Dr. Sarah Myhill

Inflammation

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If you want to contact Dr. Sarah Myhill, please click here.

Inflammation is an essential part of our survival package. From an evolutionary perspective, the biggest killer of Homo Sapiens has been infection, with cholera claiming a third of all deaths, ever. The body has to be alert to the possibility of any infection, to all of which it responds with inflammation.

However, inflammation is metabolically expensive and inherently destructive. It has to be, in order to kill infections by bacteria, viruses, parasites or whatever. For example, part of the immune defence involves a “scorched earth” policy – tissue immediately around an area of infection is destroyed so there is nothing for the invader to parasitise.

The mechanism by which the immune system kills these infections is by firing free radicals at it. However, if it fires too many free radicals, then this “friendly fire” will damage itself. Therefore, for inflammation to be effective it must be switched on, targeted, localised and then switched off. This entails extremely complex immune responses; clearly, there is great potential for things to go wrong.

Inflammation is also involved in the healing process. Where there is damage by trauma, there will be dead cells. Inflammation is necessary to clear away these dead cells and lay down new tissues.

Inflammation is characterised by heat and redness (heat alone is antiseptic), combined with swelling, pain and loss of function which immobilises the area being attacked by the immune system. This is necessary because physical movement will tend to massage the infection to other sites.

If one looks at life from the point of view of the immune system, it has a very difficult balancing act to manage. Too little reaction and we die from infection; too much reaction is metabolically expensive and damaging. If switched on inappropriately, the immune system has the power to kill us within seconds – an example of this being anaphylaxis.

Hypochlorhydria can cause lots of problems

SarahHypochlorhydria, a lack of stomach acid, arises when the stomach is unable to produce hydrochloric acid. It is a greatly overlooked cause of problems.

Acid environment in the stomach
The stomach requires an acid environment for several reasons.

  • acid is required for the digestion of protein,
  • acid is required for the stomach to empty correctly and failure to do so results in gastro-oesophageal reflux disease (heartburn),
  • acid is required to sterilise the stomach and kill bacteria and yeast that may be ingested and
  • an acid environment is required for the absorption of certain micronutrients, in particular divalent and trivalent cat-ions such as calcium, magnesium, zinc, copper, iron, selenium, boron and so on.

As we age, our ability to produce stomach acid declines, but some people are simply not very good at producing stomach acid, sometimes because of pathology in the stomach (such as an allergic gastritis secondary to food intolerance), but sometimes for reasons unknown.

Problems arising from hypochlorhydria.
There are many possible problems that could arise from hypochlorhydria:

  1. Failure to digest foods properly. This will result in a general malabsorption of proteins. Indeed, hypochlorhydria as induced by antacids and H2 blockers and protein pump inhibitors substantially increases one’s risk of osteoporosis because the body simply does not have the raw material to replace bone. Many degenerative conditions will be associated, therefore, with hypochlorhydria.
  2. Failure to absorb trace elements. Trace elements are essential for normal body functioning. If these are not present then the biochemistry of the body will go slow, organs will go slow and this will accelerate the ageing process. Therefore, one would expect to see people getting diseases, such as cancer, heart disease and neuro-degenerative conditions, before their time.
  3. Failure to sterilise the stomach contents. This will make individuals more susceptible to gut infections such as gastro-enteritis and possibly enteroviruses such as Epstein-Barr virus, Coxsackie virus, Echovirus and so on. Gastric acid is an essential part of normal defences against disease. Gastric acid is also essential for getting rid of undesirable bacteria and yeast that appear in the diet. Particularly virulent strains, of course, may cause simple food poisoning. However, if there is an overgrowth of bacteria and yeast in the stomach, then foods will get fermented instead of being digested. This produces wind and gas resulting in bloating and alcohols, which may or may not be useful to the body.
  4. Increased risk of stomach cancer. Having the wrong bacteria and yeast in the stomach will irritate the lining of the stomach and increase one’s risk of stomach cancer.
  5. Malabsorption of vitamin B12. It is well known that the stomach must be acid in order to absorb B12. Indeed, using a proton pump inhibitor such as Omeprazole, will reduce absorption of vitamin B12 to less than 1% of expected. Many people already suffer from borderline B12 deficiency – this is a difficult vitamin for the body to assimilate, but essential for normal biochemistry.

Symptoms of hypochlorhydria
When any of the above problems go wrong, it can result in symptoms.

  1. Accelerated ageing because of malabsorption.
  2. Wind, gas and bloating as foods are fermented instead of being digested, i.e. irritable bowel syndrome.
  3. A tendency to allergies – the reason for this is that if foods are poorly digested, then large antigenically interesting molecules get into the lower gut, where if the immune system reacts against them, that can switch on allergy.
  4. Gastro-oesophageal reflux disease
  5. Iron deficiency Anaemia
  6. B12 deficiency
  7. A tendency to candida dysbiosis or bacterial dysbiosis.Hypochlorhydria

Hypoglycaemia: Insulin is a stress hormone

SarahThere is an additional twist to the hypoglycaemic tale which complicates the situation further. When one becomes stressed for whatever reason, one releases stress hormones in order to allow one to cope with that stress.

Insulin is such a stress hormone and has the effect of shunting sugar in the blood stream into cells. This produces a drop in blood sugar levels and also causes hypoglycaemia.

Therefore, hypoglycaemia can be both a cause of stress and the result of stress, indeed, another one of those vicious cycles that are so often seen in disease states.

Vitamin D and Sunshine

An essential vitamin! Protects against cancer, heart and bone diseaseSarah

Western cultures have become almost phobic about any exposure of unprotected skin to sunshine with the well-recognised association between skin cancer and exposure to sunshine. Indeed the US Environmental Protection Agency is currently advising that ultraviolet light, and therefore sunlight, is so dangerous that we should “protect ourselves against ultraviolet light whenever we can see our shadow”.

