18 Apr

Antibiotic Overkill

Medicinal Overkill

If you haven’t learned about the antibiotic-over-medication disaster we are in the middle of, it is about time you did.

All posts in this series

Introduction Agents of Dysbiosis

Somewhere from the 1950s, incidents of several autoimmune diseases in the US started growing steadily. That is also when an uptick in obesity and autism was first observed. After much of research, the most probable suspect seem to be this:

In 1944, the world started using antibiotics.

Antibiotics

Antibiotics are drugs that are used to kill disease causing bacteria. Often, they end up killing the friendly bacteria that live in us too.

Before antibiotics came alone, the micro-organisms, including bacteria, were felling populations like fleas. Here is some statistics that will freeze your blood:

  • 30% of the population killed by Antonine Plauge (AD 165-180)
  • 40% of the population killed by Plague of Justinian (AD 541-542)
  • 60% of the population killed by Black Death (AD 1346-1350)
  • 80% of the population killed by Cocoliztli (AD 1545-1548)
  • 50% of the population killed by Cololiztli (AD 1576)
  • 90% of the population killed byUnknown disease outbreak (AD 1616-1619)
  • 75 million people killed by worldwide flu epidemic (AD 1918)

Note: See this Wikipedia page for more details

Compare that with the worldwide flue outbreak in 2009, which was worst we have had in the 21st century so far. It killed 14,286 people, according to Wikipedia (or 18,500 people according to this CNN page). Media, and us, couldn’t stop talking about it when it happened.

Antibiotics was a blessing to the entire human race. Without antibiotics we would have lost many more Srinivasa Ramanujans to the lowly bacteria  (we watched helplessly as Ramanujan’s body and brain was being eaten away by tuberculosis bacteria). And the humankind would have never made the kind of progress that we made in the last 75 years.

Antibiotic Overkill

But there is a dark side to antibiotics that we are beginning to understand only now: Prolonged exposure to antibiotics, or even relatively brief exposure during the childhood, permanently damages the diversity of the bacteria living in our gut.

When we lose diversity of the gut bacteria, chances are that the population of pathogenic bacteria increases.

Whenever the body senses the presence of harmful bacteria in the gut, the gut walls open, rush water into the intestine and flush its content out. We call this diarrhea. Diarrhea is the body’s attempt to flush out the toxic contents of the intestine.

When the toxins or harmful bacteria in the gut are present in large quantities, full blown diarrhea occurs. When these insults are present in smaller quantities, the gut opens up just a tiny bit. Through these slivers, the harmful content of the intestine (pathogens, toxic chemicals, food particles) escape into the bloodstream. Our immune system picks up on the intruders in the bloodstream and starts attacking them.

When these minor insults are caused by what we eat on a regular basis, or how we live, or what kind of bacteria we harbor in our stomach, the insults never end. With the intruders being present all the time, the immune system gets into overdrive.

When the overactive immune system attacks our own body tissue, we call it an autoimmune disease. Depending upon where or how the immune system attacks our body, the symptoms vary from asthma to allergy to irritable bowl syndrome to whole lots of other things.

Many of these autoimmune diseases reverse when the gut microbiome is re-balanced.

Unfortunately, in some cases like with Type-1 diabetes or autism, autoimmune disease causes irreversible damage.

What Should You Do

Here are some things you can/must do to protect yourselves from antibiotic overkill:

  • Take antibiotics only when your life depends on it.
  • This is more for kids:
    • Their microbiome is under developed. So, they are more susciptible for damage.
    • If you damage the microbiome of infants and toddlers, there is not much you can do to restore it
    • Damaged microbiome in infants and toddlers can result in irreversible disaster situations like Type-1 diabetes or autism.
  • If you must take antibiotics
    • Ensure that you combine it with a “good” probiotics. Stagger the probiotics and antibiotic. Otherwise, the antibiotic will kill all the good bacteria in the probiotics.
    • Ask your doctor to prescribe you narrow-spectrum antibiotic that acts on your particular villain, rather than the broad spectrum antibiotic that nukes every bacteria at sight.
  • At the earliest you can, start eating a diet that is friendly to the beneficial microbiome. If the damage to your gut flora is extensive, I suggest you take help from someone like Food Clinic to tweak your diet right.
  • Understand that some diseases for which doctors prescribe antibiotics are made worse by, well, taking antibiotics! Examples are
    • Clostrodium Difficile infection
    • Presistant Acne
  • Be dirty, but in a healthy way (whatever that is)

