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Estrogen – The Good, The Bad and The Ugly

Estrogen – The Good, The Bad and The Ugly
Part 1 of 5


Most people associated estrogen with women however we are beginning to see a serious impact that estrogen has on overall health. 

What is Estrogen?
Is a hormone that primarily functions to stimulate tissue growth such as in the restoration of the endometrium and during pregnancy in the expansion of breast tissue.The latest research has shown that different tissue having varying numbers of each estrogen receptor type α, β, and ϒ. 

The Ugly – Too Much Estrogen

How is Estrogen Produced?
Estrogen is produced from cholesterol from the ovaries as shown below.  Redundant pathways

From pregnenolone and progesterone precursors assure routes of synthesis.  Testosterone is aromatized to estradiol (E2), which is reduced to form estrone (E1) in a reversible reaction.  Estradiol can be reconverted to estrone or further hydroxylated to form estriol (E3). 

FSH stimulates estradiol secretion in the ovaries.  All three forms have varying levels of activity.

Estradiol – most active estrogen
Estratriol – intermediate acting estrogen
Estrone – least active form of estrogen

Synthesis of Estradiol



Metabolites of Estrone

Estrone metabolites include 2_hydroxyestrone, 4_hydroxyestrone, and 16α_hydroxyestrone.  Research has found that 2_hydroxyestrone formation is catalyzed predominantly by CYP1A2, CYP1A1 and CYP1B1 enzymes; 4_hydroxyestrone formation is catalyzed predominantly by CYP1B1, CYP1A2, and CYP 1A1 enzymes respectively; and 16α_hydroxyestrone formation is catalyzed predominantly by CYP2C19, CYP1A1 and CYP3A5.

Pathways that Compete for Estrone


Estrone has three key fates.  It may undergo reduction to estradiol or hydroxylation at the 2 or 16α positions.  Reduction of the keto group of 16α_hydroxyestrone produces estriol.  The 2_ and 16α_hydroxyestrones are major excretory products, appearing in ratios above 2:1 in healthy states.  Small fractions of these two derivatives are also methylated by catechol_O_methyl transferase and SAMe to form methoxy derivatives.  A further hydroxylation at the 4 position (not shown) occurs to only small extents, but 4_hydroxyestrone has estrogenic activity and carcinogenic activity.

Estrogen Clearance
Estrogen is cleared by Phase I and II hepatic detoxification reactions.  Phase I consists of three major pathways via the cytochrome P450 enzyme system; Phase II, sulfation, methylation and glucuronidation help to further detoxify Phase I products. 

So How Do You Clinically Assess Yourself for Estrogen
Part 2 of 5

So the majority of guys out there are probably scared to death of having high levels of estrogen.  High levels of estrogen like anything else has it bad and ugly effects.  High levels of estrogen are characterized by symptoms such as increased anxiety, difficulty sleeping and an increase in irritability. High levels are also associated with increased risk of cancer and highly proliferative breast tissue, resulting in fibroids or cysts as well as an increased growth of prostate cancer cells.  Ironically, many of these symptoms are experienced during menopause when estrogen levels fall.
Research has shown that estrogen responses are bimodal with levels that are too high resulting in dysfunctions similar to levels that are too low.  However estrogen is not all bad…research has found that appropriate levels of estradiol reduce oxygen reactive species, increase coronary blood flow and decrease bladder disorders by reducing neurogenic inflammation.
The testing of estrogen levels is recommended due to the potential adverse effects associated with both elevated and depressed levels.

FEMALE CYCLE SERUM REFERENCE VALUES

 

Follicular

Luteal

Post_Menopause

CONCENTRATION

pg/mL

 

pg/mL

Progesterone

 

5_25 ng/mL

 

Estrone (E1)

10_150

16_170 pg/mL

 

Estradiol (E2)

50_300

200_400 pg/mL

 

Estriol (E3)

5_50

10_60 pg/mL

 

Total Estrogen

70_400

70_700 pg/mL

 


Considerable attention should be given to downstream estrogen metabolites that result as a consequence of supplementing with synthetic estrogen. 

Estrogen Metabolites
Phase I estrogen metabolism occurs via a number of CYP 450 pathways, including 1A1, 1B1 and 3A4 which yield 2_hydroxytrogens (2_OHE), 4_hydroxyestrogens (4_OHE) and 16α_hydroxyestrone (16α_OHE1).

2_OHE and 4_OHE are further metabolized via catechol_O_methyltransferase (COMT) to 2_methoxyestrone (2_OMeE1) and 4_methoxyestrone (4_OMeE1).  2_OMeE, 4_OMeE and 16α_OHE1 metabolites may also be conjugated via sulfation and glucuronidation. 

Individual Analytes


Analyte

High

Low

2_OHE1 ~ Good Estrogen

If both 2_OHE1 and 16α_OHE1 are high, consider methods to better excrete estrogens or decrease HRT

If 2_OHE1 and 16α_OHE1 are both low, total estrogen production may be low.  Address underlying causes of low hormone production

16α_OHE1 ~ Bad Estrogen

If both 2_OHE1 and 16α_OHE1 are high consider methods to better excrete estrogen or decrease HRT

If 2_OHE1 and 16α_OHE1 are both low, total estrogen production may be low.  Address underlying causes of low hormone production

2_OMeE1

Produced from 2_OHE via COMT; 2_OMeE1 has shown anti_proliferative effects
Generally no treatment recommended
Ensure adequate Phase II detoxification

May be due to poor methylation
If 2/16 ratio is also low may indicate a CYP imbalance
If total estrogen metabolite production is low, consider direct assessment of estrogen levels

4_OHE1 ~ Bad Estrogen

Considered a bad estrogen
Produced via CYP1B! and deactivated via COMT to non_carcinogenic 4_OMeE
Consider testing of COMT and CYP1B1
Reduce stress: COMT also involved in metabolism of epinephrine
Increase inhibitors of CYP1B1
Grapefruit, Ginseng
Avoidance of CYP1B! inducers
Polycyclic aromatic hydrocarbons
Evaluate methylation activity
Can be converted to DNA damaging estrogen quinines
Glutathione (reduces quinones)
Resveratrol (prevents quinones)
Selenium, zinc, magnesium

Low levels of the “bad” estrogen
Generally no treatment recommended

4_OMeE1

Generally no treatment recommended

Improve methylation for high 2_OHE1:2_OMeE1 Ratio


So What Does This All Mean?

Well in a nut shell we have to look at the ratios of these analytes in order to detect any abnormalities in the detoxification and biotransformation of Phase I and II metabolism.  Imbalances in the ratios of the above analytes has been associated with an increased risk for certain cancers, including breast, prostate and colon.

How to Develop the Optimum Estrogen Cleanse Protocol for a Healthier Body but also a Better Physique
Part 3 of 5

The Estronex Test
The Estronex test measures urinary estrogen metabolites  and is an easy test which involves collecting the first urine in the morning making no blood draw necessary.  The Estronex profile is primarily used to in breast cancer prevention programs, and ideal for men to evaluate the risk of breast and prostate cancer.

However we are going to use it to assist us in designing the optimum program to assist in losing bodyfat.

2/16 Ratio (2_OHE1 + 2_OHE2/16α_OHE1)
The 2_OHE is associated with reduced cancer growth and referred to as the good estrogen metabolite
The 16α_OHE1 is a powerful estrogen receptor agonist shown to encourage tumor development

If 2/16 Ratio is Low
Increased risk of estrogen sensitive cancers:
Oral contraceptive users may have significantly lower 2/16 ratios

Treatment
Lower an elevated BMI
Increase cruciferous vegetables, including: broccoli, cabbage and brusselsprouts
Supplement with dried organic brussel sprouts or kale
Supplement with di_indolemethane (DIM)
Stimulate hepatic P450_1A1 biosynthesis
Increase ground flax seed intake
Increase intake of omega 3 fatty acids
Increase fruit and vegetable intake
Ensure adequate estrogen receptor functions:
Evaluate markers for oxidative stress such as p_hydroxyphenyllactate, 8_hydroxy_2_deoxyguanosine and lipid peroxides
Ensure adequate estrogen detoxification and biotransformation
Ensure proper gut function to avoid entero_hepatic recirculation and to encourage proper elimination

If 2/16 Ratio is High
Most but not all epidemiological studies have found that women with a high urinary 2/16 ratio are at reduced risk for breast cancer. However, excessive reduction of 16α_hydroxyestrone (leading to an increase in the 2/16 ratio) may reduce bone formation due to its role in osteogenesis
Smoking stimulates CYP1A1 and may therefore  cause a higher 2/16 ratio

Treatment
Evaluate the methylation activity of 2_OHE1 (homocysteine, B12, folic acid status).  Since metabolism of 2_OHE1 is dependent on SAMe, accumulation of 2_OHE1 may demonstrate poor methylation activity
Increase intake of antioxidants

Methylation Ratio
2_Hydroxyestrone and 4_Hydroxyestrone are methylated in Phase II to produce 2_methoxyestrone (2_OMeE1) and 4_methoxyestrone (4_OMeE1) via the COMT enzyme.  2_OMeE1 has been referred to as a good estrogen
4_OMeE1 is considered a non_carcinogenic metabolite of 4_OHE1
Methylation is important to properly clear the estrogens
High COMT activity has been associated with reduced risk of certain cancers

If 2_OHE1/2_OMeE1 Ratio is High
Means there is an imbalance in the metabolism of estrogen
It is necessary to evaluate the activity of methylation

  1. Serum homocysteine
  2. Serum B12 or urinary methylmalonate
  3. Urinary FIGLU
  4. Urinary xanthurenate
  5. Genetic testing; COMT, MTHFR, CYP1A1

Reduce stress:

  1. COMT is involved in the metabolism of epinephrine, reducing availability for estrogen metabolism

Support methylation

The Nuts and Bolts of Putting Together the Estrogen Cleanse
Part 4 of 5

The amount of estrogen needed by men to support general health function is very small and today men on average have excessive amounts of estrogen in their system for several reasons.  The first is that the enzyme aromatase which converts testosterone to estrogen is elevated and tends to be higher in fatter guys because aromatase resides in the fat tissue.  Second, men today are exposed to high amounts of chemical estrogens in the environment such as BPA and phthalates.  BPA is a petroleum based chemical that mimics the structure of estrogen and has been shown to affect the endocrine response in the body in humans and animals.  Phthalates are another chemical estrogen that are used in plastics and many personal care products such as shampoo and skincare lotion.  They contribute to excess estrogen levels and need to be detoxified as safely and quickly as possible in order to minimize the damage they have on tissues in the body.  Third, estrogen is cleared  by undergoing phase I detoxification in the liver which contains the Cytochrome P450 dependent hydroxylases enzymes (CYP1A1, CYP1B1 and CYP3A4/CYP2E); basically there are three potential pathways for estrogen to be converted via the hydroxylase pathway. 