But a certain amount of sun exposure is essential for normal good health in order to produce vitamin D – and partly as a result of current recommendations, we are seeing declining levels of vitamin D and the problems that go with it.

Human beings evolved over hundreds of thousands of years in equatorial areas and were daily exposed to sunshine. Dark skins evolved to protect against sun damage. However, as hominids migrated north, those races which retained their dark skins were unable to make sufficient vitamin D in the skin and did not survive. Only those hominids with paler skins survived. Thus the further away from the Equator, the paler the skin became. Races in polar areas survived because they were able to get an alternative source of vitamin D from fish and seafood.

There is an interesting inverse correlation between sunshine exposure, vitamin D levels, and incidence of disease as one moves away from the Equator. Even correcting for other factors such as diet, there is strong evidence to show that vitamin D protects against osteoarthritis, osteoporosis, bone fractures (vitamin D strengthens the muscles thereby improving balance, movement and preventing falls), cancer, hypertension, hypercholesterolaemia, diabetes, heart disease, multiple sclerosis and vulnerability to infections. Multiple sclerosis is a particularly interesting example of a possible vitamin D deficiency disease. Indeed mice bred for susceptibility to multiple sclerosis can be completely protected against development of this disease by feeding them high doses of vitamin D.

How much

For people living in equatorial areas, blood levels of 25 (OH) D) usually exceed 100nnmol/l and often 200nnmol/l. Since we evolved in hot climates, this is probably what is physiologically desirable. However, normal ranges in laboratories are still stated at around 40 to 100nnmol/l. This almost certainly represents sub-optimal levels – it may be enough to prevent rickets and osteomalacia, but is not sufficient for optimal health.

Sunshine

For a pale skinned Caucasian, whole body sunlight exposure barely sufficient to trigger tanning (the so called minimum melanogenesis dose) is as little as 15 minutes and is equivalent to the consumption of 10,000i.u. of vitamin D. If this is compared to the US recommended dietary allowance now standing at 200i.u. (which is the amount in a teaspoon of cod liver oil), one can readily see that the best source of vitamin D is sunshine.

Dietary

It is extremely difficult to get blood levels up to an optimum level on diet alone. Furthermore, dark-skinned individuals need very much more sunshine exposure in order to achieve the same blood levels of vitamin D. As people get older their requirements also increase – however, typically they spend less time in the sunshine and are much more prone to vitamin D deficiency and the problems that go with it.

In a study in which groups of elderly people started to take calcium and vitamin D, the occurrence of fractures is reduced by a third in the first year even though bone density is not increased sufficiently to account for the fewer fractures. What is not yet common knowledge is that vitamin D improves muscle strength and balance and it is thought that this is what reduces the occurrence of falls leading to fractures.

How to get more vitamin D

It is impossible for people living in Britain to get adequate vitamin D levels through full spectrum light. To receive sufficient vit D, you need to get the equivalent of at least 15 minutes per day whole body exposure to sunshine, probably more depending on the colour of your skin, to trigger tanning, but not burning of the skin. How likely is that? So what do you need to do to optimise your vitamin D levels?

  • If you are taking my Mineral Mix at your full correct daily dose (up to max 5 g a day), then you will be getting 4000 – 5000 i.u. of vitamin D3 a day. You do not need to take any other Vitamin D supplement, but sunshine on your skin whenever you can get it will be a welcome bonus! If you are not taking the Mineral Mix, you need to add 5000 i.u. vitamin D3 to your nutritional regime.
  • Lack of sunshine in the UK is an excellent excuse to book a holiday in a sunny climate during the winter! In order to get an equivalent dose through eating fish, one would have to consume 25 teaspoonfuls of cod liver oil or its equivalent. Eskimos and Inuit Indians probably achieve this easily with their diet, but I cannot see myself persuading my teenage daughters to do this. A foreign holiday sounds much more attractive, or keep taking your 5,000 iu daily.

Vitamin D supplements

In choosing a good vitamin D supplement, one needs to know a little of the biochemistry. Vitamin D2, ergocalciferol is made from yeast and is about a quarter as potent as vitamin D3. In order for D3 to be activated it needs to be twice hydroxylated in the liver and the kidney – bear in mind that anybody with liver or kidney problems may have a requirement for the active twice hydroxylated vitamin D (calcitriol) rather than D3.

In studies where vitamin D3 is supplemented at 10,000i.u. daily there have been no cases of hypercalcaemia. 5,000i.u. daily seems a reasonable dose for the winter months, higher amounts where there is pathology such as osteoporosis.

Sunning

People will be delighted to hear that sunshine is good for them – the overwhelming majority feel much better for sitting out in the sunshine. If the skin goes red then they are having too much exposure – they need just sufficient to promote mild tanning.

People with dark skins need much more than people with fair skins, but again they can judge this from the degree to which their skin darkens with exposure to sunshine. Redness means inflammation due to skin damage and should be avoided. It’s the old story – with any substance from water to sunshine, there is potential to underdose and overdose – it’s all about getting the balance right!

Related Articles

“THE CLINICAL IMPORTANCE OF VITAMIN D (CHOLECALCIFEROL): A PARADIGM SHIFT WITH IMPLICATIONS FOR ALL HEALTHCARE PROVIDERS” by Vasquez et al. – gives the science behind vitamin D.

External links

Pathology Department at the City Hospital in Birmingham offers a “direct to the public service for serum 25-hydroxy Vitamin D based on dried blood spots”. They send a home kit with detailed instructions, which makes it a very convenient way to check the levels. All the details on the Pathology Department’s website City Assays and in the page about the test: Vitamin D test.