What Else Should You be Watchful Of

Antibiotic usage becomes particularly destructive on your gut bacteria if you are already doing something that makes your microbiome fragile and vulnerable. Some of them are:

  • You have been on acid blocking drugs for a long time
  • You have been on some steroid medication for a long time
  • You have not been feeding the good bacteria in your stomach
  • You were being too much of a hygiene Nazi

All posts in this series

Introduction Agents of Dysbiosis

 

13 Apr

Microbiome: Antibiotic for the 21st Century Diseases

Gut-Microbes

If you haven’t heard the word “microbiome”, this post is going to be the most important thing you read in a long time.

All posts in this series

Introduction Agents of Dysbiosis

I am working on creating an enterprise (Food Clinic) that will specialize on reversing/managing chronic diseases using food as the 1st medicine. Of all the knowledge we are going to use in our practice, the most fascinating and the strangest thing is the knowledge of the friendly micro-organisms that live within, and on, us. These little guys are collectively called our microbiome.

First, the fascinating bits:

  • The number of micro-organism cells we food and shelter is 10 times more than our own cells.
  • These microbes take active part in running our bodies. They even train our immune system and switch on and off our genes.
  • After our stomach and small intestine extract energy and nutrition from the food we eat, the microbes digest the leftovers in the large intestine, producing even more energy and nutrients for us.
  • The large intestine is not just a waste-bin like we were told in our schools.

What’s in it for you?

  • If you eat the food that is eaten by the good microbes in your gut, all good things happen to you. When you avoid feeding the good microbes, they die out and the gut gets crowded by the bad microbes. Then the hell breaks loose.
  • More precisely, the gut lining breaks loose and lets undesirable things from inside of the gut (e.g. toxic chemicals, food fragments, pathogens) to escape into the blood stream.
  • When that happens,
    • The toxins in the blood cause inflammation all over the body
    • The immune system over-reacts to the inflammation
  • When the immune system overacts, you get auto-immune diseases like
    • Allergies
    • Arthritis
    • Asthma
    • Chronic Fatigue Syndrome
    • Eczema and psoriasis
    • Lupus
    • Irritable Bowl Syndrome
    • Crohn’s Disease
    • Insulin Resistance
    • Multiple Sclerosis
    • Obesity
    • And more
  • Till date, there are no reliable cures for any of these diseases.
  • But now, it is beginning to look like all these autoimmune diseases can be reversed by re-balancing the gut microbiome!
  • How come? If you remember, there is mounting evidence that most auto-immune diseases start with imbalance in the microbiome.
  • There are exceptions. Certain type of autoimmune diseases damage the body irreversibly. They don’t get better by re-balaning gut microbiome. Examples are Type-1 diabetes and autism.

How do you re-balance the microbiome?

There are five simple things you can do:

  1. Eat right: Eat stuff that the your good bacteria likes (fiber, sulfur, fermented food, etc.). These are also called prebiotics. Also, avoid sugar, simple carbohydrates, red meat and high fat diet (personally, I am not convinced about avoiding high-fat).
  2. Probiotics: Only if it is industrial strength and only if you take it for several months or years. Which, to the best of my knowledge, are not available in India.
  3. Medicines on the negative list: Unless your life depends on it, avoid antibiotics, long exposure to acid reducing medication, steroidal medication and toxin filled cosmetics. When you use these medication on kids, the effect is even more pronounced.
  4. Stay dirty: Be less clean. Play in the dirt. Don’t use anti-bacterial wipes. Bath less often (ahem). Don’t use mouth wash (ahem, ahem). Don’t use alcohol based perfumes (ahemn)
  5. Fecal Material Transplant (FMT): This is a stylish way of saying that the excretion of a healthy human being is pushed into the rectum of someone with poor gut microbiome. The material is held within the abdomen of the patient for an hour or so, and then pushed out. The process transfers microbiome of the healthy individuals to the unhealthy one.

