Every undigested protein is an allergen

If someone asked you what you thought was the most fundamental, the most essential, the most important health challenge that we face as modern human beings living in industrialised countries, what would you tell them?

Take a moment. Shift your gaze away from this text, and think about it.

When we read or hear something about health and nutrition in the news, on websites, on blogs, on social media, or even in books, the information we encounter is almost always biased and directed  in some way. It is also always restricted in scope. In fact, it is usually very restricted in scope. All this is perfectly natural and expected: whenever we sit down to write, it is usually about something in particular, something specific, some topic we want to address or explore. It’s hard to think of circumstances where this would not be the case.

Moreover, basically everybody who writes anything, does so in order to be read, and therefore naturally attempts to appeal as much as possible to their readership, both in content and in style. But maybe the most influential factor is that we have grown accustomed to information packets, to bite-size bullets of information: quick-to-read, quick-to-scroll-through, and quick-to-either-share-or-forget. And this has above everything else shaped the way information is being presented by all those people out there trying to appeal to more readers. Little can be done to counter this tendency. It’s just how it is at this time.

As a consequence, for all these reasons, we are—the whole world is—migrating away from the mindset that encourages inquiry into the global, the general, the underlying aspects of things. Instead, we are migrating towards an evermore concentrated, focused, laser-beam approach to basically everything. This is true in all fields of study and inquiry to some extent. In matters of nutrition, it is particularly noticeable. This is surely at least in part because we tend to be simultaneously very interested but highly sensitive to advice about what we should or should not eat. We take it very personally and react strongly.

Our relationship to food is very deep because it is so constant and continuous, so intimately related to our survival. This relationship starts when we come out of our mother’s womb, and persists throughout each day, every day of our life, until this life of ours itself comes to an end. What’s more, what makes this relationship so close and so intense is that if we don’t drink or eat, usually even for a few hours, we get headaches and stomach aches, we get light headed, weak, and unable to concentrate or function, we get grumpy and irritable. It is very clear and naturally understandable that we therefore tend to be—that we are—very sensitive to advice about what to eat, but immensely more so to advice about what not to eat, especially if we happen to eat those foods about which the advice is given.

Hence the movement to superficial, non-contentious, bite size bullets of information: ‘blueberries are excellent: they are low in sugar and full of antioxidants’; ‘avocados are amazing: they are not only full of healthy fats but they are also alkalising’; ‘hydrogenated vegetable oils are very bad: they are full of toxic trans fatty acids.’ But what about the essential, the fundamental, the underlying?

You have had more than a few minutes to think about it. What would you say, then, to this question of what is most fundamental to the health, to what constitutes the most fundamental health challenge we face? Well, I would say it’s digestion.

Digestion is where everything about us starts and ends: It is in and through the digestive system that we absorb all the nutrients and excrete all solid wastes. It is through the digestive system that we absorb all the constituents of everything that we call body, and excrete all that is toxic, be it produced from the environment or from within through healthy digestive and metabolic processes. Do you find this sufficient to illustrate why digestion is so fundamental? I think so. But we can go a lot further.

Evolutionary considerations, arguments, and observational evidence, are always useful, and usually very powerful in guiding clear thinking about matters of health. One of the main questions that has and continues to preoccupy evolutionary biologists is that of the growth of the human brain. In this, one of the most compelling ideas put forward to explain the brain’s evolutionary path is called The Expensive Tissue Hypothesis. I plan to, in the future, devote much more time to it. But I must refer to it here because of its relevance to digestion.

The Expensive Tissue Hypothesis is based on the fact that there is a strict minimum to the amount of calories any animal requires to survive; the observation that the brain is the most metabolically expensive organ in the body; and the conclusion that it would be really hard for any large complex animal to sustain two systems as energetically expensive as the brain. Because the gut is the second most metabolically expensive, and because both together account for a disproportionately large fraction of the body’s caloric needs, an increase in the size of the brain would necessarily be at the expense of that of the gut, and vice versa. It simply would not be possible to sustain both a large brain and a large gut. And thus, the growth of the brain would have to be accompanied by a shrinking of the digestive system. This is what we observe.