What Are the Symptoms of Hypoglycaemia

Hypoglycemic symptoms and manifestations can be divided into those produced by the counter regulatory hormones (epinephrine/adrenaline and glucagon) triggered by the falling glucose, the neuroglycopenic effects produced by the reduced energy delivery to the brain and the fatigue from reduced energy delivery to the body.

Adrenergic manifestations

  • Shakiness,
  • anxiety,
  • nervousness,
  • palpitations,
  • tachycardia,
  • sweating,
  • feeling of warmth,
  • pallor,
  • coldness,
  • clamminess,
  • Dilated pupils (mydriasis),
  • feeling of numbness “pins and needles” (parasthaesia).

Glucagon manifestations

  • Hunger,
  • borborygmus,
  • nausea,
  • vomiting,
  • abdominal discomfort,
  • headache.

Neuroglycopenic manifestations – reduced energy delivery to the brain

  • Foggy brain,
  • impaired judgment,
  • nonspecific dysphoria,
  • anxiety,
  • moodiness,
  • depression,
  • crying,
  • daydreaming,
  • negativism,
  • irritability,
  • belligerence,
  • combativeness,
  • rage,
  • personality change,
  • emotional liability,
  • poor quality sleep,
  • automatic behavior,
  • also known as automatism,
  • ataxia,
  • in-coordination,
  • sometimes mistaken for “drunkenness”,
  • focal or general motor deficit,
  • paralysis,
  • hemiparesis,
  • paresthesia,
  • headache,
  • stupor,
  • coma,
  • confusion,
  • amnesia,
  • dizziness,
  • delirium,
  • staring,
  • “glassy” look,
  • double vision,
  • difficulty speaking,
  • slurred speech,
  • abnormal breathing,
  • generalized or focal seizures

These symptoms are very similar to being drunk with alcohol – which results again in poor energy delivery to the brain.

Poor energy delivery to the body

  • Fatigue,
  • weakness,
  • lethargy,
  • poor stamina,
  • blurred vision and many others!

Sleeping Problems How to Create a Good Night’s Rest

By Dr. Sarah Myhill

All living creatures have times in their cycle when they shut down their metabolic activity for healing and repair to take place. In humans we call this sleep. During the flu epidemic after the First World War, a few sufferers developed neurological damage in which they lost the ability to sleep. All were dead within two weeks – this was the first solid evidence that sleep is an absolute essential for life. Happily the body has a symptom which tells us how much sleep we need. It is called tiredness – ignore this at your peril! During sleep we heal and repair, during our waking hours we cause cell damage. If there is insufficient sleep, then the cell damage exceeds healing and repair and our health gradually ratchets downhill. Lack of sleep is a major risk factor for all degenerative conditions from heart disease to cancer and neurological disorders.

Humans evolved to sleep when it is dark and wake when it is light. Sleep is a form of hibernation when the body shuts down in order to repair damage done through use, to conserve energy and hide from predators. The normal sleep pattern that evolved in hot climates is to sleep, keep warm and conserve energy during the cold nights and then sleep again in the afternoons when it is too hot to work and hide away from the midday sun. As humans migrated away from the Equator, the sleep pattern had to change with the seasons and as the lengths of the days changed.

Get the hours of sleep

People needed more sleep during the winter than in the summer in order to conserve energy and fat resources. Furthermore during the summer humans had to work long hours to store food for the winter and so dropped the afternoon siesta. But the need for a rest (if not a sleep) in the middle of the day is still there. Therefore it is no surprise that young children, elderly and people who become ill often have an extra sleep in the afternoon and for these people that is totally desirable. Others have learned to “power nap”, as it is called, during the day and this allows them to feel more energetic later. If you can do it then this is an excellent habit to get into – it can be learned!

The average daily sleep requirement is nine hours, ideally taken between 9.30pm and 6.30am, i.e. during hours of darkness, but allow for more in the winter and less in the summer. An hour of sleep before midnight is worth two after – this is because human growth hormone is produced during the hours of sleep before midnight.

To show how important the balance of hours of sleep and rest are, divide the day into 12 hours of activity and 12 hours of rest. If you have one extra hour of activity (13 hours), you lose an hour of rest and sleep (11 hours). The difference is two hours!

Light

Sunlight
Our biological clock is set by light. Electricity gets in the way here! Our forbearers went to bed when it was dark, simply because it was cold, boring and probably expensive on energy to do otherwise. Their daily biological clock was reset daily. They slept longer in the winter as they went into a semi-hibernation state in order to conserve energy when food supply was low. Conversely, during the summer they had shorter sleeping hours and longer working hours in order to store up food and resources to allow them to survive the next winter. People living on the Equator, of course, have the same sleep requirement throughout the year, but the further away from the Equator one is, the more obvious is this change from winter to summer. We have lost respect for those annual rhythms – actually we all need more sleep during the winter than in the summer because we go into a state of semi-hibernation and our behaviour should reflect this. Many people get into a habit of sleeping shorter hours in the summer and sustain this same pattern through the winter artificially. As a result, as a nation we are chronically sleep deprived. The average sleep requirement is for nine hours, but the national average is 7 ½ hours. Lack of sleep is a major risk factor for heart disease, cancer and, of course, chronic fatigue syndrome.

Daytime

We can use light to help re-establish our biological clock. We need bright light during the day. This switches off melatonin production and melatonin is, of course, the sleep hormone. The best light is full spectrum light and we all prefer to sit in sunshine, or next to natural light from windows. Failing that one can use light from a full spectrum light box.

Night time

Conversely, at night we should use light, or rather darkness, to allow our own endogenous melatonin
production to happen. The only way to do this is to be disciplined about the time at which one goes to bed, and not allow electricity to get in the way of adequate sleep. I often jokingly threaten my patients with cutting off their power supply to their house every night at 9pm, which would certainly help them to restore a more normal circadian rhythm! It may take some weeks or months for the body to adjust, but this is vital for short and long term health. The bedroom should be dark for melatonin to be produced – light pollution is a major problem and blackout curtains may be necessary.

