autoimmune conditions

Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus Overview:

SLE is an autoimmune disorder affecting the connective tissue throughout the body. It can damage tissues anywhere in the body, but has the highest prevalence of damage towards the heart, kidneys, liver, blood vessels, joints, skin, lungs, and nervous tissues.

 

Aetiology:

It is most common in women of non-European desent between the ages of 15 and 35. 

There is a definite genetic predisposition for SLE. It is most common in women (90%), especially of Afro-Carribean descent. Other causes or triggers include: 

  • Drug and chemical aggrevation
  • Infectious agents
  • Cigarettes
  • UV Radiation

+ Drug-Induced Lupus Erythematosus (DILE)

There is a long list of drugs known to induce lupus erythematosus. Generally, once these drugs have been discontinued, symptoms will recede.

  • Hydralazine
  • Procainamide
  • Isoniazid

+ Other Causitive Factors

Heavy Metal Exposure

insert

Pesticides

insert

Organic Pollutants

inser

Screen Shot 2017-11-14 at 2.33.23 PM.png

+ Autoantibodies

Involves the production of a large number of antibodies against self antigens like erythrocytes, lymphocytes, platelets, nucleic acids, coagulation proteins, or phospholipids.

Th1 cytokines include interleukin IL-2, IFN-y, and TNF-a. They are involved with cellular immunity, cytotoxicity, delayed-type hypersensitivity and stimulation of monocytes [1].

TH2 cytokines include IL-4, IL-5, IL-6, IL-10, IL-13. These are responsible for [1].

Screenshot 2018-03-19 10.34.20.png
Screenshot 2018-03-19 10.35.06.png
Screenshot 2018-03-19 10.35.49.png
 

Symptoms:

Fever

Weight Loss

Lymphadenopathy (Mild)

Inflammation

Fatigue

Malaise

Fibromyalgia-Like Symptoms

Skin Rash Exacerbated by Exposure To UV Light

Headache

Poor Concentration

Arthritis

Vasculitis

Pericarditis

breathlessness (Pulmonary Finrosis)

Hematuria

Proteinuria


Diagnostic Considerations:

Screen Shot 2017-11-14 at 2.29.37 PM.png
Screen Shot 2017-11-14 at 2.30.26 PM.png
Screenshot 2018-03-09 14.45.10.png

Therapeutic Aims:

1. Eliminate Exposure To Allergens

Including food allergies.

2. Reduce Inflammation

  • Antioxidants (Vitis vinefera)
  • Antinflammatories (Curcuma longa, Boswellia serrata, Filipendula ulmaria, Salix alba, Rehmannia glutinosa, Bupleurum falcatum)
  • PAF Inhibitors(Ginkgo biloba)
  • Antioxidants(Vitis vinefera, Pinus pinasta)
  • Nutritional (Fish Oil)

3. Improve Male Sex Hormone Production

  • DHEA

4. Manage Pain

  • Analgesics(Corydalis cava, Eschscholtzia californica)

5. Modulate Immune Response

  • Immunosuppressants(Hemidesmus indicus, Rehmannia glutinosa)
  • Immunomodulators(Astragalus membranaceus, Echinaceae purpurea, Picorrhiza kurroa, Ganoderma lucidum, Lendinula edodes)

6. Support Cognitive Function

  • Nootropics(Ginkgo biloba, Bacopa monieri, Centella asiatica, Camellia sinensis)

7. Improve Gut Health

  • Bitters(Achillea millefolium, Taraxicum officinale, Cynara scolymus)
  • Antinflammatories(Curcuma longa, Boswellia serrata, Calendula officinalis)
  • Nutritional Support(Probiotics)

8. Support Cardiovascular Function

  • Circulatory Stimulants(Ginkgo biloba, Zingiber officinale)

9.Encourage Connective Tissue Repair

...

  • Connective Tissue Tonics(Centella asiatica, Vitis vinefera, Pinus pinasta)

10. Improve Stress Response & Reduce Fatigue

  • Adaptogens(Panax quinquefolius, Withania somnifera, Eleutherococcus senticosus, Astragalus membranaceus, Centella asiatica)
  • Excercise(Yoga, Tai Chi)

11. Manage Mood & Sleep

  • Thymoleptics(Melissa officinalis, Turnera diffusa)
  • Nervine Trophorestoratives(Avena sativa)
  • Anxiolytics(Piper methysticum, Valeriana officinalis)
  • Nervine Relaxants(Scutellaria lateriflora, Passiflora incarnata, Valeriana edulis, Piper methysticum)
  • Antidepressants(Hypericum perforatum)
 

Differential Diagnosis:

  • Fibromyalgia
  • Chronic fatigue syndrome
 

Cautions:

Consider other autoimmune conditions.

 

Herbs For SLE:

  • Zingiber officinalis
  • Taraxacum officinale
  • Rumex crispus
  • Echinacea spp.
  • Allium sativum
  • Boswellia serrata
  • Curcuma longa
  • Echinacea spp.
  • Ginkgo biloba
  • Harpagphytum procumbens
  • G. glabra
  • Hemidesmus indicus
  • Rehmannia glutinosa
  • Salix spp. 
 