But it is the shrinking of the digestive system that allowed for the growth of the brain; not the growth of the brain that precipitated the shrinking of the gut. And this evolution was the unintended consequence of a shift from a high-fibre, nutrient-poor, plant-based diet, to one consisting mainly of low-fibre, nutrient-rich, animal-based foods.

Number two Silverback Mountain Gorilla (Gorilla gorilla beringei) of Kwitonda Group, Akarevuro, Virunga Mountains, Rwanda

Male mountain gorilla of the berengei berengei subspecies of eastern gorillas in Ruanda (Source: Time). As you can see from the chest muscle definition, this adult male’s body fat is low. The huge bulging belly that is apparent when they are seated and relaxed is the consequence of having it hold the very long gut required to process each day approximately 20 kg of fibrous roots, leaves, and stocks of the plants they eat.

It is very interesting, and it is surely related to this evolutionary history, that the gut has by far the largest number of nerve endings, second only to the central nervous system. Moreover, unlike other organs and systems of the body, all of which are entirely controlled by the brain, it is the only one with directive nervous signalling to the brain. Because of this, it is the only organ with a direct influence on the brain. Thus, besides the physical implications, some of which we’ll explore soon, it is quite literally the case that a happy gut means a happy brain. And conversely, a sad, unhappy, depressed brain is very likely to be caused by a dysfunctional gut. It is a sick, dysfunctional, damaged gut that is the primary characteristic underlying states of disease. This is why I would say that it is a sick, dysfunctional, damaged gut that is the most fundamental health challenge we face today as modern human beings.

I know this might leave you hanging. Especially because we have not yet made any reference to the title. But I promise, we’ll pick up from here next time.

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No more bipolar disorder?

Our world is replete with diseases of all sorts, illnesses of all kinds, ailments countless in numbers. Modern medicine views these in isolation, and therefore also attempts to treat them in isolation: we have a headache, we take an aspirin; we have high blood sugar, we take insulin injections; we have high cholesterol, we take statin drugs to disrupt the manufacturing of cholesterol in the liver; we have cancer, we are given toxic poisons that kill our cells and hope the cancer will be weakened; we have arthritis or multiple sclerosis, and we are given immune suppressants because it is thought that our own immune system has turned against us, attacking the very body it is intended to protect. We have no idea why, but this is what we do, and this is also what we believe we should be doing.

In psychiatry, we treat so-called mental illnesses. But because we are even more clueless in this realm of the subtle functioning of the brain and mind than we are of the subtle functioning of the body and its organs, we look for drugs that suppress the behaviours which are symptomatic of the “illness” we have been diagnosed with. It’s very simple: we take uppers and stimulants when we are down and low, and downers and sleeping pills when we are high and excited. Because we all do it, we think it’s perfectly normal.

When we take a close look, we see that there are no diseases, no illnesses, no ailments that are not caused by biochemical imbalances, we see that all of our health problems are rooted in problems in the biochemistry, and we see that the functioning of the body and the functioning of the mind cannot be considered independently, because they are both nothing other than the functioning of the whole body-mind.

Surely a most striking example of this is the now almost forgotten disease condition called pellagra. The name comes from the contraction of the Italian pelle (skin) and agra (sour), and was first used by Francesco Frapolli treating people in the 1880’s in Italy where more than 100k suffered from it. But this wasn’t unique to Italy. The same was true in Spain and in France in the late 19th century. In the US, it reached epidemic proportions in the American south where it was estimated that between 1906 and 1940, more than 3m  were affected, and more than 100k actually died from it. Can you image that? That many people, millions of people, in quite a restricted region, walking around in manic states, delusional states, paranoid states, seeing and hearing things, talking or even yelling to themselves and others around them, completely incoherent and, in addition, covered in red, sore, flaking and bleeding skin on the arms, neck, face? What a nightmare it must have been.

In all countries and all cases, pellagra was associated with poor nutrition, and more specifically, associated with corn-based diets in which the maize was not treated with lime in the traditional way. Similarly, in all countries and all cases, it was found that a nutritious diet based on fresh animal foods very quickly resolved the problems that afflicted the sufferers of this disease. So, even in the late nineteenth century, they had figured out how to treat and prevent it. But didn’t know why if they replaced the corn and starches with meats and vegetables people got better.