Does it work?

Yes! BIG YES!!

Anecdotes from clinics around the world have it that patients with multiple sclerosis and chronic fatigue syndrome are getting better, even  going into complete remission, after a few sessions of FMT!

There is research evidence, though with a small sample size, that FMT from lean individuals to individuals with insulin resistance makes the later become insulin sensitive! Let me translate it for you:

  • FMT can reverse diabetes
  • Diabetes is probably a disease of the gut

Reversing insulin resistance is a big deal because IR often leads to heart disease and several cancers.

For other diseases like C. Diff. (Clostridium Defficile) bacterial infection, IBD, Crohn’s, etc., balancing the gut flora, with or without FMT, is the only known possibility of a cure. 85% of C. Diff. infection gets cured within hours after an FMT. 95% cases are cured after just to FMT sessions. Other autoimmune disseases don’t have such fantastic success rate. But still, they are impressive.

Autoimmune epidemic

Incidence of every one of the autoimmune diseases I listed above started to climb around 1950. One number that has been etched in my mind is this: During 1940’s, 1 out of 10,000 American kids was diagnosed to be autistic (we are beginning to suspect that autism is an autoimmune disease). In 2010, the number was 1:68.

Many autoimmune diseases started skyrocketing starting 1950s to 1980s.

Several things happened around in the period between 1950 to 1980. They include introduction of certain pesticides to beginning of the usage of high fructose corn syrup.

One thing that seem to play a role in all  autoimmune diseases is this:  Antibiotics were introduced in 1944 and their usage exploded from the 50’s. This also includes usage of antibiotics on farm animals. Farmers discovered that when low dose antibiotic was administered to animals every day, they gained significantly more weight. With that, antibiotics were everywhere.

When humans use antibiotics for a long period of time, or if they are exposed to antibiotic while they were still infants/toddlers, their microbiome gets substantially damaged. If they are also on some other medication that can disturb the microbiome (e.g. acid blockers, steroidal medications), things get worse. If this person is a  picky eater who hates their veggies, or lives in a super-sterile environment that is an antithesis to microbiome diversity, God save them!

Looking in the wrong places

Whatever I’ve told you till now is summarized in the pyramid below:

 

Many of your chronic diseases start with bad microbiome (the technical term for this is “dysbiosis”). Unfortunately, instead of paying attention to the bottom of the pyramid and working on the root cause, we are busy treating the bio-markers (for example, cholesterol and blood sugar numbers). In medical field, it is called “treating the numbers”.

No wonder we have no medication to permanently fix any of the chronic/life-style diseases!

Take Home

When germ theory was understood, it demystified all the infectious diseases. Germ theory eventually brought us antibiotics, which put an end to infectious diseases. Till then, infectious diseases were periodically wiping out a substantial chunk of of human populations.

Take Home 1: Autoimmune diseases, lifestyle diseases and many mental disorders that plague us today are loosely called the 21st century diseases. We are beginning to understand that many of them are just one disease: Dysbiosis. With more understanding, treating the 21st century diseases is going to become surprisingly simple and elegant.

Take Home 2: Enriching your gut microbiome is a simple, but life-time, endeavor. If you put a little efforts to understand it, you can start enriching your microbiome today!

Some interesting books on microbiome

  • 10% Human (this is an intense book; but it’ll give you a nice foundation)
  • The Microbiome Solution (for the practical person, with oodles of how-to instructions)
  • Eat Dirt (five types of leaky gut and treatment for each one of them)
  • Brain Maker (effect of gut microbiome on the brain)

Localizing all this knowledge

These books constantly tell you to eat local. There are three reason for this:

  1. Local food is fresh. Processed food is nutrition depleted, sterile and destroys gut microbiome diversity. Though we don’t eat much of processed food in India, if we can eat food within few hours of farming, it brings us additional nutrition.
  2. Locally grown food, provided you live close to a place where your ancestors  evolved, must have evolved along with you. So, it must be more friendly to your guts.
  3. For a similar reason, local microbes are thought to be better than microbes that are shipped from far away land.

