Archives for 2014

Sep 24, 2014

Let them eat salt!

September 24, 2014 By toddcaldecott

If you have been keeping abreast of the news lately, you might have come across a news story that highlighted a recent study published in the New England Journal of Medicine (NEJM), which found that salt consumption wasn’t associated with an increase in systolic blood pressure in either men or women, after controlling for factors like age (1). Given that health authorities have been saying for years that salt increases the risk of hypertension, these recent findings are another wrench in works for low-salt proponents.

This is not to say that very high salt consumption is safe. There is good evidence that reducing salt intake from 9-12 g per day, in large part from eating junk food and prepackaged foods, to less than 7 g per day, does promote a significant fall in systolic blood pressure (2). The problem is getting a handle on what exactly this means, particularly when these same changes seem to have no effect on lipid levels, and the risk of dying from cardiovascular disease is at best weakly associated with high salt consumption (15% increase in risk). Once again, as I addressed in an earlier blog, we need to make sure that we don’t confuse our objectives, and remember that hypertension isn’t so much a disease as it is as diagnostic sign. Just because we can alter the findings of one diagnostic sign through various interventions, doesn’t necessarily mean that we have altered the course of the disease. It is really just another example of failing to see the forest for the trees.

Despite these rather unconvincing findings, authorities continue to suggest that we’re consuming too much salt, with the US Food as Drug Administration (FDA) suggesting that we consume less than 2.3 grams per day, and the American Heart Association (AHA) going even further by recommending that we consume no more than 1.5 grams. After all, if eating too much salt is a bad thing, dramatically reducing our consumption must therefore be a good thing – right?

Nope.

In another recent study published by the NEJM (3), researchers compared the health outcomes of patients that followed the very low sodium diet recommended by the FDA and AHA, consuming less than 3 g per day, and found that they had a higher risk of death or cardiovascular than those who consumed more than 7 grams per day:

Shocked? You shouldn’t be, because it’s not the first time we’ve seen these kind of results. A study published in the Journal of the American Medical Association (JAMA) in 2011 found much the same thing, after following 3,681 people for almost a decade that were eating either a low, moderate, or high salt diet (4). And while researchers again found that excessive salt intake was associated with an increase in systolic high blood pressure, they found that a low-sodium diet was significantly associated with higher mortality from cardiovascular causes:

According to the USDA and Health Canada, the average North American consumes only about 3.4 g of salt on a daily basis, which according to the latest research, suggests that most of us are consuming salt at the low end of the spectrum. Personally, I found these results surprising, especially considering just how much prepared and packaged food we eat, which is notorious for containing the high levels of salt which appeals to our tastebuds, activates our appetite centre, and stimulates impulse purchases. But it seems that even with what is still perceived as relatively high salt consumption, most of us are eating salt within a range that is associated with the least risk. Besides which, we’re talking about very small differences in risk, regardless of how much salt we eat. There are far bigger fish to fry, for example, when we compare the effects of eating too much salt, to the consumption of a high carbohydrate diet, which increases the risk of diabetes by 44% and the risk of CVD by 25% (5).

In Āyurveda, salt is a flavor that is an essential part of the diet, and to help maintain good health. Salt stimulates the appetite, promotes the flow of glandular secretions, and assists with the assimilation and absorption of food. It is described as viṣyañdī, meaning that it promotes tissue secretion, and sūkṣma, because salt opens the channels and promotes the easy passage of the feces, making it helpful in constipation. Salty flavor is hot, heavy and wet in quality, and helps to reduce and balance vāta, the component of the humoral theory in Āyurveda that is most closely associated with function of the nervous system. Sodium accounts for almost half the osmolarity of the extracellular fluid, playing a key role in conducting electrical impulses throughout the body. With excessive sweating or diarrhea, the loss of sodium and other electrolytes disrupts the function of the nervous system, leading to issues including nausea and vomiting, headache, mental dysfunction, fatigue, irritability, weakness, cramping, seizures, and loss of consciousness. Often people will think to drink water when they’re dehydrated, but without the addition of electrolytes such as sodium, the water will go right through them and the problem will likely get worse. Although medical organizations like to suggest oral rehydration packets loaded with sugar to restore electrolytes, research has shown that a traditional Āyurvedic salted rice soup (e.g. peya) is far more effective (6).