Pellagra would usually first manifest as skin problems: eczema and psoriasis-like irritations and lesions. Then, it brought about anxiety, depression, irritability and anger. And eventually, periods of full blown mania, visual and auditory hallucinations, extreme fear, paranoia, bipolar and schizophrenic behaviours.

Bipolar-Disorder-Mood_scrabbleLetters

Now, if you know someone, if you have been close to someone diagnosed with bipolar disorder, with schizophrenia, with anxiety disorders, depression, or paranoia, you will immediately recognise in this list of symptoms those you saw in this person, surely to different degrees, and surely in the most extreme during a full blown crisis. Without a doubt, at least for bipolar disorder, these symptoms are all present, often simultaneously, and sometimes in close succession. And do you know what pellagra is? It’s vitamin B3 deficiency.

Yes, pellagra, this terrible disease that caused such awful skin conditions and straight out madness in people, this disease that made these poor people act in ways indistinguishable from those of manic-depressives and schizophrenics, was a simple vitamin B3 deficiency.

When this was understood, niacin fortification was mandated, and the epidemic affecting millions of people in the southern United States was resolved almost instantly. After decades of rampant “mental illness” among so many, so fear, so much anxiety, so much terror within families and communities, so much pain and suffering, and tens of thousands of deaths, a little added niacin ended this national disaster that was the pellagra epidemic almost overnight. The fact that you have most likely never heard of pellagra goes to show how effective niacin fortification has been in preventing it. But something else happened.

Following the introduction of niacin fortification, half the patients held in psychiatric wards were discharged. Just like that, they got better, and went home. There was at least one psychiatrist who noticed this remarkable coincidence: his name was Abram Hoffer. He wondered why so many got better, but also why only a half? What about the other half? Could it be that they just need a little more niacin? Hoffer was an MD, a board-certified psychiatrist, and a biochemistry PhD. He was also the Director of Psychiatric Research for the province of Saskatchewan in Canada, a position he held from 1950, when he was hired and appointed by the department of public health, until 1967, when he opened a private practice.

What he did to check this hypothesis—that maybe more of the psychiatric patients were not mentally ill at all, but just in need of greater amounts of niacin—was to conduct a study. He chose schizophrenics because they are among the most difficult to treat, and also because together with bipolar patients, they have many of the symptoms associated with pellagra. The results were stunning: 80% of the schizophrenics given B3 supplementation recovered. And these results aren’t anecdotal—the word often used in a pejorative or derogatory manner to dismiss important observations or evidence that fall outside the narrow realm of the conventionally accepted. These were the results of the first double-blind placebo-controlled nutrition study in the history of  psychiatry.

What double-blind placebo-controlled means is that he took two equally sized groups of people diagnosed with schizophrenia, and then randomly and blindly, both on the patient’s end as well as on his end, gave half of them 3000 mg of flush-less niacin per day in three doses (niacin has a flushing effect that would be noticed, but either inositol hexanicotinate or niacinamide can be used instead). He gave the other half a placebo, which would have been a pill that looked identical, but contained no niacin or anything else that could have any significant effect on them (like powdered sugar or a starch of some kind). And in the end of the trial, when they looked at which patient got what, they found that 80% of niacin-treated recovered, whereas none in the placebo group showed significant improvements.

Over the years, Hoffer treated thousands of people with remarkable success. With simple vitamin B3 supplementation he continued to successfully treat people suffering from schizophrenia, but also people suffering from attention deficit disorder (ADD), general psychosis, anxiety, depression, obsessive-compulsive disorder (OCD), and bipolar disorder. In fact, he considered pellagra, bipolar disorder, and schizophrenia to be the manifestation of niacin deficiency on different scales, and the sufferers to be niacin-dependent to different extents. Obviously, this is the only natural conclusion he could have drawn given how effectively niacin resolved psychiatric symptoms in these people, but also in light of the fact that each individual seemed to need somewhat different amounts to have these positive effects.