Disturbed sleep is a common symptom of hypoglycaemia

When blood glucose levels fall for any reason, glycogen stores in the liver many be mobilised to prop them up. Another rapid and very effective way in which the body repletes the low glucose is by conversion of short chain fatty acids to glucose. In a healthy person on a good balanced diet the only time this is of
importance is during the night because of the long break between food intake. Short chain fatty acids are used to prop up circulating glucose and prevent a fall below whatever that person’s usual fasting glucose level is. Short chain fatty acids are made in the gut by bacteria fermenting fibre (and such starch as escapes small intestinal digestion). Production is maximised from about 3 hours after food intake.
That is to say, short chain fatty acids are highly protective against the dips we see in blood sugar.

Therefore, a key symptom of a hypoglycaemic tendency is disturbed sleep. This occurs typically at 2 – 3 am, when blood sugar levels fall and there are insufficient short chain fatty acids to maintain a blood sugar. Low blood sugar is potentially serious to the brain, which can only survive on sugar and, therefore, there is an adrenalin reaction to bring the blood sugar back, but this wakes the sleeper up at the same time. Alcohol – the commonest symptom of alcohol causing hypoglycaemia is sleeplessness.
Initially alcohol helps one to go to sleep, but then it wakes one up in the small hours with rebound
hypoglycaemia.

Recognise the sleep wave

Actually sleep does not gradually creep up on us during the evening – it comes in waves. There is a sleep wave about every 90 minutes and you will get to sleep most efficiently if you learn to recognize and ride the sleep wave. Often there is a lesser one earlier in the evening when people drop off to sleep in front of the telly, or they jump and make a cup of tea to wake themselves up because “they are not ready to go to bed” – actually they are! My sleep wave comes at 9.20 and I like to be in bed reading well before this — it is immediately recognisable now I have learnt to expect it!

Other causes of poor sleep

  • Get the right hormonal balance.
  • High level of DHEA mean low levels of melatonin.
  • Hypothyroidism can certainly present with insomnia
  • Hyperventilation
  • Hypoglycaemia can be a major main cause
  • Menopausal Sweating. I am increasingly coming to view that this is a symptom of low blood sugar
  • Bio-rhythms or circadian rhythms

Finally a sleep!

Introducing Dr. Sarah Myhill

At The Holistic Approach we have several professionals who have contributed to our website.
If you want to contact Dr. Sarah Myhill, please click here.

Dr Sarah Myhill was born and brought up in Hertfordshire and qualified from the Middlesex Hospital Medical School, London, with honours viva in 1981, since then she has been working continuously in NHS general and private practice. Sarah comes from a large family of doctors including her father, brother and grandfather, and her grandmother was one of the first lady doctors.

Dr Myhill was brought up with an analytical approach to medicine, which emphasised diagnosing the causes of disease rather than merely the prescription of drugs to treat the associated symptoms. This sparked her interest in a branch of medicine which looks for the root causes of disease and uses diet and nutritional supplements to treat those root causes. This branch of medicine is known as Ecological Medicine and in 1979 the British Society for Ecological Medicine (BSEM) was founded. It is made up of practising GPs and consultants with similar aims. Shortly after Dr Myhill qualified as a doctor in 1981 she joined this Society.

Between 1992 and 2009 she was the Honorary Meetings Secretary of the BSEM and for the latter ten years of her tenure was also the Honorary Secretary. During that time Dr Myhill organised biannual scientific conferences, a five day international conference at Oxford together with training days for other doctors – up to six days a year. She continues to lecture regularly at those sessions and indeed more widely. The BSEM has its own Special Interest Register and Sarah was one of the first doctors to qualify for this in 2004, a rigorous process which required both presenting long and short case histories and was also subject to audit.
Dr Myhill’s interest in this ecological approach has proven particularly helpful in the management and treatment of myalgic encephalomyelitis (ME), otherwise known as chronic fatigue syndrome (CFS).

Today, Dr Myhill is a private doctor with a thriving practice in mid-Wales specialising in Allergy, Nutritional & Environmental (Ecological) Medicine. Dr Myhill also has a special interest in Chronic Fatigue Syndrom (CFS), organophosphate poisoning and uses the best of her traditional medical training combined with the latest techniques in Ecologic Medicine.
Dr Myhill always looks for the root cause of illness rather than use medication to suppress the symptoms of the illness.

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Exercise – if you don’t use it you lose it


Physical exercise is vital for long-term health and longevity. One important reason for exercising physically is because inability to get fit is an early warning symptom of disease. If you can’t get fit, then something is wrong. Be mindful that as we age, we lose some fitness simply because we lose cells. Mitochondria control the ageing process and they do so by apoptosis – they literally commit cell suicide when their metabolism slows down too much.

There are different types of exercise for particular issues. Many people hate exercise and therefore need to exercise in the most time- and energy-efficient way!

Exercise – the right sort –
This is the minimum that everyone should be doing! 12 minutes a week, with home-made equipment, is all that is necessary for full cardiovascular fitness and strength as determined by numbers of mitochondria.

Exercise for pleasure
Exercise releases happy neurotransmitters called endorphins; it also allows us to enjoy the outside world, socialise and function as normal human beings!

Exercise to generate heat is a good way to detoxify by mobilising toxins onto the skin which can then be washed off. If you need to detox, but hate exercise, then a sauna does just as good a job! When I do fat-biopsies on patients, I invariably find a range of pesticides and volatile organic compounds, and my view is that in a modern polluted world we should all be doing detox regimes to keep these as low as possible. Exercise is ideal, but if you are unable to exercise, then go for weekly sauna or far infra-red saunaing. Sunshine is an excellent source of FIR so long as you do not burn your skin with the ultraviolet.