While I am an advocate for consuming salt, like anything, there is a down-side too. Apart from the overt effects of hypernatremia, which is almost impossible to achieve from dietary consumption, the excessive consumption of salt irritates the mucous membranes, and can lead to inflammation. In a similar fashion, excessive salt weakens digestion and promotes congestion, leading to a feeling of heaviness and lethargy. In this way, salt consumption is limited in kapha (congestive) and pitta (inflammatory) conditions in Āyurveda, but even with these contraindications, it is never eliminated entirely.

Perhaps the most important issue to consider when it comes to salt is the source. Most commercial sources of table salt are prepared from pure sodium chloride, to which various ingredients are added, including anti-caking agents (e.g. sodium aluminosilicate), and if the salt has been iodized, the addition of alkalis (e.g. sodium carbonate) and stabilizers (e.g. dextrose, sodium thiosulfate). I don’t recommend this salt for a number of reasons. Apart from the synthetic anti-caking agents and other additives, pure sodium chloride is a highly refined product, as pure NaCl doesn’t exist in nature. Typically derived from either marine sources (e.g. sea salt), or mined from prehistoric salt deposits (e.g. rock salt), natural salts contain a diversity of nutrients including calcium, magnesium and potassium, as well as a host of trace minerals. The net effect is that these natural salts moderate the direct influence of sodium in the body, and because salt craving can often be a sign of a mineral deficiency, helps to address the root cause of nutrient imbalances.

In Āyurveda, there are five basic groups of salt, called the pañca lavaṇa:

• saindhava lavaṇa
• sauvarcala lavaṇa
• viḍa lavaṇa
• sāmudra lavaṇa
• audbhida lavaṇa

Consumed not just as a flavor or condiment, the pañca lavaṇa are viewed as therapeutic agents, used singly or in combination, found in many different formulas used both internally and topically, such as Bhāskaralavaṇa cūrṇa and Saindhavādi taila.

Saindhava lavaṇa is considered to be the best among salts, mined for thousands of years at the feet of the Himalayas in the Sindh region of the subcontinent. It is derived from the ancient Tethys Sea that at one time separated the subcontinent from Asia. Also known as pink salt, sendha namak or Himlayan salt, saindhava is a light-colored rock salt with a mild taste and sweetish-salty flavor. Saindhava is stated to alleviate all three doṣāḥ (doshas), enkindle digestion, restore electrolytes, benefit the eyes, reduce burning sensations, and enhance fertility.

Sauvarcala lavaṇa is another type of rock salt mined in the Sindh regions and elsewhere, but contains significantly higher levels of iron sulfide, providing for its blackish-red color and characteristic sulfurous odor. Also known as black salt, kala namak, sonchal or sanchal, sauvarcala is considered best for digestion and to balance vāta.

Viḍa lavaṇa is an artificially-prepared salt, made by boiling the powders of saindhava, Āmalakī, Harītakī and sarjakṣāra (sodium carbonate) in water until it is completely evaporated. Naturally rich in ammonium chloride, viḍa is black in color, and possesses an alkaline, salty flavor. It is used to correct kapha and vāta, reducing heaviness in the chest and promoting good digestion, and the proper excretion of feces and gas. Viḍa lavaṇa is generally not used for dietary purposes.

Sāmudra lavaṇa is unrefined sea salt, prepared by evaporating off the moisture from seawater. It is made all over the world, and is differentiated from refined salt by containing a high density of trace minerals, giving it a greyish, rather than pure white appearance. It has a mildly warming energy, and acts to enhance digestion, reducing vāta and the expulsion of flatus, and is only slightly aggravating to pitta and kapha when consumed in larger amounts.

