Vitamin B6 and B6 Deficiency

The active coenzyme form of vitamin B6 is called P5P (or sometimes PLP), and is involved in many functions in the body, including protein metabolism, the release of glucose from storage in glycogen, hemoglobin synthesis, fatty acid metabolism, the synthesis of neurotransmitters (in particular serotonin and dopamine), in hormone function and immune function.

Systemic inflammation may impair the function of Vitamin B6.  There are also several kinds of medications, including NSAIDs and oral contraceptives, that interfere with vitamin B6 metabolism.  Pregnancy and nursing increase B6 needs and low B6 can cause severe morning sickness.

"Vitamin B6, also called pyridoxine, is one of 8 B vitamins. All B vitamins help the body convert food (carbohydrates) into fuel (glucose), which is used to produce energy. These B vitamins, often referred to as B complex vitamins, also help the body metabolize fats and protein. B complex vitamins are needed for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.  All B vitamins are water-soluble, meaning that the body does not store them."

"Dietary deficiency, though rare, can develop because extensive processing can deplete foods of vitamin B6.  Secondary deficiency most often results from protein-energy undernutrition,  malabsorption,  alcoholism, use of pyridoxine-inactivating drugs (eg, anticonvulsants, isoniazid, cycloserine, hydralazine, corticosteroids, penicillamine), and Excessive loss. Rarely, secondary deficiency results from increased metabolic demand (eg, in hyperthyroidism)."

"A new study shows a strong association between chronic inflammation and the essential vitamin found in foods such as lean meats, legumes, and vegetables. Researchers found that people with the lowest levels of vitamin B6 in their blood had the highest levels of chronic inflammation, based on a wide variety of indicators. Those with the most vitamin B6 circulating in the bloodstream were also the least likely to have indicators of inflammation."

Signs of B6 deficiency can include:

"Symptoms can include peripheral neuropathy, a pellagra-like syndrome, anemia, and seizures, which, particularly in infants, may not resolve when treated with anticonvulsants. Impaired metabolism (dependency) is rare; it causes various symptoms, including seizures, intellectual disability, and anemia. Diagnosis is usually clinical; no laboratory test readily assesses vitamin B6 status. Treatment consists of giving oral vitamin B6 and, when possible, treating the cause."

"Deficiency causes peripheral neuropathy and a pellagra-like syndrome, with seborrheic dermatitis, glossitis, and cheilosis, and, in adults, can cause depression, confusion, EEG abnormalities, and seizures. Rarely, deficiency or dependency causes seizures in infants. Seizures, particularly in infants, may be refractory to treatment with anticonvulsants. Normocytic, microcytic, or sideroblastic anemia can also develop."

"Other neurologic symptoms observed in severe vitamin B6 deficiency include irritability, depression, and confusion; additional symptoms include inflammation of the tongue, sores or ulcers of the mouth, and ulcers of the skin at the corners of the mouth."

"The American and Canadian Colleges of Obstetrics and Gynecology have recommended the use of vitamin B6 (pyridoxine hydrochloride, 10 mg) and doxylamine succinate (10 mg) as first-line therapy for NVP (nausea and vomiting in pregnancy)."

"One large study found that women who took 500 mg of vitamin B6 daily along with 1,000 mcg of cyanocobalamin (vitamin B12) and 2,500 mcg of folic acid reduced their risk of developing AMD (age-related macular degeneration), an eye disease that can cause loss of vision."

Possible toxicity of B6:

"Although vitamin B6 is a water-soluble vitamin and is excreted in the urine, long-term supplementation with very high doses of pyridoxine may result in painful neurological symptoms known as sensory neuropathy. Symptoms include pain and numbness of the extremities and in severe cases, difficulty walking. Sensory neuropathy typically develops at doses of pyridoxine in excess of 1,000 mg per day. However, there have been a few case reports of individuals who developed sensory neuropathies at doses of less than 500 mg daily over a period of months. Yet, none of the studies in which an objective neurological examination was performed reported evidence of sensory nerve damage at intakes below 200 mg pyridoxine daily. To prevent sensory neuropathy in virtually all individuals, the Food and Nutrition Board of the Institute of Medicine set the tolerable upper intake level (UL) for pyridoxine at 100 mg/day for adults."

Sources:
The Linus Pauling Institute at Oregon State University
http://lpi.oregonstate.edu/infocenter/vitamins/vitaminB6/

University of Maryland Medical Center
http://umm.edu/health/medical/altmed/supplement/vitamin-b6-pyridoxine

The Merck Manual
http://www.merckmanuals.com/professional/nutritional_disorders/vitamin_deficiency_dependency_and_toxicity/vitamin_b6.html

WebMD
http://www.webmd.com/heart/news/20120619/low-vitamin-b6-linked-to-inflammation

More Information:

Intake of vitamins B6 and C and the risk of kidney stones in women.
"Urinary oxalate is an important determinant of calcium oxalate kidney stone formation. High doses of vitamin B6 may decrease oxalate production.. A high intake of vitamin B6 was inversely associated with risk of stone formation."

B6-responsive disorders: a model of vitamin dependency.