So, if you want to tend to the balance of your microbiome, localizing the best practices of the West is extremely important. This includes charting one’s gut microbiome. At Food Clinic, we have started to nibble at this problem from the edges. Send us a mail if you want to be posted about the exciting developments that are going to come.

All posts in this series

Introduction Agents of Dysbiosis

 

09 Apr

The Neuroscience Pyramid

Deconstructing Neuroscience

For a few years ago, I read nothing but books on brain science. I have an unique brain that works nothing like normal brains. The key to getting control of my life depended on my understanding my own brain. With time, I graduated to reading neuroscience books written for medical professionals. From there, reading medical books on other organs was just a hop.

When I got an opportunity to work on healthcare a couple of years ago, I took it up with great gusto. It as an opportunity to bring to practice several elegant solutions that I know are available, but for some mysterious reason, hardly anyone practices. But it is easy to underestimate the inertia of medical industry.

Things got a interesting a couple of months ago: I co-founded an organization called Chennai Neuroscience Foundation, which works exclusively on neuroscience. Though I would loved to have started with biohacking and cognitive enhancement, the business compulsions have it that we start from the exact opposite end.

 

Neuroscience Pyramid

When building the business model for CNS, I realized that the entire neuroscience industry falls into a four layered pyramid

 

4-layers-of-neuroscience-pyramid

Bottom-most Layer: Neurosurgeons and Neurologists work on anything that goes wrong with the tissue of the central nervous system and its blood supply.

Second Layer from Bottom: Cells of the central nervous system communicate by exchanging electrical signals and chemicals. When the brain chemicals (called neurotransmitters) go out of balance, behavior issues like ADHD, OCD, Schizophrenia, Depression, etc., come popping up. A psychiatrist works on the brain chemicals. They try to balance the neurotransmitters as a means of curing us of mental diseases.

Though the electrical signal exchange is crucial for the function of the brain, we don’t understand it well. No medical specialty works on brain electrics. You might just find few doctors and non-doctors dabbling with brain electrics. The days of neuro-electric field is firmly in the future.

Second Layer from Top: Host of other professionals like psychologists, trainers, teachers, coaches, etc., work on the information content of the central nervous system. The information content include memory, fears, addiction, behavior, habit forming, creativity, logical reasoning, muscle memory, etc. Despite 100 years of psychoanalysis, there is much garbage to be thrown out. Novel techniques (like NLP and psychotropics aided psychoanalysis) are taking the pants off from archaic work horses like CBT. This layer of neuroscience is in for a major reboot.

Top-most Layer: The top layer of neuroscience pyramid, the wellness space, is where the charlatans and pseudoscientists roam. This is the least understood part of neuroscience, though it is going to create super-humans out us. Today, there is enough evidence based science out there to make some feeble attempts at neuro-protection and cognitive enhancement. Though it is not much, anything is better than nothing that we had  until now.

 

Education and Training

The deeper you go down the layers of the pyramid, the more education and training the professionals need.

  • A Neurosurgeon, for example, needs 20 to 25 years of formal education, if not more. After this, they undergo 5 to 10 years of in-field training before they reach a decent level of proficiency.
  • A Neurologist, the doctors who work on tissues using pharmacology, goes through similar amount of formal training. Bu their in-field training is shorter.
  • The formal training required for a psychiatrist is very similar to the training required by a Neurologist. However, their in-field training is even less demanding.
  • A psychologist goes through shorter formal education, with a less demanding curriculum.
  • Trainers, Coaches and the like are often made up of people who jump into the field as an after thought. I am yet to come across a kid who dreams of becoming a trainer or a coach when they grew up.
  • All that a neuro-wellness professional needs is a self-certification. As of today, the neuro-wellness field is full of amatuers and snake oil salesmen.

 

Sickness vs Wellness

As you go deeper down the neuroscience pyramid, the sicker the patients must be. And their sickness is more tangible.

Whereas, the customers on the wellness layer shouldn’t even be called a patient. They are already in their pink of health and they are looking for making themselves healthier.

 

Potential of Each Layer

All the life threatening conditions are addressed by the professional operating at the bottom most layer of the neuroscience pyramid.

The challenge faced by professionals operating higher up the neuroscience pyramid is with recovering the potential lost to mental health issues.