Audbhida lavaṇa is a type of salt that is collected and purified from the soil by calcination, and is rich in sodium bicarbonate. It has an alkaline taste and action, and is considered to be difficult to digest, greasy in quality, cold in energy and acts to reduce vāta. It is used therapeutically, but is generally not added to food.

Filed Under: Cardiovascular disease, Diet, Digestion, Salt

Aug 25, 2014

How to get rid of rosacea

August 25, 2014 By toddcaldecott

Rosacea is a common skin disorder that manifests as a red spotty rash typically found on the face, including the forehead, chin, nose and cheeks, but can also affect other regions of the body such as the eyes, chest and back. Sometimes referred to as the “adult acne”, rosacea is more common during middle age and is three times more likely to affect women. Although a specific cause has not yet been elucidated, rosacea has been linked to a variety of factors including chronic infection, poor digestion, improper diet, medication side-effects, and lifestyle factors. Chronic cases of rosacea often manifest as small bumps and pustules along with a generalized increase in local redness, often accompanied by red eyes, as well as burning or stinging sensations. If left untreated, chronic rosacea can lead to telangiectasia (dilation of superficial blood vessels on the face) as well as rhinophyma, in which the nose gradually becomes bulbous and red from chronic inflammation. There is also evidence that rosacea can lead to the development of basal cell carcinoma.

Over the last 20 years of practice, I have treated rosacea many times, but earlier in my career, I found myself struggling to get results. In Ayurveda, rosacea has all the characteristics and qualities of a pitta disorder, which is more or less synonymous with a state of chronic inflammation. Over the years, however, I found that the typical pitta-reducing treatments didn’t always have a positive effect. Similar to the typical recommendations, I had patients avoid spicy foods and potential irritants like coffee and alcohol, as well as hot weather, excess sunlight, and temperature extremes, in conjunction with an antiinflammatory diet and herbs. In some cases this approach was sufficient, but there were still patients that weren’t completely better. Unsatisfied with these results, I continued to look for better ways to address the condition. Although I don’t have a magic wand to make rosacea disappear, through experimentation and practice, I have been able to come up with some very useful measures that can be used to resolve rosacea permanently.

The human microbiome

If it isn’t perfectly clear by now, we humans are not autonomous organisms separate from nature. We exist as part of the ecology, and likewise, each of us maintains our own microbiome: a collection of micro-organisms that we originally acquired at birth that has grown and evolved to become a highly intimate part of our body. Our skin in particular contains an enormous diversity of microbes, with about 1000 different species of bacteria including the Propionibacteria that play a role in teenage acne, Corynebacteria that can cause diptheria, Staphylococci that are frequent causes of skin infections, and Lactobacillus, which is commonly used as a probiotic supplement. Not just bacteria, however, our skin plays host to a diversity of other organisms including fungi such as Candida that cause yeast infections, and Trichophyton species that cause athlete’s foot and jock itch. Understanding the complexity of the human microbiome is key in the treatment of many diseases, and no less so in rosacea, particularly considering the research which suggests that disturbances or alterations in the human microbiome can result in inflammatory skin disorders. For example, Helicobacter pylori is a bacterial pathogen commonly implicated in peptic ulcer disease, but some research is showing that this pathogen may also play a role in rosacea (1). This is an interesting finding, because it supports an age-old assertion in traditional medicine that what is happening in the skin can be a reflection of what’s happening in the gut. In a similar fashion, researchers have linked a condition called Small Intestine Bacterial Overgrowth (SIBO) to rosacea, demonstrating that when the antibiotic rifaximin is used to eliminate the bacterial pathogens from the small intestine, a significant proportion of patients with rosacea note an improvement in their condition (2).