Three pathways, the key to remember is that the production of 16αOHE1 via the CYP3A4/CYP2E pathway produces a compound that is an estrogen agonist which predisposes us to higher rate of cancer.  Obviously we don’t want that to happen, when we look the CYP1B1 pathway there is the production of 4OHE1 which is another bad estrogen.  Therefore we only have one pathway left.   The CYP1A1 which produces 2OHE1 (estrogen agonist) which is healthier and our strategy will be to support the conversion of estrogen along the 2OHE1 pathway.

Get Your Estronex Profile Completed
After closely reviewing the results, this middle age male who was experiencing typical symptoms of estrogen toxic overload, simply put this guy is swimming in a sea of estrogens.  The development of this program will be broken into 2 phases: identification of problematic areas and secondly how to treat the excessive estrogen in order to minimize the health effects and risks that come from too much estrogen. 

View Lab Results

This patient is characteristic of males today who have elevated levels of estradiol which is unbound floating freely in the blood allowing it to bind with cellular receptors resulting in some pretty deleterious effects on his physique such as elevated body fat, low libido and predisposes him to a number of health conditions such as prostate cancer.

Interpretation of Results

High 2/16 Hydroxyestrogen Ratio (2_OHE1 + 2_OHE2)/16a_OHE1
Causes: poor methylation activity which is part of Phase II Detox which converted the quinones to methoxyestrogens. 
Action: need to test for homocysteine, folate and B12 to assess methylation status

High 4_Hydroxyestrone and Methylation Ratio
High 4_Hydroxyestrone (4_OHE1)
Causes: produced by CYP1B1 and deactivated by COMT
Action: reduce stress, increase CYP1B1 inhibition, evaluate methylation activity, reduce build_up of DNA damaging estrogen quinines

High 2_OHE1/2_OMeE1
Causes: imbalanced estrogen metabolism
Action: need to assess methylation activity (serum homocysteine, serum B12 or urinary methylmalonate, urinary FIGLU, urinary xanthurenate, genetic testing (COMT, MTHFR, CYP1A1)

Time to Take the War to Estrogen

General Tips

  1. Improve gastrointestinal Health
  2. Improve diet with low carbohydrates, high protein and omega 3 fatty acids
  3. Decrease body fat
  4. Use phytoestrogens to promote the C2 pathway
  5. Block aromatase and stop testosterone from turning into estrogen
  6. Keep estrogen bound to sex hormone binding globulin (SHBG)
  7. Improve estrogen metabolism by promoting the C2 pathway
  8. Ensure complete elimination of estrogen
  9. Supplement with essential nutrients
  10. Watch what you drink
  11. Limit chemical estrogen exposure

The Specifics to Designing the Right Estrogen Cleanse Program
Part 5 of 5

For sake of simplicity, we are going to put everything in a table format which is easier to follow.

Goal

Instructions

Recommendation

Improve Methylation to Drive Phase II Detox

Assess methylation activity (serum homocysteine, serum B12 or urinary methylmalonate, urinary FIGLU, urinary xanthurenate, genetic testing (COMT, MTHFR, CYP1A1)

Support Methylation

Folic Acid
Tetrahydrofolate
B12
B6
SAMe
Increase antioxidants – eg. limonene
Magnesium

Reduce Stress

 

 

Drive Phase I Detox Pathway (C2 Pathway)

C_2 Pathway produces very weak estrogenic activity

Phytoestrogens
Fish Oils
DIM
Increase intake of cruciferous vegetables: broccoli, cabbage, and brussel sprouts
Supplement with DIM
Stimulate hepatic P450 1A1 synthesis
Increase intake of flax seed lignans
Reduce inflammation

Improve Gastrointestinal Health

To improve excretion of unwanted estrogen from the body

Increase dietary fiber (lignans such as flaxseeds) can bind to estrogen in the digestive tract so it will be excreted from the body
Dietary fiber will also reduce B_glucoronidase that breaks apart bound estrogen
Pre and Probiotic

Improve Diet with low carbs, high protein and omega 3 fatty acids

Help detoxify estrogens and provide adequate fiber. 
Improve insulin sensitivity will improve lean body mass composition and reduce the amount of body fat ultimately improving estrogen detoxification

 

Decrease body fat

More body fat the higher the levels of aromatase  enzyme that turns testosterone to estrogen

 

Block Aromatase from Converting Testosterone to Estrogen

Blocking aromatase is key to reducing the buildup of estrogen in the body

Selenium, melatonin, zinc, green tea and citrus flavones such as oranges and grapefruits are effective at inhibiting aromatase

Increasing the Amount of Estrogen Bound to SHBG

Increase intake of flaxseed hulls will help increase SHBG as well as aromatase preventing estrogen from floating freely in the blood acting on receptors

Flaxseed lignans

Promote Complete Elimination of Estrogen

Avoid the production of quinones
Reduce B_glucoronidase to prevent enterohepatic recirculation of estrogen

Use D_Glucurate to inhibit beta_glucuronidase
Reserveratrol, Gluthathione can help block the production of damaging quinones

Eliminate Alcohol

Alcohol increases estrogen levels in men and women

If you drink consume wine rich in either resveratrol or trans_resveratrol

Limit Chemical Estrogen Exposure

Plastics contain BPA which mimics estrogen

Avoid plastic containers for food and water
Use glass and get a stainless steel water bottle. 


I have personally used an estrogen cleanse once per year and have noticed dramatic results in the amount of body fat I was storing within 7 days and suggest that you employ this as another strategy to improve lean body composition.

 




Controlling Systemic Inflammation Naturally

Introduction
Mainstream media has been attributing the high incidence of diseases seen in the elderly population to simply the aging process and conventional medicine has not been proactively addressing the route of the problem.  However, there have been some key medical breakthroughs recently which have identified systemic inflammation as playing a central role in the development of age_related diseases such as Alzheimer’s disease, congestive heart failure and others.

What is Inflammation
Inflammation is the response of the immune system or body tissues to infection, irritation or injury. The characteristic signs of inflammation present as redness, swelling, heat, pain and dysfunction of the affected organ 1. 

Inflammation and Aging
Aging results in an increase of inflammatory cytokines (destructive cell signaling chemicals) that contribute to many degenerative diseases.  Rheumatoid arthritis is a classic autoimmune disorder where excess levels of cytokines such as tumor necrosis factor alpha (TNF_α), interleukin_6 (IL_6), and/or leukotriene B4 (LTB4) are known to cause or contribute to the inflammatory syndrome.

Chronic inflammation is also involved in diseases as diverse as atherosclerosis, cancer, heart valve dysfunction, diabetes, congestive heart failure and Alzheimer’s.  In aged people with multiple degenerative diseases, C_reactive protein is often sharply elevated, indicating the presence of an underlying inflammatory disorder.  When a cytokine blood profile is conducted in these feeble people, we usually find excess levels of one or more of the inflammatory cytokines (TNF_α, IL_6, IL_1β, LTB4).

Inflammation and Exercise
Inflammation is a common feature of muscle and its associated fascial covering due to blunt trauma sport injuries. Acute inflammation results in the interaction of the immune system and inflammatory cells which are mediated by proteins called interleukins (IL). Mobilization of various cytokines such as IL_1 and IL_6 activate neutrophils followed by recruitment of macrophages to the injured site 2.  Neutrophils appear to have a phagocytic role in addition to releasing proteases to clean up cellular debris 3. Neutrophils can also release cytotoxic and cytolytic molecules which cause destruction through lysis of muscle cells, fascia and surrounding tissues.  Overproduction of Tumor Necrosis Factor alpha (TNF_α), IL_1 and IL_6 are implicated in chronic inflammation of prolonged duration and can lead to extensive tissue damage.

What Should You Do
Science has unraveled a group of key nutrients found in dietary supplements that can help reduce the inflammation which occurs after exercise induced or traumatic injury in order to minimize the impact of tissue damage and allow the body's immune system to begin the repair process.  Evidence based supplements are discussed below.

Mixed Dietary Supplement
Phillips et al. (2003) conducted an experiment to see if markers of inflammation IL_6 and C_reactive protein (CRP) were attenuated after dietary supplements on postexercise muscle injury.  C_reactive protein (CRP), an immune system molecule, is an inflammatory marker serving as a diagnostic tool for predicting various disease states associated with inflammation 4.

Forty men were randomized to receive either placebo (high oleic sunflower oil) or a dietary supplement consisting of 300 mg mixed tocopherols, 800 mg of docosahexaenoate and 300mg of flavonoids (100 mg hesperetin and 200 mg quercetin) on a daily basis for 14 days. Three days postexercise, the control group saw increases in CRP and IL_6 whereas this rise was minimal in the supplemented group. By day 14, both groups showed decreases in both inflammatory mediators with the supplemented group having a statistically significant difference (P=0.05) on IL_6 and CRP (C_Reactive Protein).

Fish oil
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are omega 3 polyunsaturated fatty acids (PUFA) which are capable of regulating the inflammatory process.  Human studies have shown that fatty acid metabolism is linked to the immune system through effects on eicosanoids (prostaglandins, leukotrienes, and thromboxanes) 5. Prostaglandins are regulators of the immune response and their formation is influenced by fatty acids which affect arachidonic acid (AA) metabolism. EPA and DHA compete with AA to reduce prostaglandin E2 and leukotriene B4 formation. In addition, these PUFA have the ability to reduce the capacity of monocytes to produce IL_1 and TNF_alpha which cause inflammation.
By reducing the amount of saturated fat in the diet and incorporating omega 3 PUFA, studies have shown that the immune and inflammatory process in the body can be regulated through modification of cytokines, ecosanoids and gene expression. But consumption of PUFA beyond 3 to 4 grams daily may impair immunity and result in increased destruction of lipid layer in cells (lipid peroxidation) and resultant free radical generation (oxidative species) causing a reduction in components of the immune system which protect the body from invasion by bacteria and viruses  (T_cell directed function, NK cell function, and macrophage activity) 6.  Therefore, consumption of other antioxidants may be required to reduce the overall rise in oxidant byproducts.

