 University of Maryland in Journal of Psychiatry. See: The Journal of Pediatrics, Volume 135, Issue 5 , Pages 559-563, November 1999
Related Comments post lecture: •Never give children Tylenol before vaccination as Tylenol depletes glutathione. •You need glutathione in order to safely remove heavy metals and toxins from the body, and to ensure a strong immune system. Children with autism are poor ‘methylators’, meaning that they have problems combining •An absorbable form of liquid glutathione is ‘RediSorb’ Liposomal glutathione which was developed by physician and scientific researcher Frederick Timothy Gliford. You still need to add other antioxidants however, when undertaking a detoxification of the body. •To listen to interview between Dr Jeffrey Bland and Dr. Gilford on glutathione’s Redox/antioxidant and detoxification properties, see this link: http://www.readisorb.com/dr_bland_interview.html
•Low-level exposures to multiple industrial chemicals (some of which come through diet) are associated with mental health problems in children
•Brain enormously impacted by environmental toxins: toxic heavy metals (lead, mercury, cadmium, arsenic, aluminum), auto exhaust (also source of lead), PCBs, PBDEs, DDT, food additives, pesticides – even banned substances in North America being reintroduced in products from developing nations
•Water supply contaminated by industrial run-off
•Combination of this with ‘chemical soup’ of environment and pharmaceuticals is a formidable problem.
Bioaccumulation – humans at top of food chain
•Mercury and PCBs through fish – concentrated in a developing fetus and in breast milk – so be conscious of the amount and type of fish you are consuming
•The Standard American Diet (SAD) contains many toxic chemicals – especially Aspartame and MSG.
•Read labels – MSG may be listed as ‘hydrolyzed vegetable protein’ and Aspartame may appear as ‘Amino Sweet’.
•The Centre for Disease Control (CDC) estimated that out of every 300,000 newborns each year, 14 are exposed to levels of methylmercury that exceed guidelines put in place by the Environmental Protection Agency for developing fetuses.
•Mercury fillings = 50% mercury
•We must learn lessons from history – leaded gasoline alone has had a huge impact on health
•Virtually all pregnant women have chemicals in their bodies that might harm fetal development
•[research by Sangiv et al on Prentatal Organochloride Exposure to Attention Deficit Hyperactivity Behaviour– 2010 American Journal of Epidemiology]
•See: http://www.ncbi.nlm.nih.gov/pubmed/20106937 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367684/
•Exposure to mercury in womb lowers IQ – fillings, hair, cord blood
•Children living near highways are 2X more at risk for developing autism.
•The researchers from Saban Research Institute of Children’s Hospital Los theorized that the type and sheer quantity of chemicals distributed on highways are different from those on even the busiest city roadways.
•Lead in womb connected to schizophrenia (from auto exhaust) – damage to CNS in developing fetus
•Lead has been added to gas since 1920s.
•Lead from gasoline remains in soil, trees and is stirred up by the wind/traffic and carried to new sites (an estimated 7 million tons of gasoline remains in atmosphere after being burned)
•Lead is retained in bones. An adult only retains 10% of lead they have been exposed to but children retain 68% due to immature detoxification systems.
•Children have underdeveloped blood/brain barriers (up to 6 years of age).
•Kids are always ‘mouthing’ and touching things.
•Look to urine testing for levels of heavy metals.
•Most menopausal women are unable to detoxify as easily (No longer shedding excess toxins through menses cycle). Breast cancer rates increase post-menopause.
•Nutrients are your greatest defence against toxins.
•Critical time to assess and correct clinical or subclinical nutrient deficiencies in mother and educate about limiting environmental exposures
•Limit toxic exposures to mom and the developing brain
•The greatest defence against chemical exposure is nutrients – for mother and child
•Pregnancy support – Folic acid (400 mcg), Omega 3s (100-500 mg), Vit D (400 IU), Ca (300-800 mg), Mg (200-400 mg)
•Choose organic foods as much as possible
•Whole foods – NO chemicals, NO cow’s milk or casein in any ingredient list, NO gluten, NO soy, NO sugar, choose organic, local foods
•Reduce inflammation and mucus
•Prevent sugar highs and lows
•Stop drugging the brain
•Gluten and Casein when partially digested, act like opiates and disturb neurochemistry
•To balance neurochemistry, heal the gut and support healthy bowel flora
•Refined sugar is a major issue in children’s mental health
•Avoid processed foods and dietary chemicals like MSG and aspartame
•Food intolerances can be an issue
•Neurological differences between 9 year-old children fed breast milk early on, and those fed formula
•Don’t introduce milk or wheat until minimum 21 months.
•In clinical practice, Dr Gannage has noticed huge changes in behaviour after these foods have been removed from the diet.
•8,000 new synthetic chemicals have been introduced to our diets in the past 50 years – how many of them have been properly safety tested?
Top Genetically Modified Organism (GMO) Foods to Avoid:
· 85% of corn and 91% of soy are GMO.
· 84% of genetically engineered foods are ‘convenience foods’ and those foods ‘stabilized for long shelf-life’ for the convenience of the supplier.
· Pesticides can be used more easily on GMOs. Many of the seeds have built-in pesticides, i.e., Bt toxins, which damage the gut lining of larvae or insects.