Demodex mites in situ; isolated Demodex folliculorum specimen

Demodex: arthropods in your skin

Apart from the issue of gut health, it has been suspected for a number of years that rosacea could be the result of an infection with a tiny parasitic mite called Demodex (D. folliculorum, D. brevis). Although a normal part of the human microbiome, when the right factors are present, the population of Demodex can increase, resulting in an inflammatory reaction in the skin from both bites as well as the feces produced by the mites (3). Demodex in particular, thrives on the waxy sebum secreted by our skin, and when temperatures increase in the spring and summer, we produce more sebum, facilitating the growth of Demodex. This explains why rosacea seems to get worse with sun exposure or an increase in temperature. However, this association doesn’t explain why oily-skinned teenagers tend not to get rosacea, why rosacea seems to increase in prevalence with age, and why it is often associated with dry skin. One suggestion is that as we age, the skin becomes more dry, fragile and brittle, providing more opportunity and surface area for the Demodex mite to thrive (4). Certainly we see this same dynamic in other skin infections, such as toenail fungus, which grows into the cracks and fissures of aging, dehydrated skin. Likewise, it has been suggested that altered fat metabolism as we age results in the production of sebum and other factors that encourage the growth of Demodex. Thus, ensuring that the skin is properly hydrated is a key element in the treatment of rosacea, as is ensuring a proper balance of essential fatty acids in the diet, as well as promoting proper fat digestion. The key to getting rid of Demodex, however, is to take measures to restore digestion and the gut ecology, and using topical remedies that can kill the mites.

The role of altered immunity

Another feature to consider in rosacea is the issue of altered immunity. Rather than being a distinctly separate feature of rosacea, alterations in immune function that promote the inflammation of rosacea seem to be generally linked to gut health. Although the connection may seem obtuse, over 60% of immune cells are located in the gut wall, and thus when the gut ecology goes sideways, the impact is an upregulation of inflammation by the body’s immune cells. The idea that rosacea could be in part an immune disorder was given credence recently when researchers discovered that rosacea sufferers have greatly elevated levels of stratum corneum tryptic enzymes (SCTE), in conjunction with elevated levels and altered function of the antimicrobial peptide called cathelicidin.(5). When these two components are elevated, SCTE enzymes act on cathelicidin to give rise to peptides that directly promote skin inflammation. The trigger for the increased production of SCTE enzymes and cathelicidin appears to be a bacteria called Bacillus oleronius that has been isolated from the Demodex mite (6). The presence of this bacteria alters the function of toll-like receptors (TLRs) which are part of the body’s defense against microbes. Patients with rosacea have been shown to express an elevation in TLR activity, which in turn leads to increased cathelicidin synthesis. Interestingly, TLRs also play a role in vitamin D3 metabolism, enhancing the the enzymatic conversion of the precursor 25(OH)D3 to 1,25(OH)₂D3, the active form of vitamin D3 in the body. This is important because 1,25(OH)₂D3 also regulates cathelicidin production, and research has demonstrated that rosacea sufferers may have high serum vitamin D levels compared to controls (7), providing a direct link between sun exposure and the worsening of rosacea symptoms. Although it isn’t clear what factors alter TLR activity, some research suggests that glucocorticoid creams used to reduce skin inflammation enhances TLR activity, and thus may contribute to rosacea (8).

Putting it all together

While there clearly isn’t just one cause when it comes to rosacea, the research in combination with my own clinical experience suggests that rosacea is at its root an immunological disorder that is precipitated by a variety of factors, including diet, gut health, and lifestyle factors including skin care and sun exposure. Taking all this into consideration, this is a breakdown of how I approach a patient with rosacea.