"Pyridoxal phosphate is the cofactor for over 100 enzyme-catalysed reactions in the body, including many involved in the synthesis or catabolism of neurotransmitters. Inadequate levels of pyridoxal phosphate in the brain cause neurological dysfunction, particularly epilepsy. There are several different mechanisms that lead to an increased requirement for pyridoxine and/or pyridoxal phosphate. These include: (i) inborn errors affecting the pathways of B(6) vitamer metabolism; (ii) inborn errors that lead to accumulation of small molecules that react with pyridoxal phosphate and inactivate it; (iii) drugs that react with pyridoxal phosphate; (iv) coeliac disease, which is thought to lead to malabsorption of B(6) vitamers; (v) renal dialysis, which leads to increased losses of B(6) vitamers from the circulation; (vi) drugs that affect the metabolism of B(6) vitamers; and (vii) inborn errors affecting specific pyridoxal phosphate-dependent enzymes. The last show a very variable degree of pyridoxine responsiveness, from 90% in X-linked sideroblastic anaemia (delta-aminolevulinate synthase deficiency) through 50% in homocystinuria (cystathionine beta-synthase deficiency) to 5% in ornithinaemia with gyrate atrophy (ornithine delta-aminotransferase deficiency). The possible role of pyridoxal phosphate as a chaperone during folding of nascent enzymes is discussed. High-dose pyridoxine or pyridoxal phosphate may have deleterious side-effects (particularly peripheral neuropathy with pyridoxine) and this must be considered in treatment regimes. None the less, in some patients, particularly infants with intractable epilepsy, treatment with pyridoxine or pyridoxal phosphate can be life-saving, and in other infants with inborn errors of metabolism B(6) treatment can be extremely beneficial."

Vitamin B6 supplementation lowers inflammation in rheumatoid arthritis patients

"The September, 2010 issue of the European Journal of Clinical Nutrition reported a trial conducted by researchers in Taiwan which found an anti-inflammatory benefit for pyridoxine (vitamin B6) supplementation in rheumatoid arthritis patients."

The Basics of Pyroluria

Pyroluria (also called Pyrroluria, Pyrole Disorder, Mauve Factor) is generally considered to be a genetic condition that causes the overproduction of a substance (usually called kryptopyrrole or pyrole) during the synthesis of hemoglobin that binds to circulating zinc and vitamin B6, causing  a chronic deficiency in those nutrients.  It also disrupts fatty acid metabolism and can lead to a deficiency of arachidonic acid.  The many symptoms of Pyroluria are due to these deficiencies.  Pyroluria seems to strongly run in families so it is important to consider the health history of a person's birth family when considering the possibility of Pyroluria.  The list of symptoms and health problems common in Pyroluria is long and varied and individuals with Pyroluria often present very differently from each other.  Additionally, some people have very few symptoms and may have symptoms that seem contradictory.  This is because each of us is so biologically complex and there are so many factors that can change how our bodies function.

Symptoms of Pyroluria are often worsened by stress (physical and emotional), and may begin after a stressful event.  In many cases the stresses around adolescence bring out Pyroluria and the person experiences an onset or dramatic worsening of symptoms in their teens or early adulthood.  Other people experience some symptoms throughout their lives, but the symptoms may change over time and still tend to worsen with stress.  Common symptoms include:

physical symptoms- pale skin (relative to family members), anemia, thin or ridged fingernails or white spots on finger nails, poor morning appetite, tendency to become vegetarian, may gain weight on hips and butt, fatigue, sensitivity to sunlight, burns easily in sun or does not tan, hypoglycemia, joint pain, problems with cartilage (especially in the knees), prone to side stitches and unexplained nausea, motion sickness, digestive problems,

emotional symptoms- anxiety and depression are most common or at the root of many of the psychological impacts of Pyroluria.  Other emotional symptoms include mood swings, rages, panic attacks, feelings of dissociation, poor dream recall (or occasionally tendency to have bad dreams), memory problems, tendency for addictive behavior, sensitivity to some stimuli such as bright light or loud noises, may have altered or strong sense of taste and/or smell, tendency to be a "night owl" (feel more alert in evening/night), suicidal thoughts,

Health conditions that are often associated with Pyroluria include: autism, ADHD, addiction/substance abuse, Bipolar Disorder, Schizophrenia, sensory processing problems, Obsessive Compulsive Disorder,

Pyroluria is tested for by a urine test to measure the level of pyrroles in the urine.  It is most accurate if no zinc or B6 supplements are taken with a week of the test, although there is increasing evidence that the test may not be very accurate anyway.  There are quite a few people who look like they have Pyroluria based on their symptoms, have low levels of pyrroles in their urine when tested, and yet respond very well to treatment as though they did have Pyroluria.  Some people suspect that pyrroles can degrade quickly in the urine sample.  It is also possible that there are other substances that can cause this presentation. 

Pyroluria is treated with supplementation of high doses of zinc and B6 (must be in it's P5P form) in accordance with the severity of the person's Pyroluria (some people produce more pyrroles than others).  I've heard that sometimes people with Pyroluria, especially if they have been untreated for a long time, may not absorb the nutrients well from oral supplements and may need injections at the beginning of treatment.  Many people also supplement arachidonic acid (an omega-6, found in Evening Primrose Oil and Borage Oil) and manganese.  In my opinion it is also important to reduce the sources of stress in a person's life as well as learning techniques for handling stress.  It is usually believed that Pyroluria is a life-long condition requiring life-long treatment.  People tend to experience significant improvement within 1-2 weeks of beginning supplementation, and it is often reported that people begin to relapse within several weeks if they stop taking the supplements.  Some people seem to need higher doses in the beginning (could be from reduced absorption at this point or due to "filling in a hole") but then may need to reduce the dose once progress reaches a plateau. 

Additional resources:

Integrative Psychiatry on Pyroluria

Nora Gedgaudas, of Primal Body Primal Mind, discussing Pyroluria

Pyroluria:  A Hidden Disorder (this article goes into much more depth)

Naturopathy Online has a nice little article about it here.