Boswellia
Boswellia and it's main constituent, boswellic acid, is derived from the dried gum resin of Boswellia carterii. A study done on rats was designed to assess the efficacy of boswellia extract on reducing adjuvant_induced arthritis in rats 7.  A single oral dose was administered daily for 7 days to measure edema and increased sensitivity to pain (hyperalgesia). At a dose of 0.45 g/kg/day there was significant reduction in pain by day 5 whereas a higher dose (0.9 g/kg/day) reduced pain at an early stage (5 to 24 hours) and on day 5. The researchers speculate that the hyperalgesia effect is due to boswellia's anti_inflammatory properties brought about by immune modulation. Boswellic acids can reduce the production of leukotriene B4, a substance involved in inflammation, by granulocytes and macrophages as well as slowing the movement of leukocytes to the site of inflammation.

Turmeric
Turmeric root contains volatile oil, diferuloyl methane (curcumin), demethoxycurcumin, and bisdemethoxycurcumin; all of which are known as curcuminoids 8. Curcumin, the lipid soluble component in turmeric, possesses anti_inflammatory, anticancer and antioxidant properties.  Curcumin has been shown to consistently block the activity of the transcription factor Nuclear Factor Kappa Beta (NF_kB) (a compound significant in the body’s inflammatory response) 9. Intraperitoneal injection of mice with curcumin has been shown to stimulate muscle differentiation and enhance the regeneration process after injury through inhibition of NF_kB expression on various inflammatory cytokines 10.  Curcumin also mediates the metabolism of arachidonic acid (AA) by inhibition of cyclooxygenase_2, an enzyme responsible for inflammation and pain. In addition, lipoxygenase, hyaluronidase, phospholipase and collagenase enzymes which also play a role in inflammation are inhibited. 

Vitamin B6
The active form of vitamin B6, pyridoxal 5'_phosphate (PLP), is a water soluble compound which may play a role in the etiology of inflammation. Kelly et al. (2004) found a direct dose response inverse relationship between C reactive protein (a marker for inflammation) and PLP on subjects with new ischemic stroke when compared with matched controls 11. Lower plasma PLP was associated with higher CRP levels. In another study, animals fed a B6 deficient diet showed greater infiltration of inflammatory cells in the diaphragm, masseter and heart muscles after infection with T. Spiralis, compared to mice fed a normal diet  and B6 deficient rats saw edema increase by 54% compared with weight_matched controls 12. Thiobarbituric acid reactive substances (which indicate the extent of lipid peroxidation) increased by 30 and 43% in the edematous tissue of B6 deficient mice. Collectively, the data shows that pyridoxine deficiency enhances inflammation 13.

Lactoferrin
Lactoferrin, an iron_binding protein derived from milk and processed whey, possesses a host of biological activities such as antibacterial, antitumor, anti_inflammatory, antiviral, antifungal, and immune modulation 14.  Neutrophils produce high levels of lactoferrin where it is stored in secondary granules and released during inflammation to contribute to it's physiologic properties.  In vitro and in vivo studies have shown that lactoferrin can modulate the immune system and correct cytokine imbalance by inducing anti_inflammatory cytokines IL_4 and IL_10, inhibiting the proinflammatory cytokines TNF_alpha and IL_1beta and downregulating NF_kB 15,16.  Orally administered lactoferrin is broken down in the gut to form a new peptide, lactoferricin with similiar antibacterial activities as the parent compound. Mice fed lactoferrin have shown an increase in IgA and IgG in the intestinal fluid and induction of IL_18 secretion in the small intestine of mice 17. IL_18 enhances activities of T helper_1 (Th_1) and natural killer (NK) cells.

Resveratrol
Resveratrol is naturally occuring polyphenolic compound produced by certain vines, pine trees, peanuts, grapes, and other plants. It has been studied for its antimicrobial, anti_inflammatory, anticancer, antioxidant and beneficial cardiovascular properties.

Resveratrol's vast anti_inflammatory properties have been elucidated by in vitro and in vivo studies: l. inhibition of COX_1 and COX_2 enzymes, 2. antioxidant, 3. inhibition of 5_Lipoxygenase (5_Lox), 4. inhibition of mediators of inflammation from macrophage, 5. inhibition of TNF_alpha, leukotrienes, histamines and eicosanoids from mast cells and 6. inhibition of protease and oxidant release from neutrophils 18.  

Inflammation is a complex process which involves cytokine signalling and kinases such as MAPKs, PKC, phosphoinositide_3_kinase etc. MAPKs phosphorylates (adds a phosphate (PO4) group to a protein or molecule) a variety of transcription factors (NF_kB and AP_1). Resveratrol inhibits the activation of these transcription factors and disrupts the signalling pathways required for initiation of the cascade towards inflammation. In addition, topical application of resveratrol can enhance wound healing by increasing connective tissue deposition and improving the overall integrity of the wound area.

Ginger
Ginger, a rhizome of the plant Zingiber officinale, has been used in traditional medicine for centuries as a stimulant, diuretic, diaphoretic and nausea. Today, interest in ginger lies in its anti_nausea and anti_inflammatory properties.  The active components of ginger include phenolic compounds, sesquiterpenes, galanolactone, gingesulfonic acid, zingerone, monoacyldigalactosylglycerols, and gingerglycolipids.  Ginger is able to modulate inflammation through various pathways 19.  It does this by inhibiting COX_1 and COX_2 enzymes, thus lowering prostaglandin E2 production, inhibiting 5_Lox thereby reducing leukotrienes and interfering with the induction of genes involved with inflammation. In addition to its anti_inflammatory property, ginger also possesses analgesic effects. One of the active components [6&91;_gingerol, given in doses of 25 mg/kg and 50 mg/kg, was administered to mice intraperitoneally 20.  The results revealed a reduction in the acetic acid_induced writhing response (in the late phase) comparable to the nonsteroidal anti_inflammatory drug indomethacin. The acetic writhing test is used to study a drug's peripheral analgesic property and since the late phase correlates with the inflammatory response and pain it was concluded that [6&91;_gingerol acts peripherally rather than centrally.

Cat's Claw
Cat's claw is a tropical vine that grows in rainforest and jungle areas in South America and Asia.
The bark and root contain active substances such as alkaloids, polyphenols, tannins and several other phytochemicals which possess anti_inflammatory and antioxidant activity.  A study conducted by Aguilar et al. (2002) compared a hydroalcoholic extract against an aqueous freeze_dried extract from the bark of cat's claw on carrageenan_induced paw edema model in mice. While both extracts significantly reduced edema, the hydroalcoholic extract (50mg/kg) produced an anti_inflammatory effect at a much lower dose than the freeze_dried extract (200mg/kg). Cat's claw mechanisms of action involves moderate to weak activity against COX_1 and COX_2 in vitro, strong antioxidant properties of it's proanthocyanidin content in scavenging various free radicals and suppression of TNF_alpha production 22.
But of the two Cat's claw species, Uncaria tomentosa and Uncaria guianensis, the latter has the most potent antioxidant and anti_inflammatory properties.

Superoxide Dismutase
Superoxide dismutase (SOD) is a naturally occurring enzyme found in the cytosol and mitochondria. Manganese is required for the mitochondrial form while copper and zinc is required for the cytosol form. SOD plays an important role in cellular antioxidant defenses.

SOD possesses potent free radical scavenging activity and this is thought to be one mechanism by which it interrupts the inflammatory cascade 23.  Another mechanism, shown in vitro, involves reduced movement of leukocytes suggesting a reduction in infiltration of inflammatory cells 24.  Orally administered SOD can attenuate muscle damage after injury by unregulating the expression of desmin, a peptide produced by skeletal, cardiac and smooth muscles. Desmin is important in linking the myofibrils in skeletal muscles and tissue cohesion. Because orally consumed SOD is degraded in the gastrointestinal tract, it is combined with wheat gliadin to act as a protective carrier. Vouldoukis et.al has shown increased antioxidant defences and improved cellular resistance to oxidative stress with the SOD_gliadin combination 25.

Conclusion
Nutritional intervention in sports related trauma can have a dramatic impact on the recovery of the affected organ. The link between the immune system and inflammation increases our understanding of how supplements can confer benefits without the adverse effects associated with conventional drug therapy. Acute inflammation, while beneficial to some extent can lead to chronic inflammation and the use of nutritional supplements is gaining popularity as a means of mitigating the destructive effect of the inflammatory response.