1. Restoring a healthy microbiome.

In consideration of the role that our microbiome plays in immune health, it is vitally important to restore the gut ecology in rosacea. To achieve this, I typically recommend the consumption of lactic acid bacterial (LAB) ferments, such as sauerkraut, kimchi and pickled foods on a regular basis, about one cup daily eaten with food. I do not, however, recommend other kinds of ferments including SCOBYs like kombucha, as they inoculate the gut with unhelpful organisms such as yeast. In this regard, it is vitally important to make sure that the diet is low in sugar and refined carbohydrates when treating rosacea, as this will tend to promote inflammatory changes in the gut microbiome that are in turn reflected in the skin. If there are issues with SIBO, a diet low in fermentable fibers is helpful to limit bacterial growth, but more active measures may need to be undertaken to inhibit the pathogens involved, using antibacterial herbs such as neem leaf, garlic bulb, turmeric root, wormwood leaf, and Oregon grape root. Likewise, if you regularly take drugs that impair gut function, including antibiotics, NSAIDs, proton pump inhibitors, antacids and opiates, these can also play a big factor in SIBO, and hence contribute to rosacea. In addition to the consumption of live culture foods, I also have patients apply the pickle brine directly to the skin a few times a day, to inoculate the skin with lactic acid bacteria. These bacteria compete with pathogenic bacteria for nutrients, as well as produce inhibitory substances such as bacteriocins and organic acids that can kill or limit the growth of bacterial pathogens (9). Applying pickle juice to your rosacea seems like a rather unsophisticated and simplistic remedy, but I have found it very helpful in my practice to restore the health of the skin. Just remember that if you’re going to use the pickle juice topically as a probiotic, that you apply it to the skin AFTER you have applied treatments to kill Demodex, so as not to kill the probiotic organisms.

Neem (Azadirachta indica)

2. Dealing with Demodex

While not all cases of rosacea will involve the Demodex mite, the evidence that Demodex is an active player in many cases of rosacea is undeniable, although as I have stated, the bacteria that colonize Demodex may also play a role. Regardless, the goal here is to get rid of this infestation and prevent its recurrence. Remember, however, that Demodex is a normal component of our microbiome, so the measures we’re undertaking are meant to limit Demodex populations, not wipe them out completely. In part we can achieve this by using live culture pickle juice as I mentioned, and while this does encourage healthy skin, it isn’t directly lethal to the Demodex mite. For this purpose, we have a number of options, including herbs with miticidal (mite-killing) activities, including neem and wormwood, avoiding those which might otherwise be effective if they didn’t cause skin irritation (e.g. garlic) or temporarily stain the skin an unpleasant color (e.g. turmeric). As part of my protocol for dealing with Demodex, I have patients prepare a facial scrub and mask. For example:

coarsely ground green mung beans – 50 g
neem leaf, finely sieved powder – 50 g
white sandalwood, finely sieved powder – 50 g

Mix all the above ingredients together, and use a small handful with a little bit of water to make a paste. The paste can then be used as a facial scrub, gently rubbing the mixture over the affected area to exfoliate and remove the mites. If the area is too sensitive or irritated to use as a scrub, I have patients use the paste to make a mask, which is then applied over the affected area. When the mask dries, and starts to fall off about 15-20 minutes later, it can be gently removed with water. Both neem and sandalwood have miticidal properties and are anti-inflammatory, and in particular, the sandalwood has long been used in India as a skin care agent. Following this, I have the patient apply a tincture of miticidal herbs, such as neem, wormwood, black walnut hull, quassia and pau d’arco to the face with a cotton ball. Not only do the herbs kill the mites, but the alcohol from the tincture also has an inhibitory activity. Another excellent miticide is tea tree oil, which can be applied undiluted to the skin to inhibit Demodex, used by itself or in combination with neem oil.