Dr Kaslow also has a good synopsis here.

Healing Skin Problems by Healing the Gut

These are my notes from the blog radio podcast on Revolution Health Radio with Chris Kresser, L. Ac., in which he discusses natural approaches to healing from skin issues, as well as gut health and mental health issues, which are related to each other because they share the link with the gut. 

He tends to approach healing skin disorders (such as acne, rosacea, dermatitis, chronic urticaria) in a similar way, with the exception of psoriasis and eczema, which are often considered to be auto-immune conditions.  Some of the underlying conditions that these skin issues share are low stomach acid, SIBO (small intestine bacterial overgrowth), and leaky gut, and gut dysbiosis. Psoriasis and eczema also share this but have the added dimension of immune dysregulation so may require additional help to heal. 

Knowledge of the Gut-Brain-Skin axis has been around for a long time.  Over 100 years ago, Stokes and Pillsbury published work on this connection.  They connected mental health issues like anxiety and depression with altered gut function, they knew that changes in the gut flora resulted in local and general inflammation that could be expressed as skin problems. Quoting from this work "There's an important linkage of emotion with cutaneous outbreaks of erythmia, urticaria, and dermatitis by way of physiology and bacteriology of the gastrointestinal tract". In discussing their work, Kresser gives us this amazing quote:

"There's a difference between being skeptical and conservative, and just being uninformed."  "It's interesting to me how, when people encounter something that they don't understand, or that seems strange or foreign to them they dismiss it as being irrelevant or quackery.  But in the medical literature, which is supposed to guide clinical practice, it's right there and it's been there for over a hundred years."

One of the mechanisms of this connection is low levels of stomach acid, which allows bacteria to migrate from the colon where they belong to the small intestine, where they don't.  When this happens it's called SIBO (small intestine bacterial overgrowth).  They also knew that stress can induce permeability in the gut. 

Here are the remedies they discussed- probiotics and cod liver oil.

Kesser's theory of why low stomach acid causes acid reflux and GERD is because too little stomach acid allows bacteria and yeast to grow in the stomach, which produces gas that pushes up against the top of the stomach and the sphincter forcing it open, and allowing the acid to splash up and into the esophagus.  50% of patients on medications that reduce stomach acid (PPIs) have SIBO.  SIBO is also associated with Fibromyalgia and CFS, suggesting an inflammatory connection (which is supported by a lot of other evidence).  When you heal SIBO, the permeability of the gut heals.

Recent studies show that emotional stress can cause constipation, SIBO, and gut permeability.  Also, that SIBO is associated with both depression and anxiety.  Healing SIBO leads to improved mental health. 

Studies that support a link between leaky gut and acne.  Several found that people with acne were likely to be reacting to bacterial byproducts that should have been in the gut, but that had leaked out into the bloodstream.  These people are then having an immune reaction to the bacterial toxins, which results in inflammation, and thus the acne.  What they were reacting to is called LPS (lipopolysaccharide) endotoxin, a powerful toxin produced by certain bacteria that causes the body to mount an immune response, which can be against anything and cause auto-immunity. 

There are also studies showing a link between acne and constipation.  Other studies have already showed that people with constipation have altered gut flora (he often uses high doses of magnesium glycinate as a short-term way to address constipation).  70-80% of the dry weight of stool is bacteria, so which bacteria you have in your gut is a big part of your ability to form a normal stool.  Chronic constipation leads to gut permeability because the toxins from the dysbiosis (which are already more plentiful) have more time to sit in the gut and cause damage to the gut wall. 

The connection between stress and gut health is very important, as he says the gut is basically one big nerve plexus (in another post I link to a TED talk about how the gut is essentially a second brain).  Long-term activation of the sympathetic nervous system (fight, flight or freeze) will break down the gut lining and causes a shift towards pathogenic bacteria in the gut.  He also says that the parasympathetic nervous system (rest, repair, and digest) must be activated for stomach acid to be produced, and he has already discussed above how important adequate stomach acid is for gut health.  Most of us, in the modern world, are in this state of chronic low level sympathetic nervous system activation because our bodies don't differentiate between actual threats to our survival and other types of stressors. 

The last third of the podcast covers clinical experiences that Dr Kresser has had with specific patients.  His dietary suggestions generally begin with a modified paleo approach (like auto-immune paleo), which eliminates dairy (except ghee), nightshades, sometimes eggs, FODMAPS (foods with excess fructose or fructans, sugar alcohols such as xylitol), di- and polysaccharides, and limit insoluble fiber because it can irritate an inflamed gut.  Bone broth and glycine-rich foods provide the necessary ingredients to rebuild the gut wall. He also mentions that he has another diet to address migraines, that is a low tyramine, histamine, and arginine diet, and that this diet can also help clear up skin issues.  This is not surprising as many people with rosacea and chronic urticaria have already ntoiced a connection with these, especially the high histamine foods. 

Signs of Zinc Deficiency

There are many reasons for zinc deficiency to occur, such as gut problems and mercury poisoning, but this information is especially relevant for people with Pyroluria (the symptoms of Pyroluria are essentially the symptoms of the zinc and B6 deficiency that it causes). Severe stress (both physical and emotional) can aggravate and worsen zinc deficiency, as can severe burns, diarrhea, low levels of vitamin D, and a vegetarian or vegan diet (vegetarian diets are both low in bioavailable sources of zinc and contain higher levels of anti-nutrients that block zinc absorption such as phytic acid and oxalic acid).  Interestingly many people who are chronically zinc deficient find themselves drawn to eating a vegetarian diet as the zinc deficiency can led to an aversion to meat. 