References
1. Dorland's Pocket Medical Dictionary, W.B. Saunders Company, 22nd ed.
2. Bedaira HS., Ho AM., Fu FH., Huard J.  Skeletal muscle regeneration: an update on recent findings, Current Opinion in Orthopaedics 2004; 15: 360–363.
3. Tidball JG.  Inflammatory processes in muscle injury and repair.  Am J Physiol Regul Integr Comp Physiol 2005; 288: 345_353.   
4. Phillips T., Childs AC., Dreon DM., Phinney SM., Leeuwenburgh C.  A Dietary Supplement Attenuates IL_6 and CRP after Eccentric Exercise in Untrained Males.  Medicine & Science in Sports & Exercise 2003; Feb: 2032_2037.
5. Artemis P. Simopoulos.  Omega_3 Fatty Acids in Inflammation and Autoimmune Diseases.  Journal of the American College of Nutrition 2002; 21(6): 495–505. 
6. Meydani SN.  Effect of (n_3) polyunsaturated fatty acids on cytokine production and their biologic function. Nutrition 1996; 12(suppl.1): S8–S14.
7. Fan AY., Lao L., Zhang RX., Zhou AN., Wang LB., Moudgil KD., Lee DYW., Ma ZZ., Zhang WY.,  Berman BY.  Effects of an acetone extract of Boswellia carterii Birdw. (Burseraceae) gum resin on adjuvant_induced arthritis in lewis rats.  Journal of Ethnopharmacology 2005; 101(1_3): 104_109.  
8. Natural Medicines Comprehensive Database.  Therapeutic Research Faculty 2nd Edition, 1999. 
9. Cohly HH., Taylor A., Angel MF., Salahudeen AK.  Effect of turmeric, turmerin and curcumin on H2O2_induced renal epithelial (LLC_PK1) cell injury. Free Radic. Biol. Med 1998; 24: 49–54. 
10. Thaloor D., Miller KJ.,  Gephart J., Mitchell PO., Pavlath GK.  Systemic administration of the NF_kB inhibitor curcumin stimulates muscle regeneration after traumatic injury.  Am J Physiol. 1999; 277(2 Pt 1): C320_C329.  
11. Kelly PJ., Kistler JP., Shih VE., Mandell R., Atassi N., Barron M., Lee H., Silveira S., Furie KL.  Inflammation, Homocysteine, and Vitamin B6 Status After Ischemic Stroke.  Stroke 2004; 35:12. 
12. Frydas S., Papaioanou N., Vlemmas I., Theodoridis I., Anogiannakis G., Vacalis D., Trakatellis A., Barbacane RC., Reale M., Conti P. Vitamin B6_deficient diet plus 4_deoxypyridoxine (4_DPD) reduces the inflammatory response induced by T. spiralis in diaphragm, masseter and heart muscle tissue of mice.  Mol Cell Biochem. 1999; 197(1_2): 79_85.  
13. Lakshmi R., Lakshmi AV., Divan PV., Bamji MS.  Effect of riboflavin or pyridoxine deficiency on inflammatory response.  Indian J Biochem Biophys. 1991; 28(5_6): 481_484.  
14. Brock JH.  The physiology of lactoferrin.  Biochem Cell Biol. 2002; 80: 1–6. 
15. Conneely OM.  Anti_inflammatory Activities of Lactoferrin.  Journal of the American College of Nutrition.  2001; 20(5): 389S–395S.
16. Togawa J., Nagase H., Tanaka K., Inamori M., Umezawa T., Nakajima A., Naito M., Sato S., Saito T., Sekihara H.  Lactoferrin reduces colitis in rats via modulation of the immune system and correction of cytokine imbalance.  Adv Nutr Res. 2001; 10: 247_269.
17.  Tomita T., Wakabayashi H., Yamauchi K., Teraguchi S., Hayasawa H.  Bovine lactoferrin and lactoferricin derived from milk: production and applications.  Biochem. Cell Biol. 2002; 80: 109–112.  
18. de la Lastra CA., Villegas I.  Resveratrol as an anti_inflammatory and anti_aging agent: Mechanisms and clinical implications.  Mol. Nutr. Food Res. 2005; 49: 405_430. 
19. Grzanna R., Lindmark L., Frondoza CG.  Ginger_ a herbal medicinal product with broad anti_inflammatory actions.  J Med Food. 2005; 8(2): 125_132.   
20. Young HY., Luo YL., Cheng HY., Hsieh WC., Liao JC., Peng WH.  Analgesic and anti_inflammatory activities of [6&91;_gingerol.  Journal of Ethnopharmacology 2005; 96: 207–210.  
21. Aguilar JL., Rojas P., Marcelo A., Plaza A., Bauer R., Reininger E., Klaas CA., Merfort I.  Anti_inflammatory activity of two different extracts of Uncaria tomentosa (Rubiaceae).  Journal of Ethnopharmacology 2002; 81: 271_276.     
22. Sandoval M., Okuhama NN., Zhang XJ., Condezo LA., Lao J., Angeles FM., Musah RA., Bobrowski P., Miller MJS.  Anti_inflammatory and antioxidant activities of cat’s claw (Uncaria tomentosa and Uncaria guianensis) are independent of their alkaloid content.  Phytomedicine 2002; 9: 325–337.
23. Riedl CR., Sternig P., Galle G., Langmann F., Vcelar B., Vorauer K., Wagner A., Katinger H., Pfluger H.  Liposomal Recombinant Human Superoxide Dismutase for theTreatment of Peyronie’s Disease: A Randomized Placebo_Controlled Double_Blind Prospective Clinical Study.  European Urology 2005; 48(4): 656_661.    
24. Michelson AM.  Medical aspects of superoxide dismutase.  Life Chem Rep 1987; 6: 1_142. 
25. Vouldoukis I., Conti M., Krauss P., Kamate C., Blazquez S., Tefit M., Mazier D., Calenda A., Dugas B. Supplementation with gliadin_combined plant superoxide dismutase extract promotes antioxidant defences and protects against oxidative stress.  Phytother Res. 2004; 18(12): 957_962.  

 

 




Top 10 – Fat Loss Tips to Help You Get a Beach Body Physique For This Summer

Tip 1 – Eat Breakfast But Add a Liquid Meal – Add a protein shake (whey protein isolate), I suggest using New Zealand Protein which is not treated with the chemicals and hormones found in other protein products. In addition, add 20grams of glutamine, 5g of creatine monohydrate and 3g of l_carnitine (recently approved by Health Canada) to 40_60g of your favorite whey protein shake (remember to rotate your protein powders every couple of months to reduce the chance of developing a food allergy intolerance. For breakfast, there is no better choice than to take what world renown strength coach Charles Poliquin suggest – the meat and nuts breakfast. I suggest rotating between ostrich, lean game meat (elk, bison, steak) and consuming nuts except peanuts.

Tip 2 _ Eat at Least 6 Meals Per Day – use a clock with an alarm setter to remind you to eat so that your body is not in a negative nitrogen balance at any point in the day. Have your alarm go off every 3 hours and make sure to pre_cook your meals ahead of time. Lastly do not microwave or pack your foods in plastic containers containing BPA as this will just expose your body to estrogen toxins and just turn you from a man into a girly man.

Tip 3 – Consume Loads of Branched Chain and Essential Amino Acids Before, During and After Working Out –Research has shown time and time again that protein synthesis that is triggered by resistance training can be increased by taking extra EAA and BCAA before, during and after training. Also a good suggestion is that if you know that your meal is going to be delayed make sure to consume a load of BCAA like 10g worth to prevent muscle catabolism.

Tip 4 – Pack Snacks and Consume During the Day – I suggest that you develop a snack jar or bag that contains food materials that exhibit the following properties: can be stored at room temperature (require no refrigeration), contain quality calories and provide quality fat and proteins. Here are some suggested snack foods: beef, chicken, tuna, and turkey jerky for protein; for quality monounsaturated fats I suggest nuts (pistachios, cashews, walnuts, dates, pecans, brazil nuts, hazel nuts and macadamias); for antioxidants you can eat cherries, dried fruit, figs, etc.

Tip 5 – During Plateau Phases – Glutamine Load – this is a strategy once again used by strength coach Charles Poliquin who recommends taking 80g of glutamine a day for 5 days, he recommends taking 10g every 2 hours. The only problem, is that some people won’t have the gastrointestinal system to tolerate such as high load of glutamine and if you do ..lucky you.

Tip 6 – Have a Refeeding Day Every 5th Day – Dr. Mauro Dipasquale author of the metabolic diet was one of the first to propose the idea of increasing your calories by 50% above what you regularly eat every 5th day. From a caloric perspective just multiply your bodyweight in pounds by 16 and then consume 150% of that daily maintenance number.

Tip 7 – Vary Your Exercise Regimen – Remember this key phase “an exercise is only as good as the time it takes for you to adapt to it”. The principle of overload will eventually grind to a screeching holt if you are on the same weight resistance program for over 4 weeks in nearly all cases. Also stick to heavy lifting of free weight as a dogma when it comes to building size…cam machines and pulley exercises recruit less motor units

Tip 8 – Stay Hydrated – water is the most neglected nutrient when it comes to tissue health. The book called “Fascia – Role in Health and Human Performance” written by Dr. Mark Lindsay and Chad Robertson stresses the disaster of being dehydrated on tissue health. In addition, dehydration leads to higher cortisol levels which act as a catabolic and breaks down muscle tissue. As a rule of thumb you should drink between 0.6 to 0.7 ounces of water per pound of bodyweight.

Tip 9 – Get to Bed – Sleep deprivation will compromise any gains in the gym period. Lack of sleep will also lower your own androgen and growth hormone levels which are key anabolic hormones which stimulate muscle growth.

And Finally….

Tip 10 – Consume Adequate Amounts of Protein – If you want to grow like a weed, then consume at least 2g of protein per pound of body weight for the lean individual.




Top 10 – Muscle Building Tips to Help You Get a Beach Body Physique For This Summer

Tip 1 – Lift Weights to Build Muscle and Stimulate Anabolism – doing this alone will burn fat. Strength training alone has been shown to elevate growth hormone levels which is a lipolytic hormone meaning it increases fat breakdown and the metabolism of glucose and amino acids. Growth hormone also increases protein synthesis which is critical in preserving lean muscle mass during dieting.

Testosterone the man’s hormone is definitely the number one anabolic hormone. By simply increasing your rest intervals longer than 60 seconds and lifting heavier weight loads you will elevated your own endogenous level of testosterone.

Tip 2 – Do High Intensity Anaerobic Training to Burn Fat and Avoid Continuous Low_Intensity Aerobic Training – Research continues to show that HIT is much more effective in burning fat than aerobic training. HIT works on the same principle as strength training when it comes to accelerating fat burning, it triggers an increase in protein synthesis which results in an increase in muscle mass however not to the same degree as strength training.

Tip 3 – Do Not Eliminate Fat From Your Diet – to lose fat you have to eat fat. Of course removing bad trans fats from the diet is essential to health however you need the high amounts of the healthy fats (omega 3 fatty acids). Our bodies are composed of cells which each are comprised of cell membranes which are composed of lipids. By eating the wrong fats you make yourself less insulin sensitive basically resistant which will produce fat gains and put you at risk of developing diabetes. Eat the right fats and make yourself more sensitive to insulin which is critical to good metabolism and energy production.

Tip 4 – Consume a Balanced Intake of the Right Fats – In the ideal world you need to consume a nearly equal ratio of omega_3 to omega_6. Omega 3 fatty acids come from fish oil (DHA, EPA, and ALA) but they can also be found in grass fed beef and wild meats.

Charles Poliquin recommends consuming fish oil in the dose range of 1 to 1.5g of omega_3 per percent of body fat. Whatever the coach says is fine with me.

Tip 5 – Lower Your Cortisol Level – If you want to get a fat belly just stress yourself out. To lose fat it is essential that you lower your cortisol levels.

Tip 6 – Treat Your Gastrointestinal Tract Like a Lamborghini – if your gut is in a bad place “unhealthy” this will effect your neurotransmitter production as the more than half of the neurotransmitters in the body are produced in the gastrointestinal lining. If your gut is not healthy, it will negatively affect your neurotransmitter production leading to poorer cognitive function, depression and low motivation. A poor mind will lead to a less motivated person to exercise and engage in proper dietary habits.

Hence take a pre and probiotic, glutamine, zinc, essential fatty acids, betainehcl to support gut health.

Tip 7 – Detoxify, Detoxify, Detoxify – detoxification is critical to weight loss because of so many pollutants and endocrine altering molecules in our environment. Two simple steps to detoxify your body involve drinking lots of water daily and eating adequate amounts of fiber. There are dietary supplements that can help eliminate heavy metals and toxins that cause oxidative stress and alter hormones.