Sandalwood (Santalum album), leaves and flowers

3. Restoring the skin

In traditional herbal medicine, the state of the skin reflects the health of the blood, which itself is a refinement of the foods we eat in our diet. Thus anytime we see skin issues, we need to direct our attention to the nature of our diet and the health of the gut. Overall, I tend to recommend a low-carbohydrate diet in rosacea, that is rich in nourishing fats, with plenty of leafy greens and bitter foods to upregulate the liver, and correct the altered fatty acid synthesis that plays a role in abnormal sebum production in rosacea. In this regard, avoiding oils and foods rich in omega 6 fatty acids is generally a good idea, as is taking a herbal remedy to upregulate liver function, including bile stimulants (cholagogues) such as Oregon grape root, dandelion, and bupleurum root. Likewise, because of the strong immunological role for rosacea, potentially antigenic foods including wheat (i.e. gluten) and dairy should be removed from diet. Sugar in particular is bad news for the skin, as most people can observe that when they eat sweets, they typically will have some kind of skin eruption. To help heal and moisturize the skin, I recommend avoiding conventional soaps and shampoos, which are extremely drying and irritating, and completely destroy the delicate bacterial ecology of the skin. We need to remember that a healthy bacterial ecology serves as a component of the immune system, so if we weaken our bacterial ecology, we essentially weaken our immune system. Instead of soap, I recommend the daily application of oil to the body, a practice in Ayurveda called abhyanga. When oil is applied to the skin it has a cleansing activity, saturating the surface and penetrating deep below the epidermis to rehydrate, dissolve grime, and exert a mild antimicrobial activity. Choosing the right oil, however, is an important consideration, as some oils such as coconut are comedogenic, and could cause pimples in some people. I don’t have any issue using coconut oil when the skin looks very dry and fragile, but otherwise, I tend to suggest non-comedogenic oils such as almond, apricot, sesame or castor oil. These oils can be rubbed on the face after treatment to rehydrate, and can be a carrier oil for essential oils such as lavender, which not only smells nice, but also has a mild miticidal effect. Another measure that is effective for restoring the skin is the regular application of mid-stream morning urine. This can be collected in a clean glass and applied fresh to the affected area with a compress or cotton ball. Although many will balk at the idea of putting urine on their face, it’s important to note that many skin cosmetics contain urea to take advantage of its unparalleled ability to moisturize the skin. Dry, flaky skin typically occurs due to a reduction in its urea content, and thus rosacea sufferers that exhibit these symptoms in particular will definitely benefit from this measure. Not only does urea and urine moisturize and hydrate the skin, it also helps to promote wound-healing, accelerating the process of cellular renewal, and also has some anaesthetic properties, reducing the irritation and burning sensations that often accompany rosacea. As a purely symptomatic measure, fresh aloe gel scraped from the leaf rind and applied as a fresh poultice to alleviate burning sensations and overcome dryness.

These are only some of the major recommendations I employ in the treatment of rosacea. One thing I haven’t spent much time talking about is the sun and vitamin D3, but it’s worth discussing further. As I previously stated, rosacea sufferers often experience a worsening of symptoms with sun exposure, and likewise, some rosacea sufferers may have elevated levels of circulating 1,25(OH)₂D3. Although the research seems to imply that sun avoidance and limiting vitamin D3 is a good idea, it’s important to note that a significant proportion of rosacea sufferers in one study (i.e. 38%), had lower than normal levels of vitamin D3 (10). My suggestion here is to get your vitamin D3 level checked, and if it’s high, reduce your sun exposure and vitamin D3 supplementation accordingly. Otherwise, if you have rosacea, supplement with vitamin D3 to achieve optimal levels, and make sure to limit your sun exposure, wearing protective clothing and wide-brimmed hats in sunny weather. And in keeping with the recommendations of Ayurveda I discussed at the outset, try to follow a regimen that generally helps to reduce heat and inflammation (pitta), avoiding stimulants like caffeine, chocolate and alcohol, nightshades (e.g. potato, tomato, eggplant), pungent-tasting foods (e.g. chili, garlic, ginger), and sour-tasting foods such as yogurt, vinegar, and citrus. As you improve, however, these foods should cease to be an ongoing issue.

“Arthropods? On me?”