Zinc deficiency can cause-

-increased oxidative stress.
-detrimental effects on mitochondrial functioning (including disruption in programmed cell death (apoptosis) which is necessary to keep cancers from forming).
-digestive problems including poor absorption of nutrients, as zinc is an important cofactor for many digestive enzymes to function.
-inadequate stomach acid, which can contribute to poor nutrient absorption and gut dysbiosis.
-low appetite and avoidance of foods, especially proteins.  Severe zinc deficiency is one cause of eating disorders, in particular anorexia.
-slowed or stalled growth, both physical and developmental.   'Failure to thrive" is often associated with significant zinc deficiency.  Very severe zinc deficiency can cause dwarfism.
-motor problems (possibly due to the role of zinc in nerve cell signal transmission?).

-cognitive effects (it's said that "zinc rhymes with think for a reason")
-poor immune function or response, which can lead to frequent and/or chronic illnesses.
-slow wound healing.
-elevated copper levels which can be a factor in high histamine levels.
-neurological and mental health effects such as anxiety and depression.
-disrupted ability to regulate hormone levels, possibly delaying onset of puberty.
-delayed or abnormal development and maturation of genitalia.
-infertility
-rashes and other skin problems.
-thin, weak fingernails and toenails with ridges and/or white spots.
-pale skin or skin paler than relatives (zinc is part of melanin synthesis.  Melanin is neuro-protective against mercury so this may increase an individual's likelihood of becoming mercury poisoned).
-premature greying of hair or greying of hair after stressful events, for same reason as above.
-altered or dysfunctional sensory perception, including taste, smell, hearing, and vision (in particular night blindness).

-disruption in the regulation of gene expression.
-limitation of the body's ability to make glucose from amino acids and to release glucose from glycogen.  

Here are resources for more information about the significance of zinc in the body:

The Linus Pauling Institute's Micro-Nutrient Database
(this also has more specific information about the role of zinc in certain diseases such as pnemonia, malaria, HIV/AIDS, and diabetes that may be useful for people with other immune challenges as well.)

Wikipedia entry for zinc deficiency

Basic overview of research involving zinc from the Natural Partners site.

The Importance of the Gallbladder and Bile

I developed acute gallbladder disease when I was pregnant with Roo's older brother.  My gallbladder was removed in emergency surgery just 6 weeks after his birth.  Looking back, I probably had problems with my gallbladder going much farther back, at least into my teens.  I have always felt that this was probably a factor in the health issues of both children, and I have especially wondered if the fact that I had no gallbladder at all while pregnant with Roo is part of what happened to him. 

When I had my acute onset of ME/CFS about 2.5 years ago, which involved cardiac problems, my doctor mentioned that it seemed common that women who had had their gallbladders removed but who did not take bile salt supplements developed heart problems.  She didn't now why, but this sparked an interest in me to find out more.  I think that the simplest explanation is that the body absorbs Coenzyme Q10 based on how much bile it comes into contact with, and CoQ10 is essential for healthy heart function.  It is also central to healthy mitochondrial function so I have wondered if the fact that I did not have a gallbladder, and therefore had inadequate bile flow during my pregnancy with Roo, led to his mitochondrial dysfunction. 

Recently my attention has turned back to this question as I keep realizing that so many of my health issues come back to the liver, including detoxification, regulation of energy and weight, balancing hormones, hemoglobin synthesis (the process involved in Pyrroluria), and a process that leads to endogenous oxalate production.  Even my vision problems may tie back to liver health.  To read more about the function of the liver read this post.  When the gallbladder is not there to store bile, the bile produced by the liver backs up and can congest the liver, thus compromising its function.  Additionally, if the underlying problem that led to the formation of gallstones has not been corrected, stones can continue to form in the liver and cause further problems.  Several months ago I begrudgingly took a round of Azythromycin and suffered a severe adverse reaction to it that the package insert said was a sign that the drug had caused liver damage (more on this in a future post).  I began researching healing the liver again and came across this site that is very intriguing to me.  I have tried doing the apple juice cleanse to clear out stagnant bile, and although I did not follow the protocol as long as directed, I had an immediate benefit from doing it.  I plan to look into this program further.  It looks as if it may contain herbs that could help flush oxalate from the body as well.

I also have come across the following series of videos about the gallbladder, liver, and the functions of bile in the body.  Although these videos are an ad for a product they do seem to contain generally good info that I think is presented in a very accessible way.  These three videos are an excellent introduction to the significance of a healthy bile flow in the body and the many things that can go wrong when that flow is interrupted. 

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Basically, the video is saying that our bodies need the amino acids glycine and taurine, as well as phosphotidyl choline to keep the bile liquid.  If those are in short supply in the body the bile becomes thickened and can't be squeezed out into the intestines properly.  Taurine and glycine are used for detoxification, and when we are exposed to ongoing toxic exposure there is simply not enough left in the body to keep the bile healthy.  Chlorine requires these two amino acids to be detoxified and most of us in the developed world are exposed to it every day.  Phosphotidylcholine is used to process adrenaline and noradrenaline which are released when we are stressed.  If we experience chronic stress, we will become deficient in this and again not have enough to keep the bile flow healthy. When the bile becomes thick it can form into stones, causing further blockages of bile.