Nutritional Considerations:

  • B vitamins
  • Glutamine (GIT)
  • Vitamin E
  • MSM
  • Se, C, D
  • Probiotics
  • EFAs
  • Zn
  • Bromelain, Quercetin
  • Mg
  • Digestive enzymes
  • Glucosamine, Chondroitin, Green-Lipped Mussel
  • SAMe
 

Dietary Considerations For Systemic Lupus Erythematosis:

  • Eliminate allergenic foods

  • Avoid caffeine

  • Reduce red meat (Saturated fatty acids)

  • EFA

  • Garlic

 

Lifestyle Considerations:

  • Stop smoking
  • Stress management
  • Acupuncture
  • Avoid Sun exposure
  • Exercise
  • Cold pack
 

Author:

Justin Cooke

The Sunlight Experiment

Updated March 2018


Recent Blog Posts:

References:

  1. Mosmann TR, Sad S. The expanding universe of T-cell subsets: Th1,
    Th2 and more. Immunol Today 1996; 17: 138 ± 146.
  2.  

Eczema

Eczema Overview:

Eczema (also known as atopic dermatitis) is characterised by an inflammatory process on the skin resulting in patches of rough, dry, and itchy skin. This condition is generally chronic, and can happen at any stage of life. it is most common in very young children, females, and those with atopic tendencies.

There are 2 main types of atopic dermatitis; extrinsic (allergic), and intrinsic.

 

Aetiology:

The pathophysiology of atopic dermatitis can involve numerous different inflammatory cells, but will generally rely on hyper stimulatory T-cells [1].

In the case of extrinsic atopic dermatitis, T-helper-cell activity towards Th2, and the involvement of interleukin-13-induced B cell activation, and its subsequent IgE production are somewhat characteristic of this form of atopic dermatitis [1].

Elevated serum histamine levels were also linked specifically to food allergen extrinsic atopic dermatitis [2].

Differentiating atopic dermatitis from extrinsic (allergic atopic dermatitis) to intrinsic involves investigation of specific serum IgE levels for known allergens, and serum histamine levels. Intrinsic atopic dermatitis has a lower expression of (IL)-4, IL-5 and IL-13 (Tokura, Y., 2010).
 

 

Symptoms:

  • Intensely itchy skin
  • Rough, dry patches on the skin
  • Commonly associated with asthma
  • Dennie-Morgan folds
  • Ichthyosis vulgaris (more common with intrinsic AD)
  • Mild Palmar hyperlinearity bilaterally (most common with intrinsic AD)
 

Therapeutic Aims:

1. Remove Exposure To Allergens

Both doetary and environmental.

  • This can be both dietary, or lifestyle avoidance depending ont he allergens discovered in IgE testing. If unknown, remove common allergens such as dairy, gluten, soy products, peanut products, etc. Avoid contact with mould, dust, pets, and pollen wherever possible until sources are identified.

2. Modulate The Immune Response

  • Shift focus from Th2 to Th1 response.
  • Modulate histamine release.
  • Consider using mild immunosuppressants for short term symptom relief

3. Topical Treatment With Antinflammatories And Antiseptics

  • Emollients
  • Antibacterials
  • Antifungals

4. Use Depuratives For Long Term Treatment Aims

  • There are many to consider depending on the pathophysioloy of the presenting condition. Liver is a good place to start.

5. Address Possible Gut Dysbiosis

  • "Leaky gut" is a major consideration for chronic ecsema, especially if worsened by depurative or chelation therapies.
 

Differential Diagnosis:

  • Staphylococcus infection
 

Herbs For Eczema


Author:

Justin Cooke

The Sunlight Experiment

Updated: May 2018


References:

  1. Vestergaard, C., Yoneyama, H., Murai, M., Nakamura, K., Tamaki, K., Terashima, Y., ... & Matsushima, K. (1999). Overproduction of Th2-specific chemokines in NC/Nga mice exhibiting atopic dermatitis–like lesions. The Journal of clinical investigation, 104(8), 1097-1105.
  2. Sampson, H. A., & Jolie, P. L. (1984). Increased plasma histamine concentrations after food challenges in children with atopic dermatitis. New England journal of medicine, 311(6), 372-376.

Allergic Rhinitis

Allergic Rhinitis Overview:

Allergic rhinitis is the result of an overactive immune response, causing inflammation in the sinuses. Common symptoms include runny or stuffy nose, redness, sneezing, and swelling around the eyes and face. 

 

Aetiology:

Allergic rhinitis is most often caused by overactive immune response to air born allergens like pollen and dust. 

Mediated by IgE triggering the cell-bound mast cells. Blood based basophil activation is more rare, but involves far more dangerous anaphylaxis immune responses. 

The activation of mast cells causes a degranulation and release of histamine into the target tissue. When found in the nose and ears, this results in mucus production and secretion, as well as localised inflammation. 

 

Symptoms:

Excessive nasal secretion

Itching

Sneezing fits

Conjunctival swelling

Erythema

 

Therapeutic Aims:

1. Reduce exposure to allergens.

Including food born and air borne.