Benefits of being fit
Protection against heart-disease – because it keeps the heart fit and lowers blood-pressure and slows the pulse. Athletes in top training have a resting pulse of less than 40 beats per minute and a resting blood-pressure of 80/40! If you can’t get fit, then it suggests you have a problems which needs investigating.

Protection from osteoporosis – because it keeps “working” the bones which lay down more bone to cope with this work.

Prevents depression – exercise increases levels of endorphins in the brain (the “happy hormones”). Some people actually get hooked on the buzz from intense exercise and must exercise daily to be psychologically well.

Stops obesity – Exercise – the right sort increases insulin-sensitivity and stimulates hormone-sensitive lipase which in turn mobilises fats. This is essential for many dieters who have got stuck! Exercise increases muscle bulk (only 12 mins a week!) so one’s resting energy requirements increase (i.e. you burn up more energy when you are doing nothing)
Improves balance and co-ordination – these need regular daily practice to work well. Anyone who has been confined to bed for a few days will temporarily lose their balance. Regular practice of a skill improves co-ordination and reflexes.

Improves back-pain – the backbone, along with the whole skeleton, is intrinsically unstable. What makes it work are powerful blocks of muscle and connective-tissue to hold the whole thing upright. If you become weak in any muscle-group, joints will be out of shape and cause pain and arthritis.
In some way, exercising to get fit helps the immune system – we know this because exercise protects against cancer.

More muscle makes more heat and warms you up. Heat protects against acquiring viral infections.
Ensures a good night’s sleep. Physical tiredness is a great help to sleep. Sleep is an essential for normal bodily functions!

Makes you look good – a muscled body is a shapely body

Improves mental prowess

The sort of exercise will be in next weeks update.

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Being overweight and how to go about losing it!

by Dr. Sarah Myhill
Being overweight is a major risk factor for diabetes, heart disease, cancer and degenerative conditions. It is a problem which should be tackled as actively as high blood pressure, diabetes and smoking, but because it is not politically correct to accuse somebody of being overweight, this problem is glossed over.

Causes of obesity
Obesity is a problem resulting from western lifestyles. We do not see obesity in wild animals, neither is it seen in primitive communities. There are many aspects of western lifestyles which result in obesity.

Addictive diets
The single largest problem is sugar and refined carbohydrates in the diet. These are addictive because when eaten, they have profound psychological effects; therefore we eat for psychological reasons rather than physical reasons and so do not simply stop eating when we feel physically full. Carbohydrates result in high levels of insulin, which brings blood sugar levels down by shunting sugars into fats. Many people find that despite eating relatively low calorie diets they continue to gain weight or struggle to lose it because the carbohydrate causes these high insulin levels. See Hypoglycaemia

Micronutrient deficiencies
The Western diets are micronutrient deficient.
Micronutrient deficiencies result in cravings as the body looks for those essential items. In the wild we often see animals eating soil, stripping bark off trees, chewing antlers or bones, or seeking out salty rocks to help correct this. Children will sometimes eat soil if allowed! I remember one young boy who used to chew coal. This craving is particularly noticeable in pregnancy, when micronutrient demands are high. Craving to replenish micronutrients means that we end up eating more food than is good for us. We should all be taking micronutrient supplements.

Lack of sleep
Because of western lifestyles we lose sleep. Our average requirement is for nine hours of sleep between 9.30pm and 6.30am. If we do not get sufficient sleep, that causes stress and when stressed, we are more likely to comfort eat carbohydrates. There is a well-recognised association between lack of sleep and being overweight. There is a particularly vicious cycle here because if we use carbohydrates to cope with that stress, this results in hypoglycaemia and hypoglycaemia is the commonest cause of disturbed sleep. See Sleeping Problems

Toxic stress
We live in an increasingly polluted world. Many toxins are fat-soluble and cannot be easily excreted. Therefore, in the short term the body dumps these toxins in fat and that helps protect us in the short term from toxic stress. However, the body is then loath to mobilise this fat when required because that results in an acute poisoning. See Detoxification, Detoxing – Far Infrared Sauna (FIRS).

Hypothyroidism
we are currently seeing an epidemic of hypothyroidism and there are many possible reasons for that. The thyroid gland is the accelerator pedal of our car and sets how fast the metabolism goes, i.e. how fast the body turns the food we eat into energy needed to maintain life. If thyroid hormones are low, then mitochondria go slow so that less glucose is used up for life and that saved is laid down as fat (See Hypothyroidism – diagnosis of)

Lack of exercise
Lack of exercise is a major cause of obesity in Western cultures. We are intrinsically lazy and the ready supply of petrol for our cars makes this much worse! Exercise works on many levels in the prevention of obesity. Firstly, we burn up energy when we exercise; secondly, exercise warms us up and increases our basal metabolic rate so that we burn more calories for some hours subsequently; and thirdly, exercise increases muscle mass and so again we burn more calories at rest. This explains why men are able to eat more food than women. For many exercise is boring, but doing Exercise – the right sort means 12 minutes a week is all you need. This creates a large muscle mass which means you burn more calories at rest, and depletes muscle glcogen which helps hypoglycaemica and insulin resistance. The right sort of exercise is required when one gets stuck at a weight and don’t seem able to lose more.