If the bile becomes thickened and cannot be released as needed, three sets of problems occur (according to the video); the first set of problems stem from not getting enough bile into the intestines, the second set of problems occur when toxins that would normally be excreted via the bile build up in the liver, and the third set of problems occurs when the backed up bile gets into the pancreas.  In the intestines, bile is needed to neutralize the acidity of food from the stomach (bile is highly alkaline).  Bile also kills parasites and yeast and keeps them from overgrowing.  If the acidic contents of the stomach are not neutralized properly, this acidic mixture can burn the insides of our intestines.  Bile is necessary for us to absorb fats, oils, and fat soluble vitamins properly.  Bile also stimulates peristalsis, which is the movement of the intestines that keeps the food moving as it is being digested, and it regulates the intestinal immune system. 

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This video gives more detailed information about the immune system in the gut.  Bile helps keep auto-immune disorders from developing by regulating the gut's immune system.  The video also goes on to discuss what happens when toxins back up into the liver.  The only way that cholesterol can leave the body is via the bile, so if the bile is backing up cholesterol can rise.  If bile backs up into the blood, it inhibits the actions of white blood cells immuno-suppressant effect.  If bile backs up into the pancreas and liver it can cause irritation and burns.  This irritation can cause diabetes and cancer. 

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Even after surgical removal of the gallbladder, stones can and do form from the bile in the liver and in the ducts.  This video makes the point that the gallbladder regulates the excretion of bile into the intestines the way a faucet regulates the flow of water out of pipes.  It is important that bile is held in the gallbladder when not needed and released in a large enough quantity when it is needed rather than dripping out of the liver the way water would drip from an open pipe.  I wonder if this dripping action causes caustic burns in the duodenum since bile is dripping in at times when the acidic contents of the stomach are not being released.  This segment of the video introduces the product that they are selling, which contains the herb Chanca Piedra in addition to taurine, glycine, and phosphotidylcholine.  I have already read about this herb's supposed ability to dissolve kidney stones and the video claims that scientific studies have shown  that it can both dissolve oxalate stones and keep oxalate crystals from forming in the first place.  You can bet I'm very curious about this- I will try to look up this research.

The Underlying Biological Causes of Sensory Processing Issues

There are quite a few possible underlying causes to sensory issues, and since they are interconnected it's hard to know where to begin.  One common cause is elevated histamine levels in the blood (which can happen for a variety of different reasons, not necessarily about "allergies"). Among the many things that histamine
does is to regulate the "volume" of sensory input in the brain (ever had sensory auras from a migraine? that's histamine at work). A common source of histamine is an imbalance of gut flora- yeast and many bacteria produce histamine, as well as other toxins that directly alter sensory processing (such as acetyl-aldehyde given off by yeast- acetyl-aldehyde is what causes the feeling of a hangover). In this case healing the gut and restoring healthy gut flora can eliminate the sensory problems. Excessive ammonia in the system is another example.

Inflammation in the brain is also a major issue- the location of the inflammation is what determines what is affected (auditory processing, balance, etc). Histamine is a big part of the inflammatory response so there is a connection there. Neurological inflammation can also be caused by viruses in the brain (especially herpes viruses), or by auto-immune reactions to other pathogens. When the auto-immunity is caused by strep it is called PANDAS and can involved OCD and tics. If a person has a leaky blood brain barrier (BBB), then there are many chemicals (some produced by the body, some from outside) that can get into the brain and trigger inflammation. Mercury is a big one, as is aluminum. Both of those can also cause the BBB to become leaky and allow other toxins or pathogens in.

The chemicals that can be let in can be from foods that we eat (they may also be toxins produced by the imbalanced gut flora, which are often heightened after we eat food that feeds those bad bugs). Some foods contain histamine in them, and the histamine from those foods can aggravate the situation. There are several other categories of foods that can do this including phenols (think Feingold diet and red dyes), salicylates, glutamate (like MSG but there are many natural sources too), and oxalates. Oxalates are a major source for Roo and I. Allergies cause inflamation so it can be simple as an allergic reaction. People sometimes refer to sensory and other neurological issues as "brain allergies".

How you address these causes depends on the person's unique situation biologically as well a what can be made to work realistically. I also want to point out that healing from sensory processing issues does not mean that you lose your perceptiveness. Many people feel that they have a very powerful antenna that brings in more input than they can often handle and they get overwhelmed. Treating the underlying causes doesn't take away your antenna, it just puts you in control of the volume controls. Many people find that when they no longer get overwhelmed, they actually become "more" perceptive in many ways because they aren't needing to avoid or block out stimuli.

Oxalate Levels of Foods

I discovered about 3 years ago that Roo was reacting badly to the very highest oxalate foods, such as almonds, and took those out at that time.  I revisited the issue about 6 months ago because Roo was having problems with urine leaking at night, and was stunned to discover that not only did he need to be on a low oxalate diet but that I also need it very much.  This may be my primary food sensitivity.  Oxalates can cause the pain and exhaustion of ME/CFS (or at least contribute to them significantly), at least in part because oxalates injure and kill the mitochondria.  They also keep good bacteria from being able to colonize the gut if the level of oxalate in the gut is too high.  Oxalates can also cause the release of histamine and so can cause all of the same symptoms that histamine can.  Vitamin B6 inhibits the formation in the body of oxalate so a deficiency of this vitamin may predispose a person to have an oxalate problem, so there may be a correlation between Pyrroluria and having high oxalate levels. 

For the past 6 months I have been struggling to follow the low oxalate diet using a variety of lists available online as guides, but the lists often don't agree with each other and this has been very frustrating for me.  I finally created the list below by compiling information from the lists that are in the files section of the Trying_Low_Oxalates yahoo list, which has the most up-to-date lists.  One reason why lists don't agree is that newer testing is using more reliable methods, so I gave preference to newer data when I had to make a choice.  I can't guarantee that this information is correct, it's just the best I could come up with.  I will update it as I get more information.