2. Dampen overactive immune response.

Inhibit degranulation of mast cells, and modulate the immune system.

  • Immunomodulators (Ganoderma lucidum, Uncaria tomentosa)
  • Antiallergics (Scutellaria baicalensis, Albizia lebbeck, Andrographis paniculata)

3. Relieve Congestion

  • Anticatarrhal (Eucalyptus globulus)
  • Astringents (Calendula officinalis)

4. Support the lymphatic system.

  • Lymphatics (Calendula officinalis, Echinacea purpurea)
  • Depuratives (Smilax spp.)

5. Tone the mucus membranes.

  • Mucous membrane tonics (Hydrastis canadensis)
 

Differential Diagnosis:

  • Influenza infection
  • Bacterial infection
 

Herbs For Allergic Rhinitis


Author:

Justin Cooke

The Sunlight Experiment

Updated: June 2018


References:

  1. ...

Hypothyroidism

Hypothyroidism Overview:

Hypothyroidism (also known as myxedema) is a common, but often asymptomatic condition affecting the metabolic processes throughout the body. This condition is far more prevalent in females than males, some reports suggesting as much as 6:1.

Due to the common lack of symptoms associated with early-stage hypothyroidism, diagnosing the condition primarily relies on lab testing. Thyroid function tests look for levels of TSH, T3, and T4. Autoimmune conditions affecting the thyroid like Hashimoto's disease are also common so labs will often test for antiobodies associated with this condition.

Hypothyroidism can cause significant drops in basal metabolic rate (up to 60%) resulting in unexpected weight gain, fatigue, and aversion to cold.

The most common cause for hypothyroidism is an autoimmune disease known as Hashimoto's thyroiditis. In this condition, white blood cells invade and attack the thyroid gland, which is one of the most vascular organs in the human body. This leads to a gradual destruction of the thyroid, and an interfereance of thyroid hormone production by antibodies.

 

Aetiology:

+ Primary Hypothyroidism

  • Nutritional dysfunciton
  • Hashimoto's thyroiditis (autoimmune)
  • Postpartum (Transitory)
  • Subacute (Transitory)

+ Secondary Hypothyroidism

  • Hypothalamus dysfunction
  • TRH or TSH deficiency
  • Pituitary disorder
 

Symptoms:

Fatigue

Constipation

Weight Gain

Depression

Goitre

Cold Intolerance

Hyperlipidaemia

Dry Skin

Aches and pains

Menstrual disturbances

Preorbital oedema

Bradycardia

Delayed muscle relaxation

Hair loss

Muscle aches

 

Diagnostics:

Primary hypothyroidism is demonstrated by an elevation of TSH, and low T4 or T3. 

Thyroid Function Testing

Condition TSH T4 T3
Healthy Normal Normal Normal
Hyperthyroidism (Primary) Low High High (first)
Hyperthyroidism (Secondary) High High High (first)
Hypothyroidism (Primary) High Low (first) Low
Hypothyroidism (Secondary) Low Low (First) Low

Normal Thyroid Hormone Ranges

Hormone Normal Range
TSH 0.4-5.0 mU/mL
Free T4 10-25 pmol/L
Free T3 4-8pmol/L
 

Therapeutic Aims:

1. Hormone Replacement Therapy

Not a herbal approach, but the best treatment currently available. Herbs offer supportive treatment alongside thyroid hormone replacement.

  • Iodine-containing herbs (Fucus vesiculosus)

2. Support The Cardiovascular System

Hypothyroidism leads to an increased chance of developing atherosclerosis.

  • Cardiovascular tonics (Crataegus spp., Ginkgo biloba, Allium sativum)

3. Symptomatic Relief For Associated Skin Conditions

  • Emollients (Althaea officinalis)
  • Circulatory Stimulants (Zingiber officinale)

4. Symptomatic Relief For Other Negative Side Effects Of Hypothyroidism

...

  • Hepatic Laxitives (Rumex crispus, Juglans cinerea, Rhamnus purshiana, Senna spp.)

5. Treat Autoimmunity (If Applicable)

If Hashimoto's thyroiditis is suspected, address with immunomodulators and immunosuppressants.

  • Immunomodulators (Ganoderma lucidum)
 

Differential Diagnosis:

  • Pituitary tumor
 

Cautions:

None noted.

 

Herbs For Hypothyroidism

  • Bladder wrack
  • Medicago sativa (Alfalfa)
  • Chondrus crispus (Irish moss)
  • Alaria esculenta (Kelp)
 

Hypothyroid Formula

Herb Name Ratio Amount in mL
Fucus vesiculosis 1:1 40 mL
Coleus forskohlii 1:1 35 mL
Withania somnifera 2:1 25 mL
Total 100 mL

Other Endocrine Conditions:


Author:

Justin Cooke

The Sunlight Experiment

Updated: June 2018


References:

  1. Weatherby, D., & Ferguson, S. (2002). Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Funtional Perspective. USA: Bear Mountain Publishing
  2. Melbourne haematology (2013) retrieved from http://www.melbournehaematology.com.au/pdfs/guidelines/melbourne-haematology-guidelines-iron-studies.pdf

Hyperthyroidism

Hyperthyroidism Overview:

Hyperthyroidism is an overactivity of the thyroid glands. These glands play a major role in metabolism throughout the body. With overproduction of thyroid hormones T4 and T3, metabolic processes are increased, generating excess heat within the body, and increased hunger levels.

