Inflammation Is Actually Repair Deficit: Using Physiology First to Achieve Better Outcomes (July 2013) Townsend Letter for Doctors & Patients

From the Townsend Letter
July 2013

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Rethink Health: Inflammation Is Actually Repair Deficit: Using Physiology First to Achieve Better Outcomes
Part 2: The Alkaline Way is a Synthesis of Synergistic Healthful Habits
by Russell Jaffe, MD, PhD, CCN, and Jayashree Mani, MS, CCN

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Coenzyme Q10 (CoQ10): CoQ10 is produced by the human body and is necessary for the basic functioning of cells and especially mitochondrial energy. CoQ10 levels decrease with increasing essential nutrient deficits and distress. When these levels are too low, increased risk of chronic diseases such as heart conditions, muscular dystrophies, Parkinson's disease, cancer, and diabetes occurs.⁵⁷

For maximum repletion, 100 to 1200 mg/day for 1 to 2 months is indicated and 60 to 100 mg/day for maintenance. Triple increase in absorption can be expected when CoQ10 is micellized in pure rice bran oil with added tocopherols. Since HMG CoA inhibitors (statins) typically reduce CoQ10 levels by half, supplementing this essential component of the cell energy generating machinery is essential.

The absorption of the reduced form of CoQ10 (ubiquinol) is similar to that of micellized ubiquinone described above. Reduced ubiquinol has to be oxidized to ubiquinone before it can be helpful to the body. We recommend using the active rather than preactive forms of nutrients. (See Figure 4.)

Figure 4

Omega-3 Essential Fat: Omega-3 (n-3) fatty acids have been linked to healthy aging throughout life. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been associated with healthy fetal development, optimal cardiovascular function, and prevention of Alzheimer's senility. EPA and DHA influence various aspects of cardiovascular function including reduction of inflammation and management of peripheral artery disease, major coronary events, and anticoagulation.⁵⁸ The kind of fish and the method used in processing are critical to the activity and safety of EPA and DHA.

To make sure that there are the least levels of xenotoxins such as PCBs, dioxins, phthalates, bisphenol A (BPA), and heavy metals and that the oils are not oxidized, fish oil must be distilled under nitrogen and always sealed in soft gels micellized with MCT for enhanced and safe delivery.

A dosage of 3 grams for maintenance and 9 grams daily for three months to restore healthier fat balance is indicated especially in those with essential hypertension. People in industrial societies routinely need their oil changed from omega-6 dominant to omega-3 balanced. Many people are eating 50 to 100 times more omega-6 than omega-3. Omega-6 fatty acids activate; omega-3 fatty acids promote balanced repair. Omega-6 fatty acids include linoleic acid (LA), arachidonic acid (AA), and dihomogamalinoleic acid (DGLA).

Glutamine/PAK: Combining glutamine with pyridoxal-alpha-ketoglutarate (PAK) ensures that glutamine is utilized efficiently, always available, and recycled without glutamate accumulation. 1.5 grams L-glutamine with 500 mg PAK given on an empty stomach such as on rising, before bed, and just before exercising helps keep blood lipids in check, lowers LDL and VLDL along with an associated increase in HDL, and improves vascular as well as exercise.

Carnitine Fumarate: Carnitine is known as the shovel that brings the fat fuel to the furnace of the cell.
For enhanced fat metabolism and energy, 500 to 3000 mg carnitine in the form of carnitine fumarate micellized in MCT works better than other forms.^59,60 The addition of alginate (kelp) and GABA (gamma-aminobutyric acid) supports thyroid and intestinal nervous systems while also improving fat conversion to energy.

Healthful Lifestyle
The Body and Mind Choices Become Habits: Essential Lifestyle Tips
Lack of regular exercise promotes repair deficit inflammation, while regular exercise reduces inflammation.⁶¹ Exercise should be a pleasure, with a goal of adequate activity that is achievable rather than excessive activity that becomes a burden. Undoubtedly, movement is essential, not only for physical health but mental peace as well. The mind and body are always connected and interactive. TheAlkaline Way recognizes this intimate link between mind and body, and this is why we become the result of what we eat, think, drink, and do.

This also means that if our thoughts or attitudes are unhealthy, they cost us metabolically, yet can be relearned in ways that promote rather than impair health. Chronic stress is still another cause of chronic inflammation.⁶² Stress-busting techniques such as meditation, abdominal breathing, salt and soda baths, and photobiology are a crucial part of this health restoration program.

Being at peace rather than anxious can be learned observationally through well-validated practices.⁶³ Learned optimism is both possible and effective.⁶⁴ Recent evidence shows that therapeutic massage improves muscle repair after intensive exercise.⁶⁵ Particularly recommended are the systems that combine breath and movement with a priority given to core strength and musculoskeletal resilience. For example, tai chi, traditional free-form hatha and prana yoga, Pilates, Trager system, Feldenkrais method, Alexander technique, and permaculture gardening are all meaningful and restorative ways of combining breath and movement.

