ACAM Meeting: William Walsh, PhD
One of the great pleasures of attending an ACAM (American College for Advancement in Medicine) meeting is listening to a brilliant lecturer whom one has never heard before. The ACAM meeting last November in Palm Springs featured William J. Walsh, PhD, an international expert in the use of nutritional medicine in mental health. I had known that Walsh had collaborated with Carl Pfeiffer, MD, PhD, who had pioneered nutritional biotyping in schizophrenia. Pfeiffer was very impressed with Dr. Abram Hoffer's high-dose niacin treatment for schizophrenia. Pfeiffer separated schizophrenic individuals into three categories based on levels of blood histamines and urinary pyrroles. In the 1970s, Walsh was working as a research scientist at the Argonne National Laboratory in Illinois. He became interested in studying whether there were measurable biochemical abnormalities in individuals with schizophrenia as well as other mental disorders, including depression, anxiety disorder, and ADHD. In addition he was interested whether there were biochemical and nutritional abnormalities in individuals engaged in criminal behavior that caused them to fail rehabilitation. Walsh's research activities at the Argonne Laboratory offered him access to freely analyze blood, hair, and urine of patients with mental health or behavioral problems. Walsh appreciated Hoffer's work demonstrating neurochemical abnormalities in "adrenochrome," an older term for a dopamine and norepinephrine metabolite. Pfeiffer had differentiated schizophrenic individuals having elevated histamine levels (histadelia) from individuals having low histamine levels (histapenia). Walsh wondered if individuals with schizophrenia, anxiety disorder, or criminal behavior indeed had measureable histamine abnormalities and other abnormalities.
Walsh's work was not based on studying a handful of patients. His study of patients was intensive and exhaustive. Patients had the usual exam of CBC, metabolic profile, and urine analysis. As expected, the blood counts and chemistries of patients with mental health problems were normal. One exception was that the white blood cell known as the basophil was found to be elevated in individuals with high serum histamine levels and depressed in individuals with low serum histamine levels. Walsh's work confirmed that nearly 40% of schizophrenics, generally diagnosed as paranoid schizophrenics, did have a high histamine level. He also found that 30% of schizophrenics, including those with schizoaffective disorder, had low histamine level. Another 30% of schizophrenics were found to have a high urinary pyrrole level (what Pfeiffer had labeled as Mauve factor because the urine turned purple on standing). However, Walsh's work determined that while histamine levels did help in making a biochemical diagnosis, antihistamine therapy was not the key to treatment.
Instead Walsh wanted to consider the rationale for using pharmaceuticals when treating schizophrenia to determine if nutritionals may play an alternative role in treatment. He focused on the synaptic receptors that regulate the content of the neurochemicals serotonin, dopamine, norepinephrine, and GABA. Pharmaceuticals such as SSRIs and SNRIs inhibit the reuptake of serotonin, norepinephrine, and GABA. Antipsychotic medications such as Thorazine increase the reuptake of dopamine. Walsh views the neurochemistry at the receptor site as directed by methylation that inhibits the reuptake of the neurochemical versus acetylation that enhances the neurochemical reuptake. He thinks that drugs inhibiting reuptake are methylating drugs while those that enhance reuptake are acetylating drugs. Walsh's work has shown that nutrient therapy also increases or decreases methylation. In nutritional medicine, we are aware that many nutrients are helpful in methylation, such as folic acid, SAMe, and vitamin B12. However, Walsh's work has shown that while folic acid and vitamin B12 are strong methylators, they perform adversely in brain methylation. It has also shown that with individuals having low methylation, folic acid and vitamin B12 work poorly; instead these individuals respond much better with SAMe and methionine. In contrast, individuals who have high degree of synaptic methylation; for example, paranoid schizophrenics respond better to niacin and folic acid.
Walsh is emphatic that patients need individualized biochemical nutrient therapy depending on their biochemistries, their symptomatic process, their medical history, their response to pharmaceuticals, and their need to detoxify. Just as not every schizophrenic would respond equally well to folic acid and SAMe, zinc and copper detoxification, or gluten and casein restriction, neither would every depressive or ADHD patient.