 

Aetiology:

Overactive thyroid function can be the result of several key disease processes. It can be the result of autoimmune conditions (Grave's disease), pituitary tumors, or viral infection. 

Most hyperthyroidism causes are primary conditions with the exception of iatrogenic causes or pregnancy. 

Other causes include:

  • Stress
  • Smoking
  • Iodine supplementation
 

Symptoms:

Anxiety

Irritability

Tachycardia

Low heat tolerance

Heart palpitations

Profuse perspiration

Flushed skin

Amenorrhea

Increased appetite

Muscle fatigue/weakness

Constipation or diarrhea

Progressive weight loss

Bulging eyes

Goitre

 

Diagnostics:

Thyroid Function Testing

Condition TSH T4 T3
Healthy Normal Normal Normal
Hyperthyroidism (Primary) Low High High (first)
Hyperthyroidism (Secondary) High High High (first)
Hypothyroidism (Primary) High Low (first) Low
Hypothyroidism (Secondary) Low Low (First) Low

Normal Thyroid Hormone Ranges

Hormone Normal Range
TSH 0.2-4.0 mU/mL
Free T4 10-25 pmol/L
Free T3 4-8pmol/L

Thyroid Scanning

A radioactive dye is swallowed and the thyroid is scanned. This can be used to assess thyroid activity afte the uptake of radioactive dye. The darker the scan the more metabolic activity that is taking place. 


Therapeutic Aims:

1. Treat Symptomatic Anxiety

For symptomatic support, reduce anxious side effects of hyperthyroidism.

  • Relaxing nervines (Lycopus spp., Passiflora incarnata)

2. Modulate Thyroid Function

  • Thyroid Modulators (Dampeners)

3. Treat Symptomatic Heart Palpitations and Tachycardia

  • Cardiac tonics (Crataegus spp.)

4. Treat Possible Autoimmune Causes

  • Immunomodulators (Echinaceae purpurea)
  • Immune Suppressants (Hemidesmus)

5. Treat Any Suspected Viral Causes

  • Antivirals (Hypericum perforatum)

6. Dietary Considerations

  • ↑ Dietary Goitrogens
  • ↑ Carnitine

Differential Diagnosis:

  • Graves Disease
 

Cautions:

Avoid iodine containing herbs and food, especially if Grave's disease is suspected.

 

Herbs For Hyperthyroidism

  • Lycopus spp.
  • Scutellaria baicalensis
 

Hyperthyroidism Formula

Herb Name Ratio Amount in mL
Lycopus spp. 1:2 20 mL
Leonurus cardiaca 1:2 20 mL
Scutellaria spp. 1:2 20 mL
Crataegus spp. 1:2 20 mL
Bupleurum falciform 1:2 20 mL
Total 100 mL
 

Common Drug Therapies For Hyperthyroidism:

  • Goitrogens
  • Iodine & radioactive iodine
    • High doses depress TRH and TSH release.
  • Carbimazole
  • Propylthiouracil

Author:

Justin Cooke

The Sunlight Experiment

Updated: June 2018


Recent Blog Posts:

References:

  1. ...

Rheumatoid Arthritis

Rheumatoid Arthritis Overview:

Rheumatoid arthritis is a systemic inflammatory and autoimmune condition affecting the joints. it is much more frequent in females than males (3:1), and has genetic, hormonal, viral, and environmental risk factors.

 

Aetiology:

Onset tends to be gradual, and will affect the smaller joints first in the hands, wrists, and feet (compared to osteoarthritis).

  • Genetic factors

  • Hormonal factors

  • Environmental factors

  • Viral factors

Screenshot 2018-03-09 14.41.08.png
 

Symptoms:

Gradually increasing pain in the hands, wrist and feet

Most painful in the morning

Nodules around the joints

Joint swelling (usually symetrical)

Skin changes

Deformity of the joint

Warmth of affected area

 

Systemic Effects:

Rheumatoid granulomas near affected joints

Systemic vasculitis

Skin ulcers

Scleritis (eyes)

Pericarditis

Heart valve dysfunctions

Kidney infarction

Lymphadenopathy

Thrombosis

 

Diagnostic Considerations

  • Rheumatoid factor (RF)
  • Antinuclear antibodies (ANA)
  • C-reactive protein (CRP)
  • Erythrocyte sedimentation rate (ESR)
  • Anti-DNA antibodies
  • IgA, IgM, IgG
  • Anticyclic-citrullinated peptide (anti-CCP)
  • Cardiolipin autoantibodies
  • Antiscleroderma antibodies (anti-SCL-70)
  • Anti-Sjogren’s syndrome A (anti-SSA)
 

Therapeutic Aims:

1. Alleviate the symptoms of inflammation and pain

...