Tip 8 – Get Your Hormones Checked and Supplemented if Low – If you are having a hard time losing weight and following all the tips in this article, have your doctor check your TSH, T3, T4, Total and Free Testosterone, ACTH, cortisol (4 points). Low hormone levels can impair fat loss and energy levels required to exercise sufficiently.

Tip 9 – Get a Glucose Tolerance Test – this test is used to determine how much your body uses glucose for energy. If you have an impaired glucose tolerance, your doctor should consider prescribing metformin and/or an insulin sensitizer which will help control your insulin and blood glucose levels.

Tip 10 – Supplement Your Diet – beware of weight loss supplements, most of them are stacked with caffeine and stimulants that can raise heart rate and blood pressure. Instead, take L_carnitine and fish oils.




Using Exercise to Heal Injuries

The majority of us know that exercise is crucial in maintaining a health state however did you realize that exercise in general is critical in promoting the healing of soft tissue injuries. The old school of thought was that once we injure ourselves we should immobilize the injured area while reducing the swelling and inflammation. However, studies have shown that that early mobilization after injury increases capillary invasiveness and granulation tissue but limits muscle fiber spread into scar tissue 1. Immobilization, on the other hand, increases penetration of muscle fibers into scar tissue in addition to reducing the tensile strength of the injured muscle.

The Body’s Natural Repair Process

Fibronectin (Fn) is a protein found in the blood which stimulates white blood cells called macrophage to eat up cellular waste in our bodies. Whereas, fibronectin complex with connective tissue matrixes promote cell adhesion and cell to cell interaction 2. Fibronectin plays an important role in tissue repair and wound healing. After injury, the body starts making more fibronectin which spreads throughout the damaged muscle and increases its structural integrity. As the damaged muscle continues to heal, fibronectin diminishes.

The Effects of Immobilization

M. Lehto et al. (1985) studied the effects of physical activity, during various stages of wound healing, on scar formation, regeneration of muscle and production of granulation tissue. Using a rat model of injured calf muscle, they found that early immobilization after injury rapidly increased Type I collagen but poor structural organization of the tissue with contraction of the scar occurred with prolonged immobility. A short immobilization period (2 days) followed by mobilization resulted in a lack of Type I and III collagen fibers (at 7 days) and a visible fibrin clot containing fibronectin; a sign of re_injury. Faster resorption of scar tissue and better structural organization of Types I and III collagen occurred with the 5 days immobilization/mobilization interval.

Hopefully you are convinced that movement particularly in the form of a rehabilitation program is a key part to making a successful return to running. Although many specific aspects of rehabilitation protocols remain highly controversial, current evidence supports the concept that intensive rehabilitation can help to prevent early arthrofibrosis and to restore strength and function earlier. The most intensive programs have been recommended particularly for patients who are predisposed to stiffness, such as those who have had an Achilles tendon injury.

Rehabilitation

I am going to provide you an outline of the key points in to take into consideration in developing a rehabilitation program for a runner who suffers from Achilles tendinopathy which has afflicted up to 29% of all runners. The initial stage of rehabilitation will focus on keeping the ankle in a neutral position and a synthetic graft can be molded to keep the ankle in neutral during low resistance exercises. Patients are encouraged to continue to weight bear on the injured Achilles tendon as tolerated eventually progressing to full weight bearing while keeping the inflammation and swelling down.

 If the Achilles tendon has been surgically repaired the patient can start with gentle mobilization exercises of the ankle, isometric contraction of the gastrosoleus complex, and gentle concentric contraction of the calf muscles immediately post_surgery. It wasn’t too long ago that doctors requested that patients who are recovering from post surgical Achilles tendon repair remain bedridden for 3_4 weeks!

Reconditioning

Is used to address the athlete’s need to continue fitness and strength training for the first four months post_op. Reconditioning and performance training are basically the same, with the understanding that the training protocol will need to be adjusted according to the athlete’s tolerance and healing response.

After Achilles tendon surgery, managing an athlete’s physical qualities is more than just following an Achilles tendon protocol. It is developing a plan to train the entire body from post_op to return_to_comp_from strength development to cardiovascular conditioning to movement quality training. It is an individualized plan that focuses less on the on the ankle and more on the athlete’s overall physiological profile. Of course, the surgery creates limitations that require special strategies that make appropriate strength trains. Successfully managing an athlete encourages using familiar movements to motivate them. To do this requires exercising around the ankle, rather than focusing on traditional rehabilitation techniques that target isolated muscles of the lower extremity. For example, an upper_body cycle ergometer is often implemented during rehabilitation to condition an athlete’s cardiovascular system, but this is not exercising around the ankle. It is exercising without the ankle. Using functional and sport_specific movement patterns offers a level of familiarity and predictability. For the athlete, this translates into a higher_quality effort and helps to restore confidence. For example, deep_water training within two to three weeks post_op can effectively address core strength endurance and cardiovascular conditioning. Many of the movements may be new, but they encourage athletic coordination in a non_loading environment. This program’s hidden agenda is hundreds of repetitions to improve ankle ROM and reduce post_op swelling. By four weeks post_op, the athlete may be working as hard in the water as an uninjured athlete. Using winged water walkers (W3s) for forward_ and backward_resisted pool running is excellent for hip strength and anaerobic conditioning. The goal is for the athlete’s cardiovascular system to be well conditioned by three to four months post_op, so he or she will require less of this training in later stages of the comeback. Now the athlete can focus more time on sports specificity, weight training, and various movement_specific qualities. Spinning bike, elliptical cross_trainers, and treadmill programs are also developed for every phase of the comeback. The emphasis here is cardiovascular and strength endurance training. Due to lower joint stress, this training can be done very well during the first few months.

 Total body training that encourages upper and core strength should be implemented as well during the reconditioning phase. Much of this work should be performed in the standing position to emphasize the athletes’ inherent athletic ability, allowing stabilization and control during athletic conditioning.

Putting the Puzzle Together

Each rehabilitation program is uniquely different, treatment must be individualized, comprehensive, and goal directed. Formal treatment programs are mainly for pain relief rather than focusing on restoring function and promoting a speedy returning to functional activity. Now that you are healthy get running!

References

1. M. Lehto. V. C. Duance, D. Restall, Collagen And Fibronectin In A Healing Skeletal Muscle Injury An Immunohistological Study Of The Effects Of Physical Activity On The Repair Of Injured Gastrocnemius Muscle In The Rat, The Journal Of Bone And Joint Surgery, Vol. 67 B. No. 5., 820_828, 1985

2. P. N. Thompson, E. Cho, F. A. Blumenstock, D. M. Shah and T. M. Saba, Rebound elevation of fibronectin after tissue injury and ischemia: role of fibronectin synthesis, American Journal of Physiology.Gastrointestinal and Liver Physiology, Vol 263, Issue 4 437_G445, 1992





Tendinopathy Treatment using MMP_inhibitor Aprotinin

Aprotinin

  • broad spectrum serine protease inhibitor, with particular inhibition of plasmin (along with trypsin and kallikrein)
  • manufactured in the 1960s by Bayer and has been primarily used in medicine for preventing blood loss during major surgery and promoting soft tissue healing after surgery (as a component of “fibrin glue”)
  • strongly basic polypeptide with half life of approximately 7 hours
  • strong inhibitor of MMPs, including the collagenases
  • MOA – inhibition of the plasmin_activation pathway of the MMPs
  • Doses – 4.2 to 8.5mg used to inject tendons
  • Side effects:  anaphylaxis

Evidence

  • one trial sowed that aprotinin injections were superior to both corticosteroid and saline injections in patellar tendinopathy but the results reported for similar treatment in Achilles tendinopathy have been mixed
  • double blind placebo trials: 
    • study by Capasso et al.  involved athletes being injected every other week with two to four injections for patellar tendinopathy and reported superior results for aprotinin at 12 months follow_up (72% good or excellent) compared to both cortisone (59%) and saline injections (28%). 
    • A study by Brown et al. using aprotinin injections for Achilles tendinopathy reported no improvement over saline and local anesthetic injection.
  • power of the study was low, with the aprotinin group achieving generally greater improvement on raw values

Advantages and Disadvantages

  • polidocanol sclerotherapy, inert agents, or dry needling to treat tendinopathy requires tendon penetration in order to get a beneficial effect, which theoretically increases the risk of tendon damage.  Aprotinin can be injected around the tendon (in the same fashion as cortisone) so the risk of iatrogenic tendon damage is reduced
  • aprotinin is derived from bovine lungs, hence there is the potential to contract bovine spongiform encephalopathy (BSE)
  • off_label treatment for tendinopathy
  • restricted availability of aprotinin as a treatment

References

  1. Brown R., Orchard J., Kinchington M., Hooper A., Nalder G.  Aprotinin in the management of Achilles tendinopathy:  a randomized controlled trial.  Br J Sports Med 2006; 40: 275_279.
  2. Capasso G., Maffulli N., Testa V., Sgambato A.  Preliminary results with peritendinous protease inhibitor injections in the management of Achilles tendinitis.  J Sports Traumatol Rel Res.  1993; 15: 37_40.



Turbo Boost Your Performance with Deeper Sleep

Research studies dating back to the 1960s have shown that when the body is exposed to night_long sessions of very weak_pulsed DC electromagnetic fields within a very tight range of frequencies at or below 10Hz that have been shown to promote deep sleep.

So What is Deep Sleep in the First Place and Why is it so Important

The deepest and most restorative part of the sleep cycle is referred to as Delta Rhythm which can be distinguished from rapid eye movements (REM) sleep. Delta Rhythm also known as stage 4 sleep is characterized by the state at which point the organs (heart, brain, etc) slow down to such an extent that there is an abundance of ATP that is pooled inside the cells. This pooled energy upon reaching a threshold triggers physiological and neurological repair, hormone synthesis, immune function and memory consolidation. If we don’t spend enough time in delta wave sleep, our body will start breaking down and prematurely start aging on us.

Why Are People Not Able to Sleep Anymore

The most common explanation is stress. However there is another plausible cause and it has to do with the propagating RF microwave pollution and the denser the field (either closer to a cell mast or in the midst of more and more cell masts) the worse your sleep and overall well being.