Controlling Your Own Health
Self-tests such as home pH assessments give people a sense of ownership of their health status and can be performed easily. The urine pH is a good indicator of the body's mineral reserve and its acid/alkaline state.⁶⁶ Using specialized pH Hydrion test strips (Figure 5) can effectively give one a reliable assessment of the body's acid or alkaline balance. A value of 7.0 indicates the neutral state, neither acid nor alkaline.⁶⁷ Ideally, the first morning urine pH should be in a pH range of 6.5 to 7.5.⁶⁸ The range acknowledges that healthy people may produce a slight excess of metabolic acids that are deposited in the urine to remove them from the body.

Figure 5

Conclusions
Why Rethink Inflammation
Inflammation is fundamentally repair deficit. This understanding provides an opportunity to identify correctable and acquired needs of repair and thereby reverse inflammation naturally. The usual, pathology-based approach is to fight and vanquish inflammation through anti-inflammatory medications that suppress both symptoms and repair. Rethinking the causes reveals opportunities to stimulate healing responses as described above that restore homeostasis and, by completing the repair, restore comfort and function. Too often people have some but incomplete repair, leaving them functional yet vulnerable. This approach is the opposite by evoking healing responses and removing blocks to recovery at the earliest possible time and when the problem is small.

Why Integrative Science
Integrative science starts from physiology, including molecular biology, physics, and systems thinking. This integrative approach is functional and provides the least cost, least risk, and most effective strategies and tactics to restore, sustain, or enhance well being.

Why Natural Forms
Today, we know enough about the differences between mixed natural forms and synthetic single "work-alike" forms. The more we know, the more we learn about the significant value of natural mixed forms and the limited or potentially toxic synthetic "work-alike" forms of the nutrients. We have followed this approach for the last three decades. Experience and evidence encourage us to continue using standardized extract or concentrates of biofunctional molecules and to use biomimicry as a principle and practice going forward.

Why Comprehensive Care
People deserve to be treated as the individuals they are in the most complete, caring, competent way possible. This can be described as comprehensive, holistic, integrative, or eclectic care. As physicians, most take an oath to "preach, teach, and heal." Both the oath of Hippocrates and that of Maimonides contain the obligation to put patient welfare first and first of all to do no harm while caring both competently and compassionately. Virtually all of the 137 accredited US and 17 accredited Canadian medical schools use one of these oaths as part of their graduation process. Today there is an opportunity to live into this oath by personally practicing more healthful habits in conformance with our nature and responsibilities.

Why Healthy Values
Most lab tests use statistical reference ranges determined on ambulatory but not well people. With the new generation of functional tests comes the ability to set healthy values or goal ranges that minimize risk and maximize reward. This has been done for the D-penicillamine essential and toxic mineral protocol, the LRA by ELISA/ACT tests and is consistent with the predictive biomarker goal values described above.

Why Predictive Tests
With the GV or predictive goal values included in this article, a set of tests now exist that serve as independent and objective reference for how comprehensively and well individuals are doing in reaching their health goals. The healthy goal values are derived from the least risk or highest gain values for those tests. Rethinking tests to provide more predictive information is based on our decades of experience in applying and developing such meaningful metrics and measures and builds upon the current discriminators or lab test value, sensitivity, specificity, and predictive significance.⁶⁹

Why Now Is Different
Just a generation ago, a healthful lifestyle required only foods, wholesome activities, and positive attitudes. Today, with the stress of high-tech living, the toxins in the environment, and the nutrient depletion in our food supply, supplementation is more essential than ever for sustained good health along with other healthful habits of daily living.

Why Rethink Immune Defense and Repair
The immune system is more than just a defense system; it is also responsible for repair and systemic communication.^70,71 Defense takes priority over repair. When defense work in the immune system dominates, repair can be deferred so that the body now feels the aches and pains associated with abnormal renewal of tissue wear and tear.

Restoration of immune competence depends on identification of elements in both biochemistry and lifestyle that need strengthening and substitution for reactive elements until tolerance is restored.⁷² TheAlkaline Way program restores tolerance, homeostasis, energetic balance, and resilience through the Physiology 1st approach using individual, evidence-based tests that predictively show how high or low is the risk within such fundamental areas as inflammation/repair, detoxification/methylation, antioxidant status/free radical oxidation risk, metabolic status/metabolic acidosis risk, and healthy vitamin D levels.

Health for life is a goal of medicine and a personal goal for an increasing fraction of long-lived people. While it takes a rethinking, today we are able to provide predictive, cost effective risk reduction and health enhancement for each individual.

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