The foods with the very highest levels, that need to come out immediately when an oxalate problem is suspected (and should never be consumed by a person with a known oxalate processing problem), are: 

almonds, amaranth, black beans, brazil nuts, beets (root and greens), buckwheat, cashew nuts, cannellini beans, chocolate, corn meal, cooked tomatoes, great northern beans, marshmallow root, milk thistle, navy beans, oil of oregano, peanuts, pecans, pine nuts, pink beans, pinto beans, potato chips, potato flour, rice bran, rhubarb, sesame seeds and tahini, slippery elm bark, all soy, spinach, star fruit, sweet potatoes, teff (flour and whole grain), quinoa (whole grain), white bean flour, and yucca powder.

All meat and animal products are low (eggs, milk, butter)

Vegetables-

LOW- alfalfa sprouts, avocado,  arugula, asparagus (boiled), banana pepper, fresh basil, bok choy, broccoli (boiled), broccoli raab, cabbage (all kinds), cauliflower, chives, cucumber, daikon radish, garlic, kale (1/2 cup, boiled at least 6 min), kohlrabi, all lettuce, mung bean sprouts, mushrooms, mustard greens (boiled), onions, green peas (boiled), raw tomato, snow peas, sweet bell peppers (red, orange, yellow but NOT green), radishes, shallots, yellow summer squash, all winter squash (acorn, butternut, pumpkin, etc), turnip (steamed or boiled), wakame, water chestnut, watercress, zucchini, rutabaga (1/2 cup, boiled 1 hour)

MEDIUM- artichoke (boiled), asparagus (steamed), Belgian endive, broccoli (steamed), Brussels sprouts, carrots (1/2 cup boiled), celeriac, collard greens (boiled), eggplant (high histamine!), fennel, grape leaves (one), green onion, jicama (peeled), kale (steamed 6 min), nori, olives, (5), red onion, green beans (vary- roma and runner are med cut and boiled, string are high?), snow peas 

HIGH- Anaheim peppers, green bell pepper, brocollini (steamed), carrots (raw or steamed), celery, chard, chicory, hearts of palm, parsnip, potatoes (red without skins and boiled are lowest), tomatillo (one is medium), many green beans (pole, French fillet), leeks, nopali cactus, okra, parsley, sugar snap peas, purslane, radicchio, sorrel, sweet potato, green tomatoes, canned tomatoes, yams (in US yams are sweet potatoes)

Fruit-

LOW- apples, apricot (one), billberry (can get as jam), cantaloupe, sweet cherries, cranberries, dates, fresh fig, green grapes, huckleberries, lemon, lychee, mango, melon, oranges, passion fruit, peaches, yellow plum (most plums are low, some are medium), golden raisins, strawberry (less than 10), watermellon

MEDIUM- banana (half is low), Bosc pear, grapefruit (white), lime, papaya (1/4 cup), pears, pineapple (is high histamine), pomegranate, blueberries (1/2 cup), dried cranberries, dried cherries (1/3 cup), Italian prunes, tangerines, mandarins, nectarines, persimmon

HIGH- Anjou pears, dried apricots, blackberries, clementines, elderberries, grapefruit (pink), Hachiya persimmons, pomegranate, raspberries, gooseberries, goji berries, kiwi, citrus zest, currants, concord grapes, dried figs, guava

LOW FRUIT (and other) JUICES- apple, apricot, blackcurrant, cranberry, cherry, white grape, grapefruit, lemon , lime, noni, orange, pineapple, red currant juice, aloe vera juice (great for soothing, healing GI tract)

MEDIUM JUICE- carrot, coconut water, red grape, plum, pomegranate

HIGH- Kern’s apricot nectar

Seeds, Nuts Beans, and Grains

LOW- chestnuts (canned or roasted), coconut (milk is medium), flax seed, pumpkin seed (1/4 cup), 1 T pumpkin or sunflower seed butter, macadamia nuts (5 or fewer), red lentils (boiled 30 min), white rice, wild rice, black-eyed peas, split peas (both green and yellow), cellophane noodles (GF), Ancient Harvest quinoa spaghetti (1/2 cup)

MEDIUM- coconut milk, sunflower seed (1/4 cup), macadamia nuts (up to 25 nuts), pistachio (up to 25 nuts), pumpkin seeds (1/2 cup), walnuts (1/4 cup), popcorn (Orville Redenbocker’s is high), psyllium husks (1/2 cup), red kidney beans (1/2 cup), Tinkyada brown rice pasta, brown rice (1/2 cup), brown jasmine rice (1/2 cup), garbanzo beans (1/2 cup), lima beans, rice spring roll skins, millet (1/2 cup, boiled 30 min)

HIGH- Arrowhead Mills brown basmati rice, adzuki beans, black beluga lentils, fava beans, hazelnuts, hemp milk, green lentils, navy beans, poppy seeds, quinoa, red beans, rice milk, white beans, GF oats

Flours and Baking-

LOW- agave nectar, almond extract (pretty much all flavoring extracts), white chocolate, carob, coconut flour, guar gum, tapioca starch, baking soda, cornstarch, unflavored gelatin, rice starch, xylitol, stevia liquid (powder is high)

MEDIUM- flax seed meal, potato starch (1/2 cup),  sweet rice (mochi) flour (1/2 cup), green pea flour, chick pea (garbanzo) flour, pumpkin seed flour (1/2 cup), wild rice flour (1/2 cup)

