Sound Bites with Dr. Adam Rinde
Adam Rinde, ND
Naturopathic Doctor. Gut Health Expert. Clinical Educator. Medical Director. Podcast Host. I help people with holistic strategies and solutions for complex chronic illness and health.
Welcome to the Sound Bite Newsletter- Mid Summer edition 2022
This is my newsletter to communicate with patrons, friends, and supporters of my practice and work. Its an internal note; that sometimes includes articles and other times recaps.
I hope this finds you and your loved ones doing well! So much to share as it its been a busy 3 months or so.
I really just wanted to recap some things for you so you know what I am up to.
This issues Topics
B12 and Migraines
Migraines are a mystery to patients and neurologist alike. There exists many natural alternatives but since migraines are often genetic and environmental ; there may a greater need to think about actual dosing levels of natural products. Point being, we might dosing properly for migraine prevention.
In current research;?it was suggested that individuals with an increasing level of serum B12 had a roughly 80% decrease in the odds of having a migraine and that higher serum methylmalonic acid (MMA) levels were associated with an approximate 4- to 5-fold increase in the odds of having a migraine. These results need to be validated by long-term cohort studies and well-designed clinical trials that examine the link between the functional role of vitamin B12 levels in migraine . What this means that for migraine suffers just saying that B-12 is at a sufficient and normal level is perhaps not enough to prevent migraines. Migraine suffers might just want to be on a scheduled?dose.?Some people are sensitive to the Methylcobalamin for of B12 so for them I recommend Hydroxocobalamin or Adenosylcobalamin forms like the product by?Pure Encapsulations called Adenosyl/Hydroxyl B12
.Reference:?Togha M, Razeghi Jahromi S, Ghorbani Z, Martami F, Seifishahpar M..?Serum vitamin B12 and methylmalonic acid status in migraineurs: a case-control study?[published online August 31, 2019].?Headache.?doi: 10.1111/head.13618
ADMA: A new important Biomarker
What is ADMA?
A fairly recent lab biomarker called Asymmetric dimethylarginine (ADMA) gives us a window into heart disease in development even well before symptoms start.
ADMA, is an analogue of L-arginine, and naturally occurring product of metabolism found in human circulation.
Why is it important to address?
Elevated levels of ADMA inhibit Nitric Oxide (NO) synthesis and therefore impair cardiovascular endothelial function and thus promote atherosclerosis. When this happens its the process of hardening or stiffening of arteries.
So its a biomarker for stroke and heart disease prevention.
ADMA levels are increased in people with hypercholesterolemia, atherosclerosis, hypertension, chronic heart failure, diabetes mellitus and chronic renal failure concentrations are substantially elevated by native or oxidized LDL
Thus a spiraling effect occurs with high endothelial LDL cholesterol levels causing greater ADMA values, which in turn inhibit NO production needed to promote vasodilation.
The tissue can develop what is called Endothelial Dysfunction.
Who is at risk for ADMA elevation?
ADMA levels are increased in people with hypercholesterolemia, sleep apnea, atherosclerosis, hypertension, chronic heart failure, diabetes mellitus and chronic renal failure. Concentrations are substantially elevated by native or oxidized LDL.
What can I do about it?
IF ADMA is elevated; it means that there may be some low-grade damage taking place in the endothelial tissue.
We can address this with nitric oxide support, keeping blood pressure normal, stabilizing LDL cholesterol and monitoring blood sugar and maintaining an active lifestyle. Also addressing other factors like weight gain and sleep apnea.
There there are some foods that boost nitric oxide are those that contain L-arginine and Citrulline.
L-Arginine Rich Foods
L-citrulline rich foods
There is also supplement that I often recommend called?NOX synergy by Designs For Health?that is a nitric oxide supporting supplement.
This test is sometimes covered by insurance through Labcorp or Boston Heart Labs.
source: Franceschelli, S., Ferrone, A., Pesce, M., Riccioni, G., & Speranza, L. (2013). Biological Functional Relevance of Asymmetric Dimethylarginine (ADMA) in Cardiovascular Disease.?International Journal of Molecular Sciences, 14, 24412 - 24421.
Adiponectin; A smashing debut
Obesity, fat gain, and weight gain has entered a new era of research. Gone are the days when we are just hearing the old mantra " calories in, calories out" . Researchers are now focusing on the metabolic effects of fat tissue and how inflammatory signaling either helps or deranges our metabolism. One of the molecules that is under study is?Adiponectin.
I first wrote about adiponectin in a?2011 newsletter. Adiponectin is a protein hormone (classified as a cytokine) that modulates a number of metabolic processes, including glucose regulation and fatty acid oxidation. Adiponectin is secreted from fat tissue (and also from the placenta in pregnancy) into the bloodstream and is very abundant in plasma relative to many hormones. It is involved with beta oxidation (a fat burning process) and appears to associated with lowering free fatty acids from the bloodstream (lowering cholesterol). It is also involved with insulin sensitization meaning glucose control when explored in women with?Type 2 diabetes. I have also learned recently trough IntellxxDNA that its involved with brain neural connectivity .
As we gain weight; the size of of our fat cells (adipocytes) increase in the body. As this occurs, Adipocytes secrete greater amount of inflammatory markers (leptin, tumor necrosis factor, resistin, free fatty acids) which end up increasing insulin resistance and also increase the production of glucose by the liver. A the same time these Adipocytes will?decrease?the secretion of?adiponectin.
So the interest in how to keep adiponectin levels elevated is certainly a topic of interest in weight management.