Allergy
Allergies to foods result in fluid retention (very often when people cut out offending foods they lose half a stone without trying). Allergies to foods also cause low-grade inflammation in the gut. When the immune system is activated, it requires a ready source of energy and to deal with this requirement fat is dumped around the gut. This explains why apple shaped people are at greater risk of heart disease than pear shaped people – fat round the gut means that there is inflammation round the gut and inflammation in the gut causes inflammation in blood vessels and therefore damage. See Stone Age Diet
Poor mitochondrial function – mitochondria represent the engine of our car. Every cell in the body has its own supply of mitochondria. Indeed, the heart is more than 50% by weight mitochondria! If the engine of our car goes slow then less energy will be consumed and therefore there will be a tendency to put on weight. As we age, mitochondria start to run more slowly and this partly explains “middle aged spread”. As we age, we need less energy, but we need more micronutrients since the biochemistry becomes less efficient as we get older. See CFS – The Central Cause: Mitochondrial Failure

Stress
When one is stressed there is a release of the stress hormones, one of which is insulin. The problem with insulin is that running high levels reduces blood sugar levels by shunting sugar into fat. As sugar is shunted into fat, so blood sugar levels fall resulting in hypoglycaemia and the unpleasant symptoms that go with that. So very often people mitigate the effects of stress by snacking on sugar or fast carbohydrate foods, the problem is that this runs high blood sugar levels, high insulin levels and therefore they tend to put on weight readily. “Middle age spread” is a symptom of chronic long-term unremitting stress. This is often accompanied by poor adrenal function as the adrenal gland also exhausts. See Adrenal Gland – the gear box of the car (DHEA and cortisol) – underactive

How to lose excess weight
Once we understand the underlying mechanisms that result in obesity, we can then tailor a regime to get well. Conventional medicine has an all too simplistic approach to weight loss, which almost invariably fails. Conventional medicine states that if you eat less calories you will lose weight. The problem with eating less calories is that the body quickly adapts to this by shutting down its rate of metabolism. This makes us cold, lethargic and depressed, which is not conducive to weight loss! Dieting is not just a case of counting calories!

In order of importance one should put the following in place:

    1. Eat a Stone Age Diet – i.e. a diet of low glycaemic index which avoids the major allergens.
    Tackle addictions so that one stops eating for psychological reasons. The obvious addiction is to sugar and refined carbohydrates, but chocolate and alcohol all carry a calorie burden. Furthermore, one addiction triggers another – alcohol upsets the blood sugar so you then need a carb snack!

    2.Take my standard package of micronutrients.

    3. Sleep well.

    4. Exercise.

    5. Try detox regimes to mobilise toxins from the fat and the body.

    6. Check thyroid function.

    7. Introduce Far Infra Red saunaing – this raises metabolic rates and helps to detoxify

    8. Address issues of stress and adrenal fatigue. There is a general assumption that one should not be allowed to feel hungry. Many people automatically reach for food as soon as they get this sensation.

    Actually, it is normal to feel hungry sometimes – it is what drove primitive man to greater effort! Indeed, the hungry rat, fed just enough to survive, outlives his well-fed brother by 50%. Under-feeding increases longevity reliably well! If all the above interventions do not result in weight loss, then one must reduce portion size and, in the short term, expect to be hungry. The body soon adjusts!

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Cancer – the principles of prevention and treatment part 1 by Dr. Sarah Myhill


I do not pretend to be a cancer expert, but I know of some fundamental principles which apply across the board and are relevant to the prevention and treatment of virtually all cancers.

Once a diagnosis of cancer has been given, this means that there will be trillions of cancer cells already established. For a tumour to be visible on a scan, there must be between a thousand million and a million million cells present. Anything that can be done to reduce this total load is going to be helpful. The standard conventional approach to cancer, i.e. surgery, radiotherapy, and possibly chemotherapy undoubtably has its place. The problem is targeting treatment so that as much of the tumour is killed as possible with normal cells spared. In practice this is a very difficult balancing act.

However, there are other things that can be done over and above this which not only make these treatments more effective, but greatly reduce side-effects from such therapies. In my experience and evidence from a large body of medical literature, these interventions very much improve chances of survival.

You may ask yourself why these additional therapies are not routinely available within the NHS. The answer is that the NHS is overwhelmed with cancer and is struggling to provide the three basic frontline modalities of surgery, radiotherapy and chemotherapy. It simply does not have the capacity to do the rest. This is up to you, the patient.

The idea of this handout is to equip individuals with all the information they need in order to help themselves. There are marker tests which can be extremely helpful and give us an idea of which therapies are appropriate and how successful they are and these can be extremely helpful in monitoring treatment and progress.

The Underlying Biochemical Principles of Treatment

The fundamental principles behind these extra therapies are as follows:

  1. starve the cancer of its food supply;
  2. get rid of growth promoters;
  3. ensure excellent nutritional status with vitamins and minerals (to allow healing and repair);
  4. improve antioxidant status (to mop up free radicals created by the cancer treatments and limit side effects);
  5. sleep well (when healing and repair take place);
  6. do a good detox regime (to get rid of exogenous tumour initiators and growth promoters);
  7. check thyroid function (underactive thyroid is a major risk factor for cancer);
  8. exercise;
  9. use natural anticancer substances as suggested by appropriate tests;
  10. alkalinisation has been described as the poor man’s cancer treatment. Western diets are a major risk factor for cancer and most people eating Western diets have a tendency to acidosis. See Acid-Alkali balance.
  11. monitor the effects of treatment.
At The Holistic Approach we have several professionals who have contributed to our website.
If you want to contact Dr. Sarah Myhill, please click here.

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Headache, The Common Causes by Dr. Sarah Myhill


This is a common symptom which is only too often diagnosed by sloppy thinkers as Paracetamol deficiency! headache one should always think of the cause and the best clues come from careful history taking rather than tests.