  • ...

2. Repair and normalise gut function

...

  • ...
  • ...

3. Improve stress adaptation

insert

  • Nervines
  • Adaptogens

4. Support primary immunity

...

  • ...
  • ...

5. Reduce allergenic load

...

  • ...
 

Differential Diagnosis:

  • Osteoarthritis

 

Herbs For Rheumatoid Arthritis:

  • Apium graveolens

  • Harpagophytum procumbens

  • Bupleurum falcatum

  • Echinacea spp.

  • Eschscholzia californica

  • Guaiacum officinale

  • Hemidesmus indicus

  • Zanthoxylum clava-herculis

  • Salix spp.

  • Panax ginseng

  • Valeriana officinalis

  • Iris versicolor

  • Dioscorea villosa

  • Smilax spp

  • Withania somnifera

  • Centella asiatica

  • Acetaea racemosa

  • Corydalis ambigua

  • Phytolacca decandra

 

Nutritional Considerations For Rheumatoid Arthritis:

  • Se, Zn

  • Vitamin A, C, D, E

  • EFAs

  • Manganese

  • Bromelain, Quercetin

  • Bs

  • Digestive enzymes

  • Glucosamine, Chondroitin, Green-Lipped Mussel

 

Dietary Considerations For Rheumatoid Arthritis:

  • Avoid allergenic foods – inc. lectins

  • High flavonoids

  • Avoid salicylates

  • Avoid sugar, caffeine, OH, red meat, SFA, trans fat, processed foods, chemical additives

  • EFAs

  • Vegetarian sources of protein

 

Author:

Justin Cooke

The Sunlight Experiment

Updated: June 2018


References:

  1. Arnett, F. C., Edworthy, S. M., Bloch, D. A., Mcshane, D. J., Fries, J. F., Cooper, N. S., ... & Medsger Jr, T. A. (1988). The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 31(3), 315-324.

  2. Steinbrocker, O., Traeger, C. H., & Batterman, R. C. (1949). Therapeutic criteria in rheumatoid arthritis. Journal of the American Medical Association, 140(8), 659-662.

  3. Prevoo, M. L. L., Van'T Hof, M., Kuper, H. H., Van Leeuwen, M. A., Van De Putte, L. B. A., & Van Riel, P. L. C. M. (1995). Modified disease activity scores that include twenty‐eight‐joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 38(1), 44-48.

  4. Kremer, J. M. (2000). n− 3 Fatty acid supplements in rheumatoid arthritis. The American journal of clinical nutrition, 71(1), 349s-351s.

  5. Rennie, K. L., Hughes, J., Lang, R., & Jebb, S. A. (2003). Nutritional management of rheumatoid arthritis: a review of the evidence. Journal of Human Nutrition and Dietetics, 16(2), 97-109.

Chronic Obstructive Pulmonary Disease (COPD)

COPD Overview:

COPD is an umbrella term for disorders characterised by a limitation in airflow into the lungs due to an inflammatory response. This includes emphysema, chronic bronchitis, and chronic asthma.

Although some cases are reversible, many cases are the result of long term inflammation and damage to the epithelial tissue in the lungs, resulting in fibrosis, and irreversible damage to the respiratory lining.

 

Aetiology:

Generally caused by chronic exposure to an airborn irritant such as smoke or air pollution. This leads to inflammation in the airway and alveoli of the lungs. This is thought to be mediated by an increase in protease activity and a decrease in antiprotease activity (esp α1 -antitrypsin) from the neutrophils in the lungs. Neuropeptides and reduced levels of vascular endothelial growth factor may also contribute to apoptotic destruction of lung parenchyma. Over many years, this can lead to damage and breakdown of the lung tissue.

In chronic bronchitis, this damage involves a hypersecretion of mucus into the bronchial passage, which comes with an increased risk and frequency of infection.

In emphysema, elastin breaks down, resulting in damage to the alveolar septa and a loss of elastic recoil of the bronchial walls.

In both conditions, the end result is a reduction in epithelial tissue, reduced gas exchange, and trapped air in the lungs.

In about 30% of COPD patients, colonisation of Haemophilus influenzae is also found.

+ Emphysema

  • Enlargement of the airspaces distal to the terminal bronchioles.
  • Caused by a destruction of the alveolar walls without fibrosis.
  • Eventually there is a loss of elastic recoil and lung hyperinflation
  • Airway resistance increases, as does the work of breathing, resulting in hypoxia and hypercapnoea.

+ Chronic Bronchitis

  • Productive cough most days, for 3 consecutive months, for at least 2 years.
  • Mucus gland hypertrophy in the bronchial tree
  • Increased goblet cells in the small airways (metaplasia)
  • Decreased number of ciliated cells
  • Hypersecretion of mucosa & lumen occlusion by mucus plugging
  • Mononuclear inflammatory processes
  • Focal squamous metaplasia
  • Smooth muscle hyperplasia
  • Fibrosis in the brochioles and resulting distortion
  • Alveolar hypoxia can lead to pulmonary vasoconstriction and pulmonary hypertension, resulting in less blood going to the left side of the heart, lowered vascular output, lowered circulatory volume, activation of RAAS, and fluid retention.