But the highest layers of neuroscience pyramid have the capacity to release immense human potential like we have never seen. At least, that is what we technology-optimists believe.

Today, economic activities in neuroscience industry are limited to the lower layers.

In the future, the neuro-wellness industry will grow to be worth several billions of dollars. By then, all the most exciting things on earth will happen in neuro-wellness industry. I am hoping that the business I’ve started in neuroscience industry, CNS Foundation, will eventually take me there.

A guy can hope, can’t he!

13 Jun

Darwin’s Triplets

Identical Triplets

All posts in "Life in a Color Wheel" series

In the earlier post titled Evolution 101, we saw how evolution works in the wild. It discussed about how a particular biological trait is selected in a population. Darwin called this “Natural Selection“. Eventually it turned out that Natural Selection is an umbrella term for three different types of selection forces:

  • Self Selection
  • Sexual Selection
  • Group Selection

The interplay of these forces makes us who we are. Like the inter-play of three primary colors make all the hues that we can see in the nature. It is as of we live a life in a color wheel.

Self Selection

Me-Selection

Some genetic traits help an animal to live longer. These are called “Self Selection” traits. Self Selection traits may not care about finding a mate, making babies or altruism. Have you heard of rats eating their pup when they are hungry? It is the rat’s self-selection trait in action.

Sexual Selection

Sexual-Selection

Some biological traits help an animal to secure better quality/quantity mates. These are called Sexual Selection traits. These traits may or may not care if an animal lives longer or if its community flourishes.

A good example of Sexual Selection trait is peacock’s tail feathers. Luxurious tail feathers in a peacock advertises that the animal is physically/genetically fit. Tail feathers don’t increase the survival of the peacock. If anything, the long tail only makes it difficult for the peacock to catch its prey or run/fly away from the predators. Tail feathers are also metabolically expensive to maintain. A lesser peacock can’t fake a nice, long and iridescent tail. So, peacock’s tail feather is what we call a honest signal.

If the peahen selects a mate  for its luxurious tail feather, the peahen can be sure that it selected a genetically superior male. The genetic trait in a peacock to grow a beautiful tail feather is a sexual selection trait. The genetic trait in a peahen to find such a tail feather beautiful is also a sexual selection trait. These traits do not help the animal to catch a prey or save the life of an amigo. Their only purpose is to help the animal to make more healthy babies.

Study of Sexual Selection forces is full of politically unacceptable conclusions. This area is not as well studied as it must be. Even the researchers who study Sexual Selection publish their findings with caution. Even very little published insights are not adequately communicated to the public.

Group Selection

Group-Selection

Group Selection traits are hotly disputed by some scientists. But we will never understand who we really are without understanding the effect of Group Selection traits. They help the community (in which an animal lives) to flourish and sustain. They may not care about how long an animal lives or how many babies it has.

Our willingness to go to war for our country is a good example of a group selection trait. When someone goes to war, they risk their life. They are working against self-selection interest. Someone who goes to war and dies can’t have any more children. They also risk the future of the children they already have. There by, they work against the sexual selection interests as well.

Consider two prehistoric societies, Y and N. Society-Y was made up of ‘brave’ people, who were ever ready to go to war on behalf of their society/country. Whereas members of Society-N were ‘cowards’, who were quite unwilling to risk their life by going to a war. When Society-Y went to war with Society-N, Y probably decimated N. With time, genetic traits of Society-N was wiped off from the planet of earth. The ones left behind, Society-Y, are all willing to die for their society.

Group Selection makes an individual to subjugate its own self-interest to the interest of the group. When the interest of an individual clashes with the interest of the group, the group often doesn’t hesitate to get ride of the individual! When we think about group selection, we must remember one thing:

A part of 'the group that we live in' lives inside each one of us.

At one level, each one of us is the group. We act in a way that subjugates the interest of other people to the common good of the group. We willingly sacrifice some of our own self interest in the alter of the common good. How much of self interest we sacrifice, or how much of similar sacrifice we demand from others, changes based on the situation we are in. Our sense of group identity and altruism are elastic.

Feeling the Selection Forces

In an individual, selection forces express themselves as emotions/feelings.