As a last note, I want to mention that pet owners may acquire Demodex mites from their pets, particularly if their immune system is weak. Although cats and dogs have their own species-specific mites such as D. canis and D. cati that aren’t supposed to jump to humans, I have seen several patients, including myself, acquire mite infections from their pets, even if the dog or cat is otherwise healthy. Remember, Demodex is a normal part of our shared microbiome, so just because a dog or a cat has mites doesn’t mean that they have mange or are unhealthy. But if you love to rub faces with your pet(s), let them sleep in your bed, or on your clothes, you are running the risk of infection. Thus, if you are a pet owner with rosacea, it might be time to change your lifestyle arrangement. Once the dog or cat is removed from your personal area, it’s also a good idea to thoroughly wash your sheets and clothes in hot water with borax and soap, and maybe buy new pillows. For the extra paranoid, you can apply diatomaceous earth to your mattress and areas surrounding your bed, but please make sure to wear a proper ventilator, because regardless of what the “authorities” say, inhaling DE or any super fine dust is really hard on your lungs.

Do you have rosacea?
Share your experiences here!

Filed Under: Uncategorized

Feb 19, 2014

Does glyphosate cause celiac disease?

February 19, 2014 By toddcaldecott

A recent paper published in Interdisciplinary Toxicology suggests that Monsanto’s glyphosate may be a direct causative factor in the development of celiac disease. In their review, the authors provide evidence that glyphosate provokes celiac disease through a number of mechanisms:

1. Gut bacteria: Celiac patients often exhibit problems with impaired gut ecology, leading to alterations in bowel function that provoke clinical symptoms. In several animal studies, glyphosate has been shown to be directly toxic to probiotic organisms, facilitating the growth of gut pathogens including Clostridium difficile.

2. Inhibition of cytochrome P450 (CYP): Glyphosate has been shown to inhibit CYP enzymes in the liver, which act to detoxify a variety of poisons acquired from our diet and the environment. Inhibition of CYP not only increases susceptibility to toxins, it also impairs the hydroxylation of vitamin D3. A deficiency of vitamin D3 can be found in as much as 60% of the population that live in northern climates such as Canada, linked to metabolic disorders such as heart disease, and autoimmune disease such as multiple sclerosis. At the same time, glyphosate-induced deficiency of CYP enzymes could lead to increases in retinoic acid, a metabolite of vitamin A that quickly becomes toxic, and may contribute to the pathology of celiac disease. Inhibition of the liver and CYP enzymes by glyphosate could also disrupt the transport of sulfate from the gut to the liver and pancreas, resulting in reduced bile acid production, liver damage, pancreatic inflammation, and damage to the intestinal villi.

3. Nutrient deficiencies: Glyphosate may promote a broad range of nutrient deficiencies commonly seen in celiac disease. Glyphosate has been shown to chelate vital minerals in the GI tract, including iron, molybdenum, and selenium, leading to an increased risk of iron-deficiency anemia, venous thrombosis, and thyroid disorders, all of which are common issues in patients with celiac disease. Other nutrient deficiencies commonly seen in celiac disease also appear to be linked to glyphosate, which disrupts the synthesis of key amino acids in food plants, including tryptophan, tyrosine and methionine, as well as the uptake of iron, magnesium, manganese and calcium.

These are only a few of the points raised by the paper. There is also mention that celiac patients have an increased risk of non-Hodgkin’s lymphoma, the incidence of which has been steadily rising since glyphosate was first introduced in the 1970s. And in a similar fashion, the authors provide a chart showing that the incidence of celiac disease has risen and decreased in direct proportion to glyphosate use, possibly explaining what appears to be the sudden phenomena of widespread gluten intolerance.

So what do I think of the paper? What is immediately striking is that some of the arguments are little more than conjectures, and hence are subject to a great deal of interpretation. It doesn’t help that neither of the authors are medical practitioners nor established experts in the field, and so doubts will be raised about their paper, particularly because the journal that published it, Interdisciplinary Toxicology, isn’t what I would call a mainstream publication. As such, the conclusions of the authors need to be taken with a grain of salt, realizing that the research doesn’t point so much to a smoking gun, as it provides some thought-provoking ideas that needs follow-up from other researchers.