Learn more about bronchitis.

Screenshot 2018-04-25 12.26.34.png
Screenshot 2018-04-25 12.38.47.png
 

Symptoms:

Shortness of breath

Wheezing

Tightness in the chest

Excessive mucus in the lungs

Chronic cough

Cyanosis of the lips or fingernail beds

Frequent respiratory infection

Fatigue

Swelling of the ankles and feet

 

Diagnostic Considerations

  • Pink puffer and blue bloater
  • Increased respiratory rate
  • Pitting edema in lower limbs
  • Loss of cardiac dullness on percussion
  • Genetic markers:
    • α1 -antitrypsin
    • 30 other genetic variants identified

Emphysema vs Chronic Bronchitis

Diagnostic Test Emphysema Chronic Bronchitis
Overall Appearance "Pink Puffer" "Blue Bloater"
Characteristic Findings Barrel Chest Jugular Venous Distention (JVD)
Respiratory Rate Increased Increased
Palpation Pitting Edema Pitting Edema
Auscultation Wheezing? Wheezing?
FVC INSERT INSERT
FVC1 <80% predicted value <80% predicted value
Chest X-Ray Hyperexpansion, pulmonary hypertension, Bullae Hyperexpansion, pulmonary hypertension
alpha-1-antitrypsin INSERT INSERT
Arterial Blood Gases INSERT INSERT
Screenshot 2018-04-24 17.27.29.png
Screenshot 2018-04-25 12.39.51.png
 

Therapeutic Aims:

1. Improve Gas Exchange

...

  • Bronchodilators(Grindelia camporum, Adhatoda vasica, Drosera rotundifolia, Euphorbia spp, Coleus forskohlii, Glycyrrhiza glabra Magnesium)
  • Anticatarrhal(Solidago vigaurea, Hydrastis canadensis, Euphorbia hirta, Euphrasia officinalis, Plantago lanceolata, Sambucus nigra, Verbascum thaspus)
  • Mucus Membrane Trophorestoratives(Hydrastis candensis, Centella asiatica)
  • Circulatory Stimulants(Armoracia rusticana, Myrica cerifera, Sambucus nigra)

2. Eliminate Infection

(If necessary)

  • Antimicrobials(Thymus vulgaris, Allium sativum, Echinacea spp.)
  • Immunomodulators(Ganoderma lucidum, Astragalus membranaceus, Eleutherococcus senticosus)
  • action(herbs)

3. Reduce Inflammation & Allergic Response

...

  • Antinflammatories(Glycyrrhiza glabra, Verbascum thapsus, Allium cepa, Plantago spp, Boswellia serrata, Curcuma longa, Zingiber off, Camellia sinensis, Rehmannia glutinosa)
  • Antioxidants(herbs)
  • Respiratory Demulcents(Chrondus crispus, Plantago lanceolata, Verbascum thaspus, Glycyrrhiza glabra)
  • Anti-Asthmatics(Drosera rotundiflora, Euphorbia hirta, Justicia adhatoda)
  • Anti-Allergy(Albizia lebbeck, Scutellaria baicalensis )

4. Address Symptoms

(Such as cough, catarrh, fever)

  • Antitussives(Prunus seritona, Passiflora incarnata)
  • Respiratory Antispasmodics(Asclepias tuberosa, Drosera rotundifolia, Marrubium vulgare, Inula helenium, Euphorbia hirta, Prunus seritona, Thymus vulgaris, Justicia adhatoda, Hyssopus officinalis, Coleus forshkolii)
  • Diaphoretics(Archillea millefolium, Eupatorium perfoliatum, Allium sativum, Armoracia rusticana, Sambucus nigra, Tilia cordata)
  • Mucolytics(Allium Sativum, Amoracia rusticana, Pimpinella anisum, Cinnamomum cassia, Zingiber officinalis, Angelica archangelica)
  • Relaxing Expectorants(Asclepias tuberosa, Marrubium vulgare, Viola odorata, Althaea off, Tussilago farfara, Drosera rotundifolia, Foeniculum vulgare, Plantago spp, Hyssopus officinalis, Thymus vulgaris, Verbascum thapsus)
  • Stimulating Expectorants(Inula helenium, Polygala senega, P. tenuifolia, Lobelia inflata (Sched), Cephaelis ipecacuanha, Glycyrhizza glabra, Euphorbia hirta, Marrubium vulgare, Justicia adhatoda)

5. Address Complicating Factors

(Hayfever, leaky gut, autoimmunity)

  • Anti-Allergy(Albizia lebbeck, Scutellaria baicalensis )
  • action(herbs)
  • action(herbs)
 

Diagnostic Considerations:

  • Chest Xray
  • Vital signs
  • Chest auscultation
  • Blood testing:
    • Arterial blood glad (glad?... wtf?)
    • Full blood count
 

Differential Diagnosis:

  • Bronchiectasis
  • Untreated chronic asthma
  • Heart failure
  • Tuberculosis
  • alpha-1-antitrypsin deficiency
  • Acute bronchitis
  • Pulmonary embolism
  • Lung cancer 
 

Herbs For COPD:


Author:

Justin Cooke

The Sunlight Experiment

Updated: April 2018


Recent Blog Posts:

References:

  1. ...