ACUTE

Meningitis – this is one of the rarest causes of headaches, but understandably it is the one most people worry about. In acute meningitis, almost always there is a high temperature and nearly always the patient is not with it. They cannot think clearly, they are totally occupied by the pain, there may be lowering of the level of consciousness, or even acute confusion. They are irritable and dislike bright light, loud noises. Any movement of the head is painful and clinically this results in a stiff neck. In advance cases, there may be bleeding of the small vessels – in the skin this causes a rash that does not fade when you press on it. The treatment is high dose injected antibiotics given as soon as is possible. Indeed one should not wait for hospital admission or tests before initiating therapy as a matter of urgency.

Eye disease – a visit to an optician is always a good idea.

Glaucoma, (raised pressure in the eye) – can present with loss of vision.

Ear disease – infection or pressure can cause headache.

Shingles – before the rash appears the diagnosis can be awkward.

Dental problems – undetected abscesses, impacted wisdom teeth, temporo-mandibular joint dysfunction (feel for the jaw joint in front of the ear – does it hurt when you press on this joint and open and close the jaw?).

Sinusitis – may be acute or chronic. Often this causes headache which is worse lying down – this is because it increases the pressure in the head. Chronic sinusitis is often caused by allergy to dairy products.

CHRONIC HEADACHE – all of the above, plus:

Lack of sleep.

Excessive caffeine – if the problem is caffeine, then when you stop drinking caffeine suddenly this can cause the mother of all headaches within a few hours. It can be surprising how little caffeine is necessary to do this.

Allergy – migraine is the classic food induced headache but allergy can cause almost any headache.

Toxic headache – many of my patients with CFS and/or poisoning – complain of headache, the characteristics of which sound like raised intracranial pressure. It is fairly constant, waxes and wanes a little, feels like a pressure and is worsened by movement. It feels like a nasty hangover from alcohol – which of course is another sort of toxic headache! Sometimes it can be so severe as to be mistaken for meningitis. My guess is that it is due to some sort of inflammation in the brain which results in mild oedema or swelling of the brain. But the brain cannot swell within the bony skull – so there is pressure in the ultrasensitive coverings of the brain i.e. the meninges. It is this that causes the headache. But why should there be oedema? Usually because of inflammation. Where there is a toxin there is often immune activation against that toxin. This type of headache may be made initially worse by a detox regime (as toxins are mobilised) but in the longer term got rid of by detoxing.

Problems with the cervical spine (e.g. following neck whiplash injury from car accidents) – often causes occipital headaches (back of head). X ray or MRI scan may be needed to make sure it is safe for a physio to manipulate the neck.

Head injury – sometimes a headache will persist for weeks after.

Raised intra-cranial pressure – this is a rare cause of headache (usually worse in the mornings) but should be picked up at an eye examination where the back of the eye is viewed. If the headache gets progressively worse despite one’s best efforts to find a cause, then further investigation is required.

Blood pressure is not supposed to cause headache unless the pressure is very high. However many of my blood pressure patients instinctively know when their pressure is up.

Hypothyroidism sometimes presents with headaches.

A brain tumour is the cause of chronic headache that everybody worries about, but again is uncommon. It is often accompanied by neurological symptoms, which may be subtle at first, such as change in personality, depression, lack of motivation and so on. MRI scans are now inexpensive and freely available to anybody and one can self refer to organisations such as Lifescan.

Related Articles

At The Holistic Approach we have several professionals who have contributed to our website.
If you want to contact Dr. Sarah Myhill, please click here.

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Melatonin – The Sleep Hormone

by Dr. Sarah Myhill
Melatonin is the natural hormone which controls our biological clock, telling us when it is time to sleep and time to wake up. Sleep is an essential for life just like food and water. Some people are larks (I am – bed at 9.30, up at 5.30) some are owls (bed at 12.00, up at 8.00). It is melatonin which makes it that way.

Melatonin is also a powerful antioxidant and has been heralded as an anti-ageing drug (sleep is the best cosmetic!). It is made in the pineal gland in the brain.

There is a close relationship between melatonin and DHEA. If one is abnormal the other is also likely to be! With stress, such as low blood sugar, DHEA levels run high, so melatonin may be low and this further impairs sleep.

Now, if I see an Adrenocortex Stress Profile (salivary) with high levels of DHEA at night, I prescribe a melatonin supplement.

There is also an interesting relationship between brain neurotransmitters, DHEA and melatonin. The raw material is an amino acid tryptophan which is converted in the body to 5 hydroxytryptophan from which serotonin (the “happy” neurotransmitter which Prozac works on) and then melatonin.

Tryptophan -> 5 hydroxy tryptophan -> serotonin -> melatonin

Melatonin levels are normally very low in the day.

Melatonin has been of proven benefit in jet lag (5mgs at night), for cancer therapy (40-50mgs at night), for chronic insomnia (up to 75mgs at night) and in elderly insomniacs (1-2mgs at night). I usually suggest 3mgs at night and to adjust the dose up or down according to the response. Everyone seems different, for some, just 1mg is sufficient. I don’t use more than 9mgs.

Using these low doses of melatonin I do not measure levels first. However if a patient wanted to try a high dose, (above 10mg) then I would insist on monitoring levels.

The only side effect which has been a problem for some patients is depression and so I warn patients to look out for that. Other side effects are mentioned in the literature but these must just apply to the high doses because I have not seen them. They include confusion, headache, hypothermia, itching and tachycardia.

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Nutritional supplements by Dr. Sarah Myhill


It has become increasingly apparent that the long established Recommended Daily Amounts (RDAs) of nutritional supplements are now out-dated. Either the levels have been incorrectly set, or they do not represent levels for optimum health, or they do not permit the necessary latitude for individual biochemical differences or disease states. Increasingly, they are not relevant to people leading modern Western lifestyles and eating Western diets. It is time for a new set of RDAs.