· Bt toxin can now be found in human blood and it is not harmless. A 2012 study from France shows that Bt Toxin kills human kidney cells.
· [See Seralini et al: http://www.sciencedirect.com/science/article/pii/S0278691512005637 ]
· All of these chemicals cause oxidative stress, and this depletes glutathione and other antioxidants in the body.
Flame Retardants (PBDEs)
· PBDEs (Polybrominated diphenyl esters) were brought to the marketplace by Monsanto.
· They are now banned in North America , but are still being used in developing countries. Products imported from these countries may still contain PBDEs.
· The fibres in these products act like lead in the body.
•Glutathione is a critical antioxidant in brain protection. It supports the brains from oxidation and chemicals
•Glutathione is low in children with Autism
•Stress depletes glutathione levels
•Other important nutrients include: Essential Fatty Acids, B vitamins (esp B12, B6, B3 and folate), iron, magnesium, certain amino acids (theanine, taurine, GABA, tryptophan), Alpha-lipoic acid
•Magnesium is very important for mental health, possibly the most important mineral
•[research Jill James study B12 + folinic acid can raise glutathione levels and B6]
•[great book – Alan Gaby 2011, Nutritional Medicine]
•Start in every case by supporting the gut and liver
•Glutathione protects the brain from oxidation and toxins
•The mothers of children with autism have been tested and also found to be low in glutathione.
•Mitochondrial support – use Ubiquinol form of Co-Q10.
•Acetyl-Cystein and Alpha-Lipoic Acid convert into glutathione in the liver
•A very stable version of glutathione is a liquid (liposomal) version produced by physician and scientist Tim Gilford, called RediSorb.
•Antioxidants and plant-based foods protect against pro-oxidants which damage the brain cells.
•Stay away from refined carbohydrates and eat lots of vegetables and fruits.
· MethylB12, folate, and B6 are very important. You can make them in the gut from whole foods, alpha-lipoic acid, and other antioxidants.
· These are ‘gears’ that switch things on or off in the body (switch good things on/switch undesirable things off).
· The Krebs cycle is important for making energy. The brain never really sleeps. Neither does your heart or other muscles.
· Conversions in the Krebs cycle require B6 and zinc (incidentally, these are your mental health vitamins, and during times of stress, these nutrients get depleted).
· That’s where folic acid comes in.
· Jill James et al showed that Folinic Acid and methylB12 will raise glutathione in kids with autism.
· Children with Autism are poor methylators
Caesarian-Sections and Child’s Gut Health
· Despite the World Health Organization’s advice, 1 in 4 women will get a C-section
· As the baby leaves the birth canal, it picks up certain bacteria from the mother which the help to populate its own body.
· Non-vaginal birth babies tend to have different gut bacteria.
Advice – pre-conception and post-birth
· Don’t eat gluten and dairy for 9 months, especially if you already have a child with autism in the family (or any child that is ill with an auto-immune or gut-related illness).
· Hold off painting the nursery and avoid purchasing new carpets.
· Close windows during summer if near a highway.
· Don’t use pesticide on the property and stay away from all pesticides.
· Dental cleaning – be careful. Don’t undergo a cleaning during pregnancy (there is potential re: bacteria entering through scraping of gums).
· Avoid immediate clamping of the umbilical cord following birth. Let the blood flow. This helps to boost iron stores to the baby.
Pregnancy Vitamin Advice
· Folic Acid – reduced by BCP, alcohol, low intake of fruits and vegetables.
· Just 400 mcg of folic acid per day will decrease autism risk by 40% (Jama, 2013)
· Omega 3 oils from fish (100-500 mgs DHA daily)
· Vitamin D – more than 400 iu/day for newborn
If planning pregnancy, also check:
· Omega 3 score
· Methylation profile
· MTFHR (Methylenetetrahydrofolate reductase) levels.
· The MTFHR gene provides important instructions for how the body will process amino acids, (the building blocks of protein).
· Methylenetetrahydrofolate reductase is important for a chemical reaction involving forms of the B-vitamin folate (also called folic acid or vitamin B9).
· This reaction is required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine, which the body uses to make proteins and other important compounds
· Variations in the MTHFR gene have been associated with an increased risk of neural tube defects, so you want to make sure that MTFHR is optimal
Breast Milk Contains:
· Probiotics, Vit D, B6, B9, B12
· Good B vitamin status helps to ensure methylation for the child
Nutrients for Behaviour
· Give support to liver (incorporate herbs, homeopathics)
· For anxiety and restlessness, use magnesium, B vitamins, iron, omega 3s, and amino acids L-Theanine, Taurine, GABA and Tryptophan.
· For ADHD, use same approach.
Ensure quality of Supplements
· DON’T purchase supplements from countries that do not have strict health regulatory practices in place . Only purchase from companies that perform 3rd party, independent quality assurance and batch-testing.
· Any industry regulating itself has proven to be dangerous to human health – especially since the goal of industry is profit before public health.
· Exposure to toxins affects health acutely, chronically and across generations.
· NB: Vitamin D during pregnancy is vital for keeping the lead in the bones and not free-circulating.
Our greatest defence comes from nutrients, education and avoidance.
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Mindful is a network that provides education about the role that diet, nutrition and lifestyle play in maintaining children’s mental health.