I am no fan of Monsanto, a huge multinational conglomerate that time and again has been found guilty of the agricultural equivalent of piracy. But do I think that Monsanto’s glyphosate is the cause of celiac disease? Perhaps… this review seems rather adamant, and I worry about having too myopic of a focus. We often use terms like “cause” in an exclusive way, not fully comprehending that disease, like life, is multifactoral. Thus while glyphosate could contribute to the incidence of celiac disease and gluten intolerance, there are other explanations as well, apart from the inherent toxicity of this storage protein.

One under-explored mechanism I discuss in Food As Medicine is the inherent toxicity of ALL seeds – essentially – because seeds contain a variety of toxins to discourage predation. Think about it: seeds are little babies, the future of the species, and would any mother send their children off into the world without some kind of protection? Nope – which is why seeds contain a hard waxy coating and are impregnated with a plethora chemicals that are inherently toxic, or do things like inhibit digestion and absorption. There are many many examples of these constituents, including toxic storage proteins, lectins, phytic acid, and non-protein amino acids. Humans are the only mammals to selectively eat and attempt to digest small seeds. To be sure: a cow or a horse may swallow seeds while grazing, but most of the seeds are eliminated undigested in the animal’s stool. This is all part of the dalliance between plants and animals for millions of years, and the plants’ grand design to promote seed distribution.

With the advent of the agricultural revolution 9000 years ago, humans began to selectively eat seeds that we had never eaten before, in large quantities and on a chronic basis. And in so doing, the archeological record shows that our ancestors experienced a dramatic decline in health and longevity, from a life expectancy of around 54 in hunter-gatherers, to around 20 in neolithic farmers. Commensurate with this decrease in longevity was a reduction both body mass and height, as well as an increase in infectious disease, infant mortality, increase in iron deficiency anemia, osteomalacia, dental caries and enamel defects (Cordain 1999).

The basic signs and symptoms of celiac disease have been around for a very long time. In the agrarian society of ancient India, a disease called grahani was described in the texts of Ayurveda, characterized by digestive weakness, chronic diarrhea and weight loss. In ancient Greece, the physician Aretaeus of Cappadocia described a condition called ‘koiliakos’ that resembles celiac disease, bolstered by archeological evidence that celiac disease was found in the Mediterranean (Gasbarrini et al 2012). More recently, a disease called pellagra that has a very similar progression to celiac disease ravaged the south-eastern United states for almost a hundred years, before the cause was determined to be improperly processed corn. Like our experiment with pellagra in the late 19th century, the spectre of widespread gluten intolerance has only arisen since we abandoned traditional methods of food preparation, such as the fermentation of wheat. Similar to the nixtamalization of corn, which prevents pellagra, fermenting wheat not only hydrolyzes gluten into harmless amino acids, but along with cooking, helps to denature the many anti-nutrient factors that have interfere with digestion and absorption. Traditional methods of food preparation such as fermentation have demonstrated their merit in clinical research, showing that when wheat is properly fermented, it can be safely given to celiacs without causing any clinical symptoms (Di Cagno et al 2004). I believe that once we restore these traditional methods of food processing, the incidence of gluten intolerance that has steadily increased over these last few generations will begin to decline. However, as this paper illustrates, there may be other factors in celiac disease, and if the suggestions of the authors prove true, it should be even more incentive to governments to ban the use of glyphosate.

References
Cordain L. 1999. Cereal grains: humanity’s double-edged sword. World Rev Nutr Diet. 84:19-73.
Di Cagno R. et al. 2004. Sourdough bread made from wheat and nontoxic flours and started with selected lactobacilli is tolerated in celiac sprue patients. Appl Environ Microbiol. 70(2):1088-96.
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