The expression niacin-dependent was used to emphasise that they needed to take it on a daily basis. Naturally, an essential vitamin is not only essential in the sense that it is absolutely needed, but also in the sense that it needs to be consumed regularly because it is not manufactured within the body-mind. Deficiencies develop when the diet lacks in these essential nutrients, and grow more severe as time goes on. When the nutrients are then reintroduced, the deficiencies can be corrected. Some nutrients are abundant, some are rare. Some are easily absorbed, some are not. Some are more easily stored, and some cannot really be stored at all.

In addition, besides the fact that in any given population there is always—for the very same essential nutrient—a range of nutritional needs that vary between individuals based both on their genetic predispositions and on what they do, countless other factors influence and affect the amounts of essential nutrients that each needs to be healthy. These include various kinds of injuries the body-mind, and in particular the gut where absorption of nutrients take place, may have incurred at one point or another from an infection, a virus, a bacteria, a bad diarrhoea we had when we were babies, a childhood disease we don’t even remember, and really anything that could have damaged a specific part of the intestine where a specific family of nutrients are absorbed.

Any such injury could result in a greatly increased need for a particular nutrient that, without knowing about it, could not be supplied in adequate amounts from diet alone, and would inevitably develop into a progressively more severe deficiency whose effects on the body-mind would eventually appear as dysfunctions that would, without a doubt, have physical as well as psychological or psychiatric manifestations. Why? Because there is no body that functions independently of the mind, and there is no mind that functions independently of the body. There is only this single body-mind.

Niacin and B vitamins in general are water-soluble. This means that we pee most of them out, and therefore it also means that we need to have them every day, or nearly, in order to prevent the development of deficiencies. The experience from the last decades of the nineteenth and the first five decades of the twentieth century in Spain, Italy, France, and  in the US, showed that a single vitamin deficiency, a simple niacin deficiency, could cause extreme symptoms that included severe psychiatric dysfunctions. It also showed that even very small amounts of B3 added to the otherwise nutrition-less white bread that was eaten as a staple could cure millions of pellagra sufferers, and prevent the disease from developing in the bulk of the population.

Unexpectedly, niacin-fortification coincided with a large number of the psychiatric ward patients getting well enough to go home. This observation prompted a study with niacin supplementation which showed that in 80% of the schizophrenia patients treated with niacin, symptoms disappeared in the same way they had in pellagra sufferers, but with higher doses of niacin. It was also shown that a similarly high cure rate was seen in people suffering from ADD, psychosis, anxiety, depression, OCD, and, in the point we wanted to emphasise in this article, bipolar disorder. In almost all cases, niacin supplementation resolved the dysfunctional behaviours and psychiatric symptoms. What varied were the amount of vitamin B3 needed to achieve recovery, and the speed with which symptoms would come back upon interruption of the supplementation.

Therefore, whether you are among the lucky people who never were niacin deficient, among the lucky people who need very little niacin, or among the less lucky ones who are deficient, who do need more of it than most, or who are suffering from anxiety or depression, schizophrenia or bipolar disorder, doesn’t it make sense to just start taking a little bit of extra B3 each day? Doesn’t it make sense to give your body-mind the amount of vitamin B3 it needs, recognising that for each one of us this amount may be different, that for some it will be a lot more than for others, but resting in complete assurance that no ill effects will come from it, because niacin supplementation is harmless, and that the only disadvantage of it being harmless, even in large doses, is that we need to take it daily.

And given how inexpensive any form of niacin is, shouldn’t we be giving it in large amounts to every patient in every hospital, psychiatric ward, and medical institution? We should, but this will probably never happen. What we can do is take care of ourselves, of those people closest to us like our children and spouses, siblings and parents, of those people we care about like our friends, colleagues, and even simple acquaintances who come to us for advice or just to share their concerns about a health issue. And one of the simplest and most effective things we can to improve our own health and the health of those around us is by taking a little B3 supplement every day. It could just make you feel more relaxed, more focused, calm and at ease, as it does for me, or it could completely transform your world, bringing you from a state of hyper-anxious, paranoid, delusional and hallucinatory mania, back to a relaxed, helpful and trusting, conscientious and reasonable self, giving you the gift of your own life back to yourself.

Could it really be this simple and this amazingly miraculous? No more pellagra, no more schizophrenia, no more bipolar disorder, just with a little B3 supplementation? Well, maybe. You try it, and let me know.

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