Walsh headed the Walsh Research Institute and the Pfeiffer Clinic for nearly two decades, studying 30,000 individuals with mental illness and behavioral disorders. Using protocols based on intensive history and physical diagnosis as well as comprehensive laboratory testing, individualized treatment programs were designed with a very high rate of success. Most patients need to continue to use their psychiatric medication for a number of months, but they can be tapered or reduced in dose, lessening adverse effects.
Walsh's work with criminals and youngsters with behavioral problems did demonstrate laboratory abnormalities that were not found with basic lab studies. Perhaps the most intriguing lab study was the finding that zinc/copper ratios were abnormally low or high. Elevated copper burdens were found to be very common in misbehaving youngsters with explosive outbreaks. Strangely, the children who expressed the most oppositional defiance and the most antisocial criminals had a high zinc/copper ratio. Walsh's nutrient therapy seeks to rebalance the zinc/copper ratio; this is not necessarily an easy task – frequently, many nutrients are needed to bring a lab test abnormality into balance.
Walsh has found that this work also plays a role in treating autism. While behavioral therapy is important for the newly diagnosed autistic child, diagnosing and treating an abnormal zinc/copper ratio or overmethylation/undermethylation is equally important. Walsh brilliantly discusses his work and theories in the book, Nutrient Power: Heal Your Biochemistry and Heal Your Brain (Skyhorse Publishing; 2012). Walsh offers educational training for physicians to administer nutrient therapy. Laboratories offering Walsh's testing include Direct Healthcare Access Lab, Bio-Center Lab, and Vitamin Diagnostics. For further information: www.walshinstitute.org.
Wikipedia Gives Townsend Letter a Thumbs-Down
As the Internet takes an increasing role in the media and education, we thought that it would be important to see what, if anything, Wikipediahas to say about the Townsend Letter. It turns out that most alternative medicine, naturopathic, and nutritional magazines and journals are not cited in Wikipedia. The Townsend Letter is included, but the short entry is considered a "stub," meaning that the entry is just bare bones and additional discussion is invited. Unfortunately, the editors of Wikipediaclearly show a bias by permitting only a degrading observation of our publication. Rather than considering the breadth of review publications by naturopathic physicians and medical doctors, Wikipedia opts to cite a few lines from our disclaimer statement: "We encourage reports which frequently are not data-based but are anecdotal. Hence information presented may not be proven or factually correct."
This derogatory comment is followed by a terse review from Quackwatch, a website operated by Stephen Barrett, MD. Quackwatch considers the Townsend Letter a "not-recommended publication."
Given the open editing policy of Wikipedia,we decided that our stub listing should be edited to include discussion about the evidence-based review articles written by naturopathic physicians and medical doctors. In November 2013, we made two attempts to edit the Townsend Letter listing. In the first editing, we did not omit the defamatory statements noted above; instead we added two sentences regarding our authors, review articles, and citations from the literature. The sentences were successfully added. However, within 10 minutes, the edited discussion was removed and the original listing was in place. A second attempt to edit the listing led to similar results. The "editor's" comments (Wikipedia authorizes "volunteer" editors) were that we did not provide "source" materials to prove our remarks. Furthermore, the editor stated the fact that we cite the literature was not worth mentioning – despite the fact that a previous statement indicated that we are not data based.
Lest anyone might think that the Townsend Letter is alone in being given the thumbs-down by Wikipedia,one can see the same sort of denigration in its review of alternative medical practitioners. Well-recognized Jonathan Wright, MD, physician and author whose review of the literature is highly respected by clinicians, is also given a cursory, belittling listing. Rather than recognizing Wright's acclaim for establishing evidence supporting nutritional medicine, Wikipediadefames Wright's acceptance of unproven bioidentical hormone therapy.
Wikipedia reserves its greatest condemnation for the overall field in a lengthy entry called "Alternative Medicine." For those of you who think that alternative medicine has made great strides in the past three decades in being accepted by academia and the public, think again. In page after page, the Wikipedia editors have portrayed alternative medicine as a collection of healing arts that are not only not fact based but are driven by greedy economics and practiced by quacks. Nearly every discipline taught in naturopathic school is dismissed as being without scientific basis. The editors condemn alternative medicine as lacking scientific validity and also wasting a patient's time and money before getting conventional medical treatment.
I would recommend your reading of the Wikipedia "Alternative Medicine" entry. I think that it behooves the naturopathic community to edit this; Wikipedia characterizations will slow the public acceptance of naturopathy for years to come.
Jonathan Collin, MD