  • Self Selection may express itself as hunger, fear, cold, warmth, satiety, anger, etc.
  • Sexual Selection may express itself as pride, libido, competitiveness, creativity, etc.
  • But the way we feel the Group Selection is interesting. The sense of oneness we feel when you stand in front of God is how the Group Selection feels. When we feel the forces of Group Selection, we have a strong urge to merge and lose the sense of one’s self into the identify of the group.

Emotions of Group Selection are just as seductive, if not more, as the emotions of Me Selection or Sexual Selection. Though, we don’t readily recognize it. The interplay of the three selection forces determines who we are and how our societies are made.

Some of our traits are fostered by two or three different selection forces. For example, having a broad shoulder and good shoulder muscles in a man helps him to be a good hunter (Self Selection). It also helps him to find more/better mates (Sexual Selection). Being a good hunter, while it caters to Self Selection forces, sharing the spoils with the group also caters to the Group Selection forces.

When a particular trait is exclusive to a single selection force, expression of that trait might be opposed by other forces. For example, human equivalent of peacock’s tail feather (sexual selection) is often considered as vanity and looked down upon by the society (group selection).

Our natural desires and urges are endless and shifting inter-play of the three selection forces that played a part in molding us. At any given point in time, your natural feelings are just a pixel on the color wheel. At times, you play near the edges. At times, you play right at the center.

Life becomes gets uncomplicated when you understand the color wheel of selection forces and then design your life around that understanding. Life in a color wheel might be the simplest answer to so many of your life’s dilemmas. In the future posts, let’s take a closer look at the inter-play of these hues.

I promise you, it will be nothing less than liberating.

All posts in "Life in a Color Wheel" series
11 Jun

Evolution 101

Evidence-of-Evolution

All posts in "Life in a Color Wheel" series

We can’t understand human nature without understanding the forces of evolution that made us who we are. We are the happiest if we design our lives/societies around the human nature, like a well fitting glove is designed around a hand. Failed philosophies like Marxism and Objectivism are results of failing to design our societies around what evolution has made us to be.

In a series of future posts, we will dissect the impact that evolution has on our nature. In this post, let us make sure that we have a clear understanding of how evolution works.

Mutations-happen

Let’s start with an animal called ‘Grey Circle’. Due to genetic mutation, the some of the babies of Grey Circle are slightly different from the original. Of the three babies, the baby named ‘White Circle’ has mutation gives it a survival/propagation disadvantage (e.g. being born without limbs). The genes of the baby named ‘Black Circle’ were mutated in such a way that it has some special advantages over others (e.g. ability to run faster). And the baby Grey Circle has no advantage or disadvantage over its parent.

Second-Generation-After-Mutation

Over the subsequent generations, White Circle doesn’t get to make babies because it dies early. Whereas the Black Circles ends up having more babies as they are very good at out running their predator.

Advantageous-Mutation-Over-Generations

With every passing generation, there are more Black Circles in the population.

Inter-Breeding-of-Mutants

Of course, Grey Circles and Black Circles may end up inter-breeding. But for the sake of simplicity, let’s ignore the effect of inter-breeding now.

Domination-by-a-Mutant

Eventually, the Black Circles dominate the entire population as they successfully out-compete the Grey Circles. Thus, a new population is born with a new trait.

In another isolated part of the world, where the Grey Circles haven’t mutated into Black Circles, the Grey Circle population continues to thrive.

Mutations-keep-popping-up

Mutation is a messy business. It is never just Black or Grey. Mutations keep happening all the time, in million different forms. Some of the mutations/traits end up dominating the entire population (e.g. intelligence in humans) . Some of the mutations/traits persist in the population, but they never fully dominates the population (e.g. skin color, super-intelligence, schizophrenia). Some mutations/traits get wiped off from the population immediately (e.g. anencephaly) or eventually.

Evolution carries forward that traits that eventually dominate the population. Period. Evolution doesn’t care for good, bad, virtuous, evil, etc. When we hear the phrase “survival of the fittest”, we tend to confuse it with “survival of the superior”. Evolution is blind to anything other than population explosion.

In the next post, we’ll look into three sub-types of evolutionary forces.

All posts in "Life in a Color Wheel" series