I recently learned about the SMASH acronym for raising adiponectin ; meaning including consumption of omega-3 rich foods in the diet such as salmon, mackerel, anchovies, sardines, and herring (SMASH).?This meta analysis?showed that fish oil modestly increased adiponectin levels. Now , this is most appropriate for someone on the brink of type II diabetes or fully into diabetes but really any one who is struggling with obesity should think of this. Of course, there are concerns about how often we should eat fish as some are a source of mercury. Its best to refer to to the Monterey Bay Aquarium to understand the importance of purchasing and consuming fish sustainably harvested. Also this?guide?to see if which fish to avoid due to mercury content. For my sardine and mackerel consumption I purchase?Wild Planet?products. Why? For example King Mackerel is on the avoid list; while planet uses Atlantic Mackerel in their product. This is a more sustainable type. I have not really ever been so into anchovies even though my New York City-bred Father, swears that they are amazing as a pizza topping.
I generally recommend 2-3 servings of fish per week from the SMASH list and a daily mercury free fish oil like O.N.E. Omega by Pure Encapsulations. Also worth noting that High Intensity Interval Training (HIIT) also increases?adiponectin?while lowering inflammatory markers (Il-6, TNF-alpha).
领英推荐
You will hear me lament a little bit about how High Intensity Interval Training should be done in appropriate doses. If done too often in the wrong person I see other problems arise like cortisol imbalances. I do think that a baseline of low intensity aerobic exercise most days of the week and 1-2x's per week of HIIT with adequate recovery might be the most reasonable way to approach things.
Brain Fog
Brain Fog is a common health complaint that spans across many health disorders . This includes autism spectrum, ADHD disorders ,celiac disease, chronic fatigue syndrome, fibromyalgia, M.S., mastocytosis, postural tachycardia syndrome, and early/minimal cognitive impairment.I also see it in SIBO and other dysbiotic scenarios like IBD and IBS,
The common thread is neuroinflammation that is related to heightened microglial activation secondary to excess histamine release . Histamine can be excessive in the body due to genetic predispositions, excess histamine in foods (especially left overs), and excess histamine being produced by dysbiotic gut bacteria.
If unchecked the histamine can lead to increased brain fog and decreased learning and cognition.
The brain is the CEO of the body . If it is underfunctioning then all functions and organs that serve it seem to suffer. Just like any organization. Taking care of the brain is as important as taking care of the heart.
This?article?looks at the benefit of luteolin in these scenarios. Luteolin is a flavonoid found in many plants that is determined to be inhibit mast cell degranulation . As part of our immune system, mast cells reside throughout our body including our brain, lungs, and gut. When mast cells degranulate they release histamine. Luteolin can slow this degranulation. It also appears to reduce microglial activation and reduce the inflammatory molecule IL-6. As we are getting more sophisticated it appears liposomal forms of this vitamin might work best. I have seen one brand that appears to have liposomal luteolin and its called?neuroprotek?, The author of this article is Dr. Theoharides who also formulates Neuroprotek. I have no problem endorsing this though as he donates the proceeds of the supplements to research and he has devoted his life to helping patients with adhd, autism, and mast cell disorders.
There are many ways to approach brain fog but my general approach is to look at what is creating the fire (inflammation) and try to extinguish it. But while searching for the fire, we must control the smoke (the histamine).
What I am Learning
I am learning so much these days even in my 16th year of practice I feel like that I am just getting started. Beginners mind has always been my motto. I wake up everyday and tell myself that I don't know anything and that gets me in the mindset to learn, grow, and integrate. Once I learned the power of reviewing , then things started to make even more sense. I learn something new and then I ask myself three questions ; "Where have I learned this before"? , "What do I already know about the topic"? " How does this new information add to what I already know"? I use a notetaking app to record all my learning and refer back to it all the time.
So what have I been focused on? I took the following courses this year for example:
Joint Hypermobility Syndromes and Comorbidities?with Alena Guggenheim , ND and Carla Guggenheim, DO
Plus others.
I have learned so much about complex cases and also fine tuned my more straight forward approaches. Most of the time I am sneaking in 30 minutes per day to 1 hour per day to learn. That's all the time I really have these days, but I really look forward to that time! I hope you all are benefiting from this and I am pretty sure you are.
Where I have been presenting and published.
Two articles came out this quarter that I published ; One on IBS/SIBO in relationship to the use of Boswellia and Curcumin for Bloating and digestive symptoms; check it out?here
The other was on Cranberry juice and extracts for?Urinary Tract Infections.
I had the prestigious honor of presenting at the 2022?National University of Natural Medicine?Gastrointestinal Conference and speaking on IBS and IBD and the immune system and metabolites. It was quite an intense process and topic to present. Really glad I did it.
Also..
I appeared as a guest on?The Briana Approved Podcast?and spoke about functional medicine, integrative medicine, nutrigenomics, and more. It was a lot of fun
Who I have interviewed
Have you been listening to my podcast. The guests have been really amazing.
We most recently had Aly Cohen, MD, FACR ; a triple board certified Rheumatologist speak all about?Water?; what's in our water, health effects, and how to drink clean water.
Also talked to? Stephan Guyenet ,PhD; author of?The Hungry Brain about fat loss resistance and how the hypothalamus is involved with fat loss resistance. Click here to listen
And had a most interesting interview on integrative addiction approaches with Ravi Chandiramani, ND ?click here to listen
Finally a really important conversation with a repeat guest, Dr. ? Dr. Lauren Tessier where we spoke on Mold and Mycotoxins.?
Closing Thoughts
I hope you are enjoying the information I am putting out.
Drop me a line: do you want more articles, blog posts, classes, podcasts?
If you are willing to support my work on my content , then please leave me a tip?here.
Co-Founder of Transcendent Coaching
2 年This is SPOT ON, you hit the nail on the head, love this. I'd love to get notified and see more of your content in my feed, it'd be awesome to connect Adam.