The Relationship Between the Earth’s Geomagnetic Field and Sleep, Maintenance and Repair Mechanisms

The German scientist Schumann discovered in 1952 that there is a resonant cavity between the earth’s surface and the ionosphere containing a frequency modulated electromagnetic field in the spectrum from below 1 Hz to more than 100 Hz. The Russian Space Agency discovered that Schumann wave generators in space craft (formerly void of fluctuating magnetic fields) improved general health and well being of their cosmonauts on extended space voyages. NASA decided to include them in the development of the International Space Station to counteract the negative effects of zero gravity on the body such as muscle wasting and osteoporosis.

The frequency or band of healthy frequency which we can refer to as the Schumann resonance is a spectrum of frequencies with the majority of its amplitude below 15Hz and with peaks around 1 Hz, 2.5 Hz, 7.8 Hz, 14.1 Hz, 20.3 Hz and higher. These spectrum of frequencies are a strong signal to “entrain” to during the night time to help us to achieve Delta rhythm sleep.

Research from the past 50 years has shown conclusively that a 10Hz field produced the most exceptional healing and tissue regenerating effects. NASA has discovered that a 10Hz field for 17_21 days turned gene sequences for maturation off while turning on those for development. Additionally, there was a four fold increase in the rate of neural tissue regeneration. Tong (2007) found that 10 Hz tripled nerve synapse energy and doubled mitochondrial density at nerve synapses within minutes. Hood (1989) found that more than 30 days on average 10 hours per day of 10 Hz stimulation increased two critical enzymes of cell respiration, citrate synthase and cytochrome c oxidase by three fold which is consistent with improved oxygen metabolism. PEMF devices are now being used world wide as a sports performance ergogenic enhancement device.

The next question you probably have is how can I find the 10Hz application found to enhance cellular functioning in the body to improve on field performance.

Welcome to the Earth Pulse

The Earth Pulse is a pulsed electromagnetic therapy device that promotes sleep with a very weak, near earth_amplitude signal typically generated from under the person’s mattress during the night time when they are sleeping.

Earth Pulse on Command produces a spectrum of genomagnetic vitamins from the production of the very low Delta and very low Beta wave frequencies wit special attention paid to the mitochondrial 10 Hz frequency requirements.

What Can You Expect

  • Deeper more restful sleep
  • Better focus and executive performance
  • Enhanced day time energy
  • Better aerobic capacity
  • Vastly improved recovery
  • More flexibility
  • 10_15% increase in muscular strength within 14 days
  • 20_30% increase in stamina within just 14 days



Body Repair Expert

Head_to_Toe Injury Advice from the Pros

New Methods to Conquer a Painful Golfer’s Elbow

Golfer’s Elbow commonly referred to as medial epicondylitis is a painful and frustrating injury for golfers because of its tendency to heal slowly and re_occur often. Golfer’s elbow is most often attributed to an incorrect golf swing, in which the club is “thrown” from the apex of the backswing down toward the ball. Appropriately termed “hitting from the top,” this incorrect technique creates similar valgus forces upon the medial epicondyle of the dominant arm, leading to the same tension overload pattern. The body produces an inflammatory response due to the repetitive stress on the flexor_pronator muscle groups. Later stages of epicondylitis is characterized by microtearing and tendon degeneration with or without calcifications. If you’ve had medial elbow pain for the past 3 months and have tried the typical conservative treatment outlined in classic cures with no luck and want some relief before you hit the golf greens this coming spring, ask your doctor about these innovative procedures.

Nutritional Supplementation

There are a number of key nutrients that can significantly help in reducing inflammation in addition to accelerate the body’s natural healing capacity for the traumatize tendons.

Arginine – soft tissue injuries significantly increase the need for the amino acid arginine, which is essential for a variety of metabolic functions. Supplementing the diet with arginine can significantly increase the amount of reparative collagen at the site of injury.

Vitamin A – increases white blood cells at the injured area in addition to promoting collagen cross_links which improves the tensile strength of connective tissue like tendons.

Copper – has been shown to promote biosynthesis of bone and other connective tissues. It works along with Vitamin C to create strong collagen which cross_links with another key protein elastin which improve the tensile strength and enhances healing.  

Zinc – appears to play little role in the initial inflammatory stages of repair but a greater role during tissue regeneration.

EPA – everyone has heard of the benefits of fish oil and I agree. Eicosapentaenoic acid (EPA) found in Omega 3 fish oils have been shown to have a positive effect on collagen synthesis and healing.

Bromelain – is found in pineapple and contains a proteolytic enzyme which breaks down scar tissue which can build up on injured tissues and reduce their elasticity.

Curcumin – is an extract of the spice tumeric and displays anti_inflammatory properties in addition to speeding up the healing process by changing the arrival time and concentration of cytokines which regulate cell growth.

For the acute stages in which medial epicondylitis displays the hallmarks of inflammation and synovitis the following modalities and therapeutic:

Low Level Laser

Method – is increasing in popularity however the exact mechanism of action has not been fully determined. It is thought the therapeutic nature of low level laser is attributed to the alteration of the resonant frequencies inside connective tissue which triggers physiological processes such as growth and injury repair.

Result – has been shown by numerous studies to enhance the body’s regenerative capacity after injury. LLL increases procollagen synthesis, reduces swelling, activates macrophages, increases DNA and ATP synthesis, etc all of which improves the overall healing capacity of damaged tissue.

Acupuncture Therapy

Method – has been in existence in China for more than 2000 years and has been increasing in popularity amongst North Americans. Acupuncture involves a needle puncturing the surface of the body, a phenomenon known as needle grasp in which the connective tissue literally grasps the needle and any rotation and pistoning of the needle will cause a deformation of the extracellular matrix leading to downstream effects.

Topical Therapy

There are a new set of therapeutic topicals (IGNITE® and XCCELERATE®) which been formulated to target the biochemical processes associated with connective tissue trauma: degeneration, inflammation, regeneration and fibrosis. These topicals are crucial in increasing nitric oxide and collagen synthesis which is a key step in supporting the healing of tendons. In addition these topicals will help mitigate inflammation, reduce local oxidative stress and pain. For a more detailed explanation of these topicals, visit www.zanagen.com.

Myofacial/Active Release Therapy®

Method – is a manual soft tissue therapy that decreases the tension in the fibrous bands of connective tissue that surrounds the body. Often after an injury to the connective tissue, fibrous adhesions known as scar tissue builds up which can be a common source of pain and impede range of motion. ART when performed by a certified practitioner combines the use of precisely directed tension along with very specific body movements to free restrictions in the traumatized tissue.

In cases where medial epicondylitis is characterized by evidence micro_tearing of the tendon origin at the epicondyle, scar tissue build_up and/or calcifications the following therapeutic treatments can be explored:

Sclerosing Injections/ Prolotherapy

Aprotinin

Method – is a serine protease inhibitor which inhibits the breakdown of collagen by enzymes known as matrix metalloproteinases (MMPs) which are at highly elevated levels during tendinopathy.

Result – investigations using Aprotinin injections have shown they are superior to both corticosteroid and saline injections in patellar tendinopathy.

Platelet_Rich Plasma

Method – involves blood being drawn and spun using a centrifuge into concentrated platelets that are then injected into the injured area. When the platelets degranulate they release growth factors in physiologic proportions which stimulate the regeneration of tissue.

Result – recent studies investigating the effect of various growth factors such as GDF_5, IGF_1 and PDGF_2 on tendons and ligaments have shown to play positive roles in healing.

Classic Cures

Traditional Approach for treating Golfer’s Elbow

  1. Apply Ice three to four times daily to the affected elbow
  2. NSAIDs are taken for 10_14 days

If the patient does not respond to the above measures the next steps are taken:

  1. Night splinting
  2. Local corticosteroid injections 

I hope that some of the suggestions in this article have been informative. Still the most important step is prevention and overcoming flaws in your golf swing is the key step if you don’t want to be re_injured – even the best golfers in the world have a swing coach.




Dietary Spice to Speed up Healing

Most athletes whether they are competitive road racers or just your weekend warrior are pushing their bodies to the point that they are inflamed out of control and their skeletal muscle is traumatized. Most people think that the quick answer to this conundrum is to use the rest, ice, compression and elevation (R.I.C.E) approach in treating their pain to help them recover faster or just take an anti_inflammatory like an Advil.

The Problem with NSAIDs

The limited value of anti_inflammatory drugs is limited to merely reducing pain with no significant value in promoting the muscle repair process which is crucial in getting the body to recover faster. This problem has led researchers to study alternative means to assist the body to recover faster from hard, rigorous training sessions.

The Holy Grail

Researchers have been carefully studying a new bioflavonoid which are part of a class of plant secondary metabolites and have exhibited antioxidant properties. This new bioflavonoid of keen interest to us is called curcumin which has been showing some promise in terms of application for sports related injuries.

The turmeric root contains volatile oil, diferuloyl methane (curcumin), demethoxycurcumin, and bisdemethoxycurcumin; all of which are known as curcuminoids 1. Curcumin, the lipid soluble component in turmeric, possesses anti_inflammatory, anti_carcinogenic and antioxidant properties. Curcumin has been shown to consistently block the activity of the transcription factor Nuclear Factor Kappa Beta (NF_kB) (a compound significant in the body’s inflammatory response) 2. Intraperitoneal injection of mice with curcumin has been shown to stimulate muscle differentiation and enhance the regeneration process after injury through inhibition of NF_kB expression on various inflammatory cytokines 3. For runners or any other athlete in general this ground breaking research is crucial in finding natural ways to accelerate the healing process.

Most of us have heard of these two key enzymes involved in the inflammatory cascade. The first being Cyclooxygenase (COX) which is responsible for the formation of mediators called prostanoids, including prostaglandins and thromboxane. Inhibition of COX can provide a relief from symptoms of inflammation and pain. The other enzyme Lipoooxygenase (LOX) which is involved in the metabolism of prostaglandins and leukotrienes. Curcumin inhibits lipoxygenase but also hyaluronidase, phospholipase and collagenase enzymes which also play a role in inflammation. Curcumin also mediates the metabolism of arachidonic acid by inhibition of COX_2 but unlike NSAIDs which specifically target the COX_2 enzyme, curcumin’s effect is mediated by transcription factors NF_B and activator protein_1 (AP_1) 4.

Curcumin’s effects extend beyond muscle regeneration. Davis et.al. (2007) studied the effects of curcumin on both voluntary (wheel) and involuntary (treadmill) running on mice 5. Curcumin sped the recovery of running performance after eccentric induced exercise. Inflammation can delay muscle recovery and performance through increases in inflammatory cytokines and this has been shown to be offset by curcumin. So if you are serious about your body’s performance I suggest you start looking at adding some curcumin to your diet.