HIGH- arrowroot, brown rice flour, chestnut flour, Chatfield’s carob powder, carob chips, fava bean flour, millet flour, sorghum flour, stevia powder, white rice flour (especially Bob’s Red Mill stone ground)

Flavors, Spices, Other

LOW- vanilla, coconut oil (be careful- it kills bacteria, fungi, viruses and can cause die-off), olive oil, sesame oil (including toasted, great flavor), mace, maple syrup, mayonnaise, mustard, vinegar (high histamine), capers, chives, cilantro, ginger root, bay leaves, prepared horseradish, saffron, green herbs (dill, basil, oregano, rosemary, sage, thyme, tarragon, etc), white pepper (black pepper is high), nutmeg (up to 3 tsp), sweet paprika, parsley (dried, 1 tsp), Torani chocolate syrup, peanut oil, tabasco sauce (up to 2 T)

MEDIUM- cardamom (1 tsp), cayenne (1 tsp), cinnamon (1/2 tsp), chili powder (1 tsp)

HIGH- allspice, anise, black pepper, celery seed, clove (ground), coriander seed, cumin, curry powder, fennel seed, turmeric

Tea, Beverages-

LOW- chamomile, fennel, hibiscus (?), licorice, mint/peppermint, Kukicha twig tea, nettle, Ojibwa tea, pau d’arco tea, roibos (?), rose hip tea, senna tea, yerba mate (medium), wine (high histamine), coffee

There is a lot of disagreement about black tea and green tea.   It appears that if either is brewed very briefly, they may be medium oxalate, but if they are brewed longer they are high.  This seems to vary quite a bit by brand of tea as well so I chose not to include either kind of tea here.

Melanin, Mercury, and Neurological Disorders

There has recently been a series of posts on the blog Age of Autism written by Teresa Conrick on the relationship between melanin levels and autism, as well as other neurological conditions.  I have wondered about this myself as I have albinism, Roo has very pale skin (identical to mine) that doesn't tan, yet his older, NT brother has a much darker complexion and tans very easily.  Apparently this pattern is common in ASD families.  I began reading about this connection on the Facebook group "Redheads and Autism" which was started by Ginger Taylor, herself the mom of a child with autism with bright red hair.  Many people have noticed that there seem to be a relatively high number of people with autism with red hair compared to the the percent of the general population who has red hair.

This is the first piece in the 3-part series, called Autism and Redheads: the Canaries in the Epidemic, Part 1.

From the author of the post:

"So here is my hypothesis.  It includes both anecdotal evidence and published studies.  If it is possible that redheads are more vulnerable to an autism diagnosis and therefore more prevalent on the autism spectrum, I believe that looking for the reasons for that could open doors on causation and possible treatments, not only for that population but for many others."

From a study quoted in the post:

""Neuronal pigments of melanic type were identified in the putamen, cortex, cerebellum, and other major regions of human brain. These neuronal pigments have some structural similarities to the melanin found in skin. Furthermore, the resulting melanic component serves an additional protective role through its ability to chelate and accumulate metals, including environmentally toxic metals such as mercury and lead...."

 From another study, this time about Tourette's:


"A causal association between red hair and melanocortin-1 receptor has been shown, and is the only gene that is known to explain physiological variation in human pigmentation. Melanocortins are believed to be involved in many disease states including pigmentary disorders, adrenal disorders, obesity, anorexia, prolonged and neuropathic pain, and inflammatory response""

From the author of the post:

"In humans, melanin is found in the skin, the hair, the eyes, the adrenal gland, the inner ear, and in pigment bearing neurons deep within the brain nuclei."

From a study looking at melanin in Parkinson's Disease (PD):


"Now why would light hair color yield greater risk for PD (Parkinson's Disease)? The chemical that determines hair and skin color is melanin. A major problem of PD is an abnormal loss of melanin-containing cells within the brain region that produces dopamine—the substantia nigra. Neuromelanin helps to scavenge up toxic chemicals in the brain like free radicals, active metals (eg, iron), toxic metals (eg, mercury and lead), and organic toxic compounds (eg, pesticides). 

 And this, from a study looking at melanin in Macular Degeneration:

"Chemist James Norris, Ph.D., and retina surgeon Kourous Rezai, M.D., combined resources to show that melanin, a pigment found throughout the human body, acts like a neutralizing sponge inside cells in the retina to soak up and destroy reactive oxygen species." 

Click here for part 2 of the series.

 Interestingly for our family, the author mentions a possible connection between low melanin and both skin tags and cafe au lait spots.  Roo was born with a cafe au lait spot, and bot his dad and I have skin tags.  I have heard that some people have had skin tags go away after supplementing with cysteine so perhaps melanin is related to some of the biochemical processes involving cysteine.

 The author moves on to discuss albinism, which I have.  Here are several quotes from a study looking at melanin and mercury from skin lightening creams:

""In the present study, we investigated the dermal absorption of mercury and its accumulation in the tissues of albino and pigmented mice treated with two brands of mercury containing skin-lightening creams for a period of one months at different intervals. Mercury levels were measured in a total of 133 and 144 liver, kidney and brain tissue samples of albino and pigmented mice.  Significant differences in the mercury levels were observed between the albino and pigmented mice. This emphasizes the protective role of melanin against mercury toxicity.""

From another study on the subject:

"Inorganic mercury compounds are also widely used in skin-lightening soaps and creams, due to the ability of the mercury cation to block the production of melanin pigment in the skin."