Reasons for a new set of RDAs
Modern agricultural techniques
1. The vast majority of our crops are annual crops, so that only the upper few inches of soil are exploited. This soil is rapidly becoming depleted of minerals.
2. Traditional systems of crop rotation have been abandoned in favour of monocultures. This increases the need for pesticide and herbicides.
3. Human manure is not recycled back onto the growing fields; therefore, there is a net depletion of minerals.
4. The use of nitrogen fertilisers and pesticides reduces the humus content (mycorrhiza) of soil; therefore, plants will malabsorb minerals.
5. Pesticides, such as glyphosphate, work by chelating minerals in soil, thereby reducing mineral availability to plants.
6. Modern plant varieties are often developed to suit the palate. Fruit, for example, is cultivated to increase sugar content – increasing fructose consumption is a major cause of “metabolic syndrome”.
7. Genetically modified crops – genetic modification is largely done to develop pesticide resistant strains rather than for improving micronutrient density. So, more pesticide is used exacerbating the above problems.
8. Foods may be bred or genetically modified for their “keeping qualities” at the expense of good micronutrient content. Indeed, people often comment how tasteless modern varieties are, and this loss of flavour reflects declining levels of micronutrients.
All these issues result in food crops being micronutrient deficient. Plants grown on mineral-deficient soils will not be able to synthesise other micronutrients essential to their health and the health of consumers downstream (farm animals and humans). In practice, this means the plants themselves are more susceptible to diseases, such as fungal infestation, and therefore they are more heavily sprayed to counteract this. Consumers downstream will be rendered deficient in not just minerals but vitamins, essential fatty acids and many other constituents essential for healthy life which they can only get from eating plant material.
For further reading please see Nutrition Security Institute’s White Paper: Human Health, the Nutritional Quality of Harvested Food and Sustainable Farming Systems

Modern food processing
For reasons of convenience we have adopted food processing techniques which further deplete the micronutrient content of food. All the following processes have this effect:
1. Food storage – it may be many months between harvest and consumption. Storage inevitably results in micronutrient depletion.
2. Food processing – whole fruits are very acceptable, but fruit juices not so because of their high fructose content. Potato is a good food until crisped! Food processing often results in production of hydrogenated and trans fats, which effectively are anti-nutrients.
3. High temperature cooking results in production of transfats and lipid peroxides, all of which are directly toxic in their own right.
4. Cooking to serving times – it may be some time between cooking and eating; a particular problem with ready meals, take-away foods etc.

Food choices and addictions
Western diets are addictive with respect to sugar, refined carbohydrates, allergens (particularly dairy and wheat), caffeine, alcohol, chocolate and, of course, tobacco. This creates problems for the following reasons:
1. We consume these micronutrient-poor foods to the exclusion of micronutrient-dense foods.
2. The above consumables require additional micronutrients for their elimination from the body.
3. Many of these consumables are diuretic.
4. Eating addictively means we do not get the normal cues that tell us when to stop eating. Westerners eat more food than they need and so there is a tendency to weight gain.
5. Fast food and snacking. These are now accepted parts of Western lifestyle, but lead to eating refined and processed foods.
6. Whole-foods are less efficiently digested. In contrast, refined foods are rapidly absorbed, thus hiking blood sugar and insulin levels resulting in metabolic syndrome.
Essentially, these socially acceptable addictions are anti-nutrient, increase our need for micronutrients, and encourage over-consumption of micronutrient-poor foods.

Poor education and ill-advised beliefs
Many people make food or lifestyle choices in the mistaken belief they are doing the healthy thing. Modern advertising campaigns are highly influential, are often aimed at children, and encourage poor food choices through subliminal association of ideas.

1. Many people still believe that saturated fat is unhealthy and believe that low-fat diets are healthy.
2. Foods highly coloured with synthetic colourings are attractive and desired.
3. Sunshine is the only substantial source of vitamin D. Vitamin D deficiency is pandemic because of western climates, but largely due to ill-founded advice to avoid sunshine and use sun blockers.
4. Dairy products are believed to be healthy options, but for many people this is not true. The evolutionarily correct diet is free from dairy products.

Modern western man is less physically active
Consequently, he needs to eat less than our physically active ancestors and lesser amounts of food carry lesser amounts of micronutrients.

Increasing toxic stress of Western environments
Xenobiotic chemicals (pesticides, volatile organic compounds and heavy metals) all need to be detoxified and excreted from the body, but this process is highly demanding of micronutrients. Our increasing xenobiotic load increases micronutrient requirements. Furthermore, xenobiotics are directly anti-nutrient: so, for example, nickel increases our requirement for zinc; fluoride increases our need for iodine; and mercury increases our need for selenium.

Xenobiotics come from:
1. Contamination of our food and water in ways indicated above.
2. Contamination by packaging – many products are wrapped, and sometimes cooked, in plastics with phthalates leeching into food.
3. Contamination of the environment by persistent organic pollutants from agricultural industry, polluting industry, war, fires, road traffic and waste disposal.
4. Cosmetics often contain volatile organic chemicals and/or heavy metals such as nickel and aluminium – this increases the toxic load and thereby the requirements for micronutrients to detoxify them.
5. Jewellery and piercings increase exposure to toxic metals.
6. Prescription medication – the best example of this would be the malabsorption induced by proton pump inhibitors and other acid blockers, resulting in an increased risk of osteoporosis. Most drug side effects result from micronutrient deficiencies.
7. The medication of healthy people, including children, with vaccinations which often contain heavy metals together with live or attenuated viruses. Vaccinations have immune disrupting potential and the potential to switch on novel disease processes.
8. Dental work and surgical prostheses – these often involve use of heavy metals such as mercury, palladium, titanium, nickel, gold and silicones, all of which may be toxic either directly or through their potential to disrupt the immune system.

Other mechanisms not yet identified

At The Holistic Approach we have several professionals who have contributed to our website.
If you want to contact Dr. Sarah Myhill, please click here.

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