References

 1. Jellin JM, Batz F,Hitchens,K. Pharmacist's Letter/Prescriber's Letter, Natural Medicines Comprehensive Database, Stockton, CA:Therapeutic Research Faculty 2nd Edition, 1999

2. Cohly HH, Taylor MF, Angel A, Salahudeen AK. Effect of turmeric, turmerin and curcumin on H2O2_induced renal epithelial (LLC_PK1) cell injury. Free Radic. Biol. Med 1998; 24: 49–54.

3. Thaloor D, Miller KJ, Gephart J, Mitchell PO, Pavlath GK. Systemic administration of the NF_kB inhibitor curcumin stimulates muscle regeneration after traumatic injury. Am J Physiol. 1999 Aug; 277(2 Pt 1): C320_329

4. Kang G, Kong PJ, Yuh YJ, Lim SY, Yim SV, Chun W, Kim SS. Curcumin suppresses lipopolysaccharide_induced cyclooxygenase_2 expression by inhibiting activator protein 1 and nuclear factor kappab bindings in BV2 microglial cells. J Pharm Sci 94: 325–328, 2004

5. J. Mark Davis, E. Angela Murphy, Martin D. Carmichael, Mark R. Zielinski, Claire M. Groschwitz, Adrienne S. Brown, J. David Gangemi, Abdul Ghaffar, and Eugene P. Mayer, Curcumin effects on inflammation and performance recovery following eccentric exercise_induced muscle damage, Am J Physiol Regul Integr Comp Physiol 292: R2168–R2173, 2007




The Gastrointestinal System – The Key Target to Improving Your Health and Performance

The short version of this article appeared in Inside Fitness Magazine, we have been fortunate enough to get our hands on the long informative version.

Today the majority of professional athletes are well coached in the key principles to achieving optimal nutrition such as macronutrient partitioning, nutrient timing, maximizing recovery to prevent neuromuscular and central nervous system fatigue, and the list goes on. However, nearly all athletes including their performance consultants have no clue as to the value in assessing the gastrointestinal tract even though many of them have personally experienced bloating, gas, intestinal discomfort, dysbiosis, irritable bowel syndrome (IBS) on a number of occasions. The majority of them will try to ride out these symptoms without seeking qualified advice and testing.

My message to all of you is quite simple….you are what you INGEST, DIGEST and EFFICIENTLY ABSORB.

Working with elite athletes affords me the option of using comprehensive assay testing which is a non_invasive tool used to assess the inside of the body.   In this case, the above symptoms warrant a comprehensive digestive stool analysis and/or comprehensive parasitology profile. By the time you finish reading this article you will be able to do the following:

  • Understand the general functions and importance of the gastrointestinal tract in the body
  • Identify the most common gastrointestinal tracts disorders
  • Identify the proper evaluation/testing procedures to evaluate GI tract disorders
  • Know how to prevent gastrointestinal tract disorders
  • Know how to treat specific gastrointestinal tract disorders

Not bad for 5 minutes of your time.

Introduction

Proper gastrointestinal (GI) function is critical to ensuring adequate nutritional status and can have a significant impact on our body’s ability to function in daily life. Approximately 1/3 of our daily energy expenditure is spent on driving the digestive, assimilative and immune functions while maintaining the health of the gastrointestinal tract. Gastrointestinal disorders are one of the most common medical conditions as well as the least understood. Did you know that 2 out of every 5 Americans experience some form of suffering and disability due to some type of functional gastrointestinal disorder which costs the taxpayer over $30 Billion annually. Furthermore, as these disorders often overlap with each other, many are affected by more than one functional GI disorder simultaneously.

Failures of the gastrointestinal system manifests in a variety of digestive diseases such as gastroesophageal reflux disease (GED), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), non_alcoholic steatohepatitis (NASH) and colorectal cancer. Disorders of atopic immune origin, such as allergies and asthma, or of autoimmune dysfunction, such as rheumatoid arthritis, type I diabetes, autism and Hashimoto’s thyroiditis can originate in gastrointestinal disturbances.

Why Should You Give A Crap

Quite simple, any disorder or malfunctioning of the gut will most likely contribute significantly to a nutritional deficiency due to poor digestion and absorption resulting in poor performance in the gym and slow to no changes in the composition of your body.   In reality, anyone serious in improving their health or performance in the gym should develop strategies to support optimal gastrointestinal health.

Gastrointestinal System Physiology 101

The gastrointestinal tract may be thought of as a tube that connects our mouth to our ass. However we should give it more credit than that as there are a number of aspects and structures which have to be considered such as the following: stomach, pancreas, liver/gallbladder, small intestine, colon, immune barrier, physical barrier and microbial population.

The proper function of the GI tract depends to a large degree on a myriad of autonomic processes that regulate peristalsis and coordinate it with the opening and closing of the appropriate sphincter valves. These actions control the uni_directional movement of food through the gut at a pace slow enough to allow for proper absorption, but fast enough to continuously bring new nutrients as needed by the body. Digestive secretions, formed principally in response to the presence of food in the G.I. tract, vary according to the amount and type of food present. The amount of each digestive secretion must be accurately modulated by just the amount required for proper digestion. The nervous system that regulates these activities is known as the enteric nervous system which functions to a large degree independent of the brain, although it responds to signals from the sensory organs and the immune system.

Main Functions of the GI Tract

  1. Ingestion
  2. Digestion
  3. Absorption
  4. Excretion

BRAIN AND GUT CONNECTION

One of the laboratories I use frequently is Cyrex laboratories who evaluation of complex thyroid, gluten, and gut_associated disorders and related neurodysregulation

Measuring certain antibodies and cytokines allows us to accurately predict the risk of developing immune disorders in addition to the development of increased intestinal permeability aka “leaky gut syndrome”.

Cyrex uses test arrays that helps us in identifying disease triggers by assessing intestinal permeability, mucosal reactivity and wheat_gluten proteome reactivity and autoimmunity before the disease starts manifesting itself in the body.Cyrex tests and arrays will allow me to remove dietary and environmental triggers and focus on restoring GI barrier protection to prevent the disruption of the blood brain barrier and allow repeated exposure of autoreactive lymphocytes and other factors to the nervous system which may result in neural autoimmunity and neurodegenerative disorders. Thus a compromised gut barrier is the gateway to inflammation and many autoimmune and neurodegenerative diseases.

Normal Bacterial Flora of the GI Tract

Aerobic and anaerobic bacteria, yeast and fungi live in a natural balance referred to as ‘symbiosis’ in a healthy intestinal tract. There are more than 2000 species of commensal bacterial organisms within our bodies, the vast majority in the gut.

 The normal flora that colonizes the GI tract play a role in metabolic, nutritional, physiological and immunological processes in the human body as discussed below:

  1. Synthesizing and Excreting Vitamins in Excess
  2. Prevent Pathogen Colonization
  3. Inhibit or Kill Non_Indigenous Species
  4. Stimulating the Development of Certain Tissues
  5. Stimulating the Production of Antibodies
  6. Produce a Variety of Substances (eg. fatty acids, peroxides, bacteriocins, etc)
  7. Development, Maturation and Maintenance of the GI Sensory and Motoric Functions, Intestinal Barrier and the Mucosal Immune System
  8. Influence Energy Balance

Alright So What Can Go Wrong

With so many parts forming the GI tract there is a high likelihood the something may not be working quite right. Stomach and GI disorders are some of the most common complaints globally with people suffering from conditions such as heartburn, GERD (gastroesophageal reflux disease), indigestion, ulcers, H. Pylori infection, intestinaldysbiosis to name just a few.

What Can You Do To Transform Your GI System into a High Performance Engine

In order to ensure proper gastrointestinal health it is critical to evaluate gastrointestinal function which includes detection of inadequate physical and immune barrier functions and measures of the digestion and absorption of food.

Invasive procedures for observation or luminal specimen retrieval can be highly informative, but they can be performed only by trained specialists and often are expensive and uncomfortable. Such procedures are beyond the scope of this article. However there are a number of non_invasive laboratory evaluations of gastrointestinal function which are summarized in Table 1.

Table 1 – SUMMARY OF LABORATORY EVALUATIONS FOR GASTROINTESTINAL HEALTH

GI Aspect

Function

Testing

Abnormal

Intervention

Stomach

Gastric acid, pepsin

Heidelberg capsule

Direct pH readings

 

Indirect indicators

↓ pH

 

 

Multiple ↓ Trace elements or amino acids

Mucosal building protocol

BetaineHCl

Free_form amino acids

B_vitamins

Trace elements

Pancreas

Protease

 

 

Lipase

Fecal chymotrypsin

PABA Index

 

Plasma fatty acids

Fecal fats

↓ Activity

↓Index

 

↓PUFA

↑Fat

Pancreatic replacement enzymes (proteolytic, lipolytic and amylytic) and essential fatty acids

Liver/gallbladder

Bile acid secretion

Fecal fatty acids

↑Fatty Acids

Ox bile, cholerectic herbs (milk thistle) and essential fatty acids

Small intestine

Absorption

Schilling test

 

Lactulose_Mannitolchallenge

 

Fasting plasma amino acids

 

Food_specific IgG

↓Urinary B12

 

↓Urinary Mannitol

 

 

Multiple low values

 

 

Multiple elevations

B12 by injection or ≥ 1,000 ug/d sublingual

Mucosal restoration

 

 

Essential amino acid mixtures

 

Food Elimination/Rotation Diets

Colon

Water resorption, microbial containment

Fecal butyrate or other SCFA

↓ Butyrate

↑Isobutyrate

Increase Dietary Fiber

Butyrate enemas

Immune barrier

Glycocalyx antigen binding

Allergy – antigen elimination

Serum, urinary or fecal IgA

 

Serum IgE

↑Food_specific IgA

 

 

↑Total IgE

Eliminate offending antigens

 

Immune_support nutrients such as Glycerrhizaglabra (licorice) root or L_glutamine 3,000_6,000 mg daily

Physical barrier

Regulate nutrient admission and restrict toxicant and microbial access

Serum IgG

 

 

 

 

 

 

Lactulose_Mannitol challenge

 

Many + foods

 

 

 

 

 

 

↑Urinary Lactulose

 

↓Mannitol

Eliminate + foods by group (Rotation Diet)

Add free_form amino acids and glutamine

Zinc 50_100 mg/d

B5 100_200 mg/d,

 

Eliminate + Foods

 

Mucosal restoration

Microbial populations

Normal: nutrient delivery

 

 

 

Pathogen: toxin production

Urinary metabolic markers

 

 

Hydrogen_Methane breath test

 

 

 

 

 

 

 

Stool microbial DNA quantitation for culture and sensitivity

↑Bacterial markers

 

 

 

↑Protozoal markers

 

 

↑Yeast markers

 

 

↑Expired gases

 

 

↑Growth

Herbal or pharmaceutical antibiotics (eg. berberine alkaloids, etc)

 

Prebiotics and probiotics with antiprotozoals

 

Restrict simple sugars with antifungals

 

Herbal or pharmaceutical bacteriostatic agents

 

Specific antibodies

 

For the sake of keeping this article short, I am going to focus on one key disorder known as Leaky Gut Syndrome.