 And from another study:

"The pharmacologic activity of the skin-light-eners occurs as the mercury blocks the production of melanin pigment in the epithelial melanocytes, thus lightening the skin over time."

 This is from a study looking at heavy metal exposure to fish:

"Heavy metals (As, Cd, Cu, Hg, Se, Zn) were shown to increase the incidence of albinism. Metal-induced albinism resulted from exposure of both adult fish and eggs."

 Wow...that's a pretty amazing thing to find.  It has been clear to me for awhile that Roo's issues have their root in familial patterns of illness including my grandmother's Celiac disease, my auto-immune problems and chronic inflammation, the HHV-6 virus that he may have received from me congenitally, and the fact that I didn't have a gallbladder while pregnant with him, but I'm surprised to think that my albinism could be the result of mercury poisoning that may have also been passed along.

Click here for part 3 in the series.

 The author talking about Mastocytosis:

"Urticaria Pigmentosa needs some clarification as it has some very pertinent pieces.  It actually goes by another name and one that some of you may have read about in the news two years ago -- "Autism is five to seven times higher in patients with a rare disease called mastocytosis, a discovery that may have just uncovered a vital clue to a biological cause that contributes to autism, according to a recent published report authored by a Brookline researcher."

 More on mastocytosis:

"We report that the apparent prevalence of ASD in patients with mastocytosis, a rare disease occurring in 1/4,000 children and characterized by an increased number of hypersensitive mast cells in many organs, is about 1/10 or 10 times higher than the general population....(a)llergic, infectious, neuroimmune and environmental triggers may activate mast cells to release vasoactive, inflammatory and neurotoxic molecules. These could disrupt the gut-blood-brain-barriers, and/or activate susceptibility genes, thus contributing to brain inflammation and ASD."  

That seems pertinent to our family as we have high histamine levels.  This next quote  seems even more relevant:

"Mast cells, by virtue of their location in the skin, respiratory tract, and gastrointestinal system are potential targets for environmental agents with immunotoxic effects [22]. Mast cells are critical not only for allergic reactions, but also important in both innate and acquired immunity [23], as well as in inflammation [24]. In view of the fact that a subgroup of ASD patients have allergy symptoms that do not appear to be triggered by IgE, it is noteworthy that mast cells can be stimulated by non-allergic triggers originating in the gut or the brain.....The results of the present study support the biological plausibility of how mercury could contribute to ASD pathogenesis by inducing VEGF (vascular endothelial growth factor) and IL-6 release from mast cells, and as a result disrupt the BBB and thus permit brain inflammation."

The author of the posts ends with a plea for more research, as there clearly seems to be relevant information in these studies that needs to he followed up on and put together in a  more coherent manner. 

Orthomolecular Medicine

Since I began my research into understanding what was going on with Roo and what to do about it, I have come across so many new ideas and areas of study.  It's as if there s a whole additional world hidden just below the surface of this one- a world that is invisible until you stumble upon it, but once you see it you realize it's all around you.  In the surface world, sick people go to the doctor and occasionally experience some improvement from symptoms, but often their illness continues or they continue to get sick and suffer.  Sometimes they catch sight of this other world, but if they ask, they will be told it is dangerous, a lie, and that it has never been shown to help anyone.  At some point many of us "cross over" into this other world either from sheer desperation, from accident, or because someone guides us there.  Once here we are greeted enthusiastically by those in this new world.  They welcome us, listen to us, and help us.  Soon many of us have achieved a level of health that we had become convinced we could never achieve.  We want so much to share this knowledge and to help others, so we try to carry the message of hope back to the surface world, where we are mostly met with disbelief, incredulity, and even bitter resentment.

Still, it is hard not to want to spread the word that there is so much hope and so many people are healing.  One of the most exciting things that I found in this new world is Orthomolecular Medicine.  This is an entire field of medicine that I had never heard of before.  Now that I know about it I do see it peacefully coexisting with conventional medicine around me, hidden in plain sight.  This article in Wikipedia gives an accurate depiction of the mainstream view of orthomolecular medicine.  Roo's DAN! doctor turns out to be somewhat familiar with it and of the things she has done the orthomolecular-based treatments have helped us all the most.  I say "helped us" because orthomolecular medicine recognizes the tendency of certain symptoms and traits to cluster in families moreso than conventional medicine and tends to "treat the family" more as a result.

The term Orthomolecular medicine was coined by Linus Pauling in 1968, which he described this way "Orthomolecular psychiatric therapy is the treatment of mental disease by the provision of the optimum molecular environment for the mind, especially the optimum concentrations of substances normally present in the human body."  I have seen in myself and my family such improvement by making use of the concepts of orthomolecular medicine, in particular Histadelia and Pyroluria.  I have also seen so much improvement in many others such that I cannot dismiss that this field of study has stumbled on some very significant truths.  I do not believe that they have everything figured out, nor do I claim to know that everything they say is correct, but learning more about what they have to offer has been so fruitful.  Below are some resources that I have found helpful in understanding more about Orthomolecular medicine.

 This is a long excerpt from the book Depression-Free, Naturally by Joan Mathews Larson, Ph.D.that gives a brief history of the field as well as some case examples and an overview of many of the basic concepts.  Here's a quote from the excerpt "What Pauling is telling us is that the human mind cannot operate in a vacuum because it is totally dependent on the brain and its molecular function to create your emotional health."

Search the archives of The Journal of Orthomolecular Medicine:
http://orthomolecular.org/library/jom/index.shtml

I will add more resources to this post soon.

Orthomolecular Psychiatry by Linus Pauling