Celiac Disease

Celiac Disease Overview:

Celiac disease occurs after an abnormal immune response to a protein found in wheat products. The reaction can severely damage the cilia of the intestinal tract, causing the, to flatten and become inefficient at absorbing nutrients. 

 

Aetiology:

Celiac is an autoimmune disease triggered by a protein found in wheat known as gluten. Specifically, the reaction is due to the gliadin portion of the gluten protein. 

A significant immune reaction of the small intestine result in a flattening and gradual destruction of the microvilli. This eventually leads to malabsorption, and eventual nutrient deficiency conditions. 

Causes are mainly genetic. 

 

Symptoms:

Diarrhea

Failure to thrive

Weight loss

Irritability

Bone abnormalities

Steatorrhea

Anemia

Fatigue

 

Diagnostic Considerations

  • Blood Tests:

    • IgA and IgG, anti-endomysium antibodies, HLA-DQ2, HLA-DQ8

    • Fe, B12, Folate, tHcy

  • Biopsy of small intestine

Celiac vs Non-Celiac Gluten Insensitivity

Test Celiac Non-Celiac Gluten Insensitivity
IgA ADA 81.4% Predominance 56.4% Predominance
IgA tTGA 98.7% Predominance None
IgA EmA 95% Predominance None
IgG ADA 75% Predominance 1% Predominance

[1]

 

Therapeutic Aims:

1. Eliminate all sources of gluten from the diet.

...

  • ...

2.

...

  • ...
  • ...

3.

...

  • ...
  • ...

4.

...

  • ...
  • ...

5.

...

  • ...
 

Differential Diagnosis:

  • Non-Celiac Gluten Intolerance

 

Medical Treatment

  • Gluten free diet
  • Antiobiotics
  • Corticosteroids
 

Herbs For Celiac Disease:

Herbs

  • Centella asiatica
  • hydrastis
  • Turmeric
  • Slippery elm
  • Calendula

Nutritional Medicine

  • Glutamine
  • Zn
  • A
  • C
  • E
  • Omega 3
  • Quercetin
  • Consider nutrient deficiencies

Diet

  • Gluten avoidance
  • Lower caffeine
  • Protein
  • High antioxidant intake

Author:

Justin Cooke

The Sunlight Experiment


Recent Blog Posts:

References:

  1. Volta, U., Tovoli, F., Cicola, R., Parisi, C., Fabbri, A., Piscaglia, M., ... & Caio, G. (2012). Serological tests in gluten sensitivity (nonceliac gluten intolerance). Journal of clinical gastroenterology, 46(8), 680-685.

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) Overview:

Chronic fatigue syndrome or CFS, is a complex syndrome characterised by long term (6 months or more) severe or disabling fatigue with no other clinical explanation (such as influenza or other viral infection). The United States Centers For Disease control and Prevention (CDC) list the following as diagnosis for CFS:

  1. Severe idopathic pain lasting 6 months or longer
  2. Having 4 or more of the following symptoms:
    • Post-exertional malaise
    • Impaired memory or concentration
    • Unrefreshing sleep
    • Muscle pain
    • Multi-joint pain without redness or swelling
    • Tender cervical or axillary lymph nodes
    • Sore throat
    • Headache
  3. The symptoms must have persisted or been recurring for 6 months or longer and have not predated the fatigue.

In the past this condition was referred to as "neurasthenia", and more modernly "myalgic encephalomyelitis" or "post viral fatigue syndrome". Doctors used to dismiss these patients of being "hypochondriacs" as there was no identifiable cause for the illness.

 

Aetiology:

Possible causes:

+ Viruses

  • Epstein Barr (EBV)
  • Herpes simplex virus (HSV) (HHV-6)
  • Coxsackie B Virus
  • Human parvovirus (HPV)-B19

+ Bacteria

  • Mycoplasmal blood infections
  • Staphylococcus spp.
  • Borrelia burgdorferi (Lyme disease)

+ Fungi

  • Candida albicans

+ Immune abnormalities and inflammation

  • Increased levels of IL-1, IL-6, TNF-alpha, and TNF-beta have all been noted to be high in CFS patients.
  • Reduced NK levels have also been noted in CFS patients.

+ Pituitary And Hypothalimic Abnormalities

  • Structural abnormalities
  • Tumour

+ Circulatory abnormalities

  • Congestive heart failure
  • COPD

+ Brain and cognitive abnormalities

  • Alzheimer's disease
  • Parkinson's disease
  • Depression
 

Symptoms:

Chronic (>6 months) of disabling fatigue

Mild fever

Sore throat

Painful lymph nodes

Weight gain

Exertion malaise

Muscle weakness

Joint pain

Muscle pain

Headaches

Depression

Light-headedness

Anxiety

Cognitive impairment

Visual impairment

Sleep disturbances

 

Diagnostic Considerations:

  1. Severe idopathic pain lasting 6 months or longer
  2. Having 4 or more of the following symptoms:
    1. Post-exertional malaise
    2. Impaired memory or concentration
    3. Unrefreshing sleep
    4. Muscle pain
    5. Multi-joint pain without redness or swelling
    6. Tender cervical or axillary lymph nodes
    7. Sore throat
    8. Headache
  3. The symptoms must have persisted or been recurring for 6 months or longer and have not predated the fatigue.

Testing

  • FBE
  • Iron studies
  • B12/folate, vitamin D, RBC fatty acid profile
  • Thyroid panel – TSH, fT4/T3
  • Organix acids
  • Functional liver detoxification profile
  • Hair mineral analysis
  • Serum/saliva cortisol
  • Functional digestive stool analysis
  • Intestinal permeability – lactulose / mannitol
 

Therapeutic Aims:

1. Support The Adrenals

Depending on the cause for CFS, the adrenals will likely need to be regulated (adaptogens) or toned (adrenal tonics)

  • Adaptogens(Withania somnifera, Panax quinequefolius, Panax ginseng)
  • Adrenal Tonics(Rehmannia glutinosa)

2. Support The Immune System

Used to prevent recurring viral and bacterial infection common with CFS patients. When using tonic herbs, they are often contraindicated during infection, so preventing these infections are of utmost importance.

  • Immunomodulators(Glycyrrhiza glabra, Astragalus membranaceus, ganoderma lucidum, Lentinus edodes, Echinaceae purpurea)
  • Immune Stimulants
  • Antivirals ()
  • Antibacterials(Hypericum perforatum, Salvia officinalis, baptisia tinctoria, Thymus vulgaris, Tabebuia impetiginosa)

3. Reduce Inflammation

Downregulate cytokine production and other immune responses.

  • Antinflammatories (COX and LOX inhibitors)(Curcuma longa, Boswellia serrata)
  • Antinflammatories (glucocoritcomimetics)(Glycyrrhiza glabra, Rehmannia glutinosa)
  • Antinflammatories (eicosanoid synthesis modulators)(Scutellaria baicalensis)
  • Antinflammatories (TNF-a & NF-kB)(Curcuma longa)
  • Immunosupressants(In some cases)
  • Antioxidants(Camellia sinensis, Vitis vinefera)

4. Identify & Address Infection

  • Antibacterials(Thymus vulgaris)
  • Antivirals()
  • Antifungals(Tabebuia impetiginosa)
  • Antiparasitics()

5. Address Any Nutritional Deficiencies

6. Optimise Neurotransmitter Function

  • Nootropics (Bacopa monieri, ginkgo biloba, Camellia sinensis, Vinca major, Romarinus officinalis)
  • Nervine Trophorestoratives (Centella asiatica)

7. Promote Gentle Detoxification

  • Depuratives(Taraxicum offinale, Urtica dioica (leaves), Trifolium pratense, zanthoxylum clava-herculis, Calendula officinalis, Rumex crispus)

8. Improve Sleep Quality

  • Sedatives(Scutellaria lateriflora, Passiflora incarnata, matricaria recutita, Zizyphus jujube, Humulus lupulus, Valeriana officinalis)
  • Adaptogens(Withania somnifera)

9. Support Mood

  • Antidepressants(hypericum perforatum, Trichilia catigua)
  • Thymoleptics(Melissa officinalis, Turnera diffusa)
  • Nervine Relaxants(Passiflora incarnata, Scutellaria lateriflora, Verbena officinalis)
 

Differential Diagnosis:

Adrenal insufficiency, fibromyalgia, cancer

 

Herbs For Chronic Fatigue Syndrome:

  • Lycium spp
  • Hypericum perforatum
  • Salvia miltorrhiza
  • Gingko biloba
  • Valerian
  • Avena sativa
  • Phytolacca decandra
  • Astragalus membranaceus
  • Echinacea spp.
  • Scutellaria lateriflora
  • Andrographis paniculata
  • Thymus vulgaris
 

Nutrients For Chronic Fatigue Syndrome:

  • B vitamins
  • Vitamin, C, D
  • Mg
  • Zn
  • EFAs
  • 5-HTP
  • SAMe
  • CoQ10
  • L-carnitine
  • Probiotics
 

Pharmaceutical Interventions For CFS:

  • SSRIs, tricyclic antidepressants for sleep disorders
  • Aspirin, NSAIDS for pain management
  • Serotonergic modulators (fluoxetine) (SSRIs, SNRIs, NRIs) for associated mood disorders

  • Benzodiazepines for anxiety
  • Non-sedating histamines for allergic responses
  • Gammaglobulin therapy: administered intramuscularly two to three times per month for passive immunity (no evidence of efficacy and expensive)
  • Alpha-interferon – enhances immune response.
 

Herb & Nutrient Interactions With Pharmaceutical Interventions:

Screenshot 2018-03-19 13.34.35.png
 

Author:

Justin Cooke

The Sunlight Experiment

Updated: March 2018


Recent Blog Posts:

References:

  1. ...