What is Leaky Gut Syndrome

Leaky gut syndrome is a condition in which the intestinal lining is damaged resulting in increased intestinal permeability which can result in the development of a variety of disorders such celiac disease, Crohn’s disease, chronic fatigue syndrome, allergies and fibromyalgia.

What Causes Leaky Gut Syndrome

There are several theories about the proposed causes of increased intestinal permeability such as the following:

Table 2 – FACTORS, SYMPTOMS, AND DISEASES ASSOCIATED WITH DYSBIOSIS AND INTESTINAL HYPERPERMEABILITY

Contributing Factors

Diseases

Alcohol Abuse

Inflammatory bowel disease

Corticosteroid Use

Irritable bowel syndrome

Antibiotic Use

Celiac disease

Excessive Stress

Infectious enterocolitis

Nutrient Insufficiencies

Cystic fibrosis

Gastrointestinal Infections (Giardia lamblia, Salmonella, malaria, ascarislumbricoides, hepatitis A, Rotavirus, and non_specific gastroenteritis)

Chronic fatigue immune deficiency syndrome

Food Reactions

Acne

Improper Fasting

Eczema

Exposure to Environmental Toxins

Psoriasis

Hemorrhage

Urticaria

Sepsis

Dermatitis herpetiformis

Low Fiber Diet

Autism

Symptoms

Childhood hyperactivity

Abdominal Distention

Spondyloarthropathies

Diarrhea

Pancreatic insufficiency

Constipation

HIV infection

Abdominal Pain

Neoplasia treated with cytotoxic drugs

Food Intolerances

Hepatic dysfunction

Skin Rashes

Alcoholism

Poor Exercise Tolerance

Environmental illness

Shortness of Breath

 

Cognitive Deficits

 

Fatigue and Malaise

 

Arthralgia

 

Myalgia

 

Fevers of Unknown Origins

 


If you have the above symptoms and believe you may have leaky gut syndrome ask your doctor to conduct a test to assess for increased intestinal permeability.   Several tests can be used in conjunction with one another such as: polyethylene glycol (PEG) test, food allergy testing, stomach acid production assay, comprehensive stool analysis with parasitology, candida antibody profile, and gluten sensitivity profile.

When the Rubber Hits the Road…How to Treat Gastrointestinal Disorders such as Leaky Gut Syndrome

If you are serious in making improvements in nutrient absorption, immunity, vitamin synthesis all of which are critical to making progress from a performance and recovery standpoint, I suggest you incorporate an intestinal wellness program which I have incorporated for professional athletes as theyare at high risk of developing food allergies and intestinal dysbiosis due to their frequent traveling and high stress professions.

Here is a specialized prophylaxis and treatment for dysbiosis and “leaky gut” utilizing a variety of herbal , vitamin, specific foods, pre and probiotic therapies as seen in Table 3.

Table 3 – INTESTINAL WELLNESS PROGRAM

Focus

Category

Agents

Product and Dosage

Digestive Function

Stomach

 

 

 

 

 

 

 

 

 

Pancreas

 

 

 

 

Hepaticobiliary

 

 

 

 

Consume

 

 

 

 

 

Avoid

Betaine hydrochloride

Pepsin

L_Histidine

Gentian Root

 

 

 

 

 

 

Pancreatic Enzymes

 

 

 

 

Ox Bile

Taurine

Olive Oil

 

 

Flora Enriched Foods

 

 

 

 

 

Anti_acids, H2 blockers, Proton pump inhibitors

Cholecystectomy

Large, rushed meals high in protein and fat

Metagest – dose is individual specific.

 

L_Histidine (Ajinomoto) – 1000mg daily.

 

 

 

 

DevigestAMD– 1_2 capsules prior to eating food.

 

 

GB3 – 1 tablet daily.

Taurine – 2g daily.

Olive Oil – 2 tablespoonful daily.

 

Kimchi, Sauerkraut, yogurt/kefir/cottage cheese/cultured dairy, fibrous carbohydrates

Mucosal Integrity

Nutrients supporting cell growth and protection

 

 

 

Nutrients protecting against cellular oxidation

 

 

 

 

 

 

 

 

Energy substrate

 

 

 

 

Cell membrane

 

 

 

Avoid

Small intestine: Glutamine

 

 

 

N_Acetyl Cysteine

R_Alpha Lipoic Acid

Glutathione or precursors

 

 

 

 

 

 

 

Large intestine: soluble and insoluble fiberButyrate retention enemas

 

Essential Fatty Acids

 

 

 

NSAIDs

L_Glutamine (Ajinomoto) – 10g daily.

 

 

NAC (Alapars) – 2 capsules twice daily.

R_ALA (Meta Lipoate) – 1 capsule three times daily with meals.

HMS 90 – 1 packet twice daily.

 

 

Fiber Smart – 4 capsules twice daily taken with full glass of water.

 

Tristars Omega 3 – 3g of EPA/DHA daily.

 

 

 

Intestinal Dysbiosis

Prebiotics       Bacteria

 

 

 

                         Yeasts

 

                         Probiotics

L.acidophilus, L.salivarius, L.plantarum and L.casei, Bifidobacterium

 

Saccharomyces boulardii

 

Soluble and insoluble dietary fiber, Fructo_oligosaccharides, Inulin

Syntol AMD – 4 capsules three times daily. At least 1 hour before and/or 2 hours after eating with full glass of water.

 

Bacteriostatic Agents  

                         Bacteria – Severe

 

                         Bacteria _ Moderate

 

 

 

 

 

 

 

                         Yeast – Severe

 

                         Yeast _ Moderate

 

Amoxicillin + clavulinic acid or other, as indicated

 

Berberine_containing herbals such as goldenseal, Citrus seed extract, Olive leaf extract, Aloe vera, Garlic, Glycyrrhiza (licorice)

 

 

Nystatin

 

Capric and undecylenic acids

Avoid simple sugars

 

 

Summary

Gastrointestinal dysfunction is real, however the way it is treated by many healthcare professionals today is outdated and incomplete. With advanced research and a better understanding of how all the systems in our body work together our methods of treatment will evolve.

Just remember the old saying “you are what you eat”, after reading this this article we could clearly revise that to “you are what you ingest, digest and absorb”.

References 

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  2. Angulo P. Non_alcoholic fatty liver disease. N Engl J Med 2002; 346(16): 1221_1231.
  3. Ashwood P., Anthony A., Pellicer AA., et al. Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immune of pathology. J ClinImmunol 2003; 23(6): 504_517.
  4. Auer IO. The small intestine as and immune organ. Fortschr Med 1990; 108(15): 292_296.
  5. Bascom A. Incorporating Herbal Medicine into Clinical Practice. Philadelphia: FA Davis; 2002.
  6. Birkett A., Muir J., Phillips J., et al. Resistant starch lowers fecal concentrations of ammonia and phenols. Am J ClinNutr 1996; 63(5): 766_772.
  7. Brandtzaeg PE. Current understanding of gastrointestinal immune regulation and its relation to food allergy. Ann NY AcadSci 2002; 964: 13_45.
  8. Cheallier A. Encyclopedia of Medicine. London: Dorling Kindersley; 2000.
  9. DibaiseJK., Zhang H., Crowell MD., Krajmalnik_Brown R., Anton DG., Rittman BE. Gut microbiota and its possible relationship with obesity. Mayo ClinProc April 2008; 83(4): 460_546.
  10. Gerritsen J., Smidt H., Rijkers GT., de Vos WM. Intestinal microbiota in human health and disease: the impact of probiotics. Genes Nutr 2011; 6: 209_240.
  11. Grundy D., Schemann M. Enteric nervous system. CurrOpinGastroenterol 2006; 22(2): 102_110.
  12. Guarne F., Schafsma GJ. Probiotics. Int J Food Microbiol 1998; 39(3): 237_238
  13. HawrelakJA., Myers SP. The Causes of Intestinal Dysbosis: A Review. Alternative Medicine Review 2004; 9(2): 180_197.
  14. Herman RE. Bio Techniques Laboratories, Inc., assignee. Antibiotic resistant strain of lactobacillus acidophilus. US patent 5, 256, 425. 09_29_92, 1993.
  15. Hess G. Intestinal immune system. ZentralblHygUmweltmed 1991; 191(2_3): 216_231
  16. Holdeman LV., Good IJ., Moore WE. Human fecal flora: variation in bacterial composition within individuals and a possible effect of emotional stress. Appl Environ Microbiol 1976; 31(3): 359_375.
  17. Hollander D. The intestinal permeability barrier: a hypothesis as to its regulation and involvement in Crohn’s disease. Scand J Gastroenterol 1992; 27: 721_726.
  18. Hudson MJ., Marsh PD. Carbohydrate metabolism in the colon: In. Gibson GR, MacFarlane GT., eds. Human Colonic Bacteria: Role in Nutrition, Physiology and Pathology. Boca Raton: CRC Press; 1995: 292.
  19. Jones D, ed. Textbook of Functional Medicine. Gig Harbor: Institute of Functional Medicine: 2005.
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  23. Ma TY. Intestinal epithelial barrier dysfunction in Crohn’s Disease. Proceedings of the Society for Experimental Biology and Medicine 1997; 214(4): 318_327.
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Use Cluster Training to Make Training Gains

It is widely considered amongst the weight lifting circle that one’s ability to develop power and strength is best when the training intensity is maximized. In other words any way to improve recovery while minimizing fatigue is ideal for making gains.

In the bodybuilding circle this rest_pause form of training is often referred to as cluster training

What is Cluster Training

Cluster training or inter_repetition training is when you introduce a rest interval after each repetition or after a certain number of repetitions within a set. It allows you to increase the amount of load lifted in a given set while maintaining power as you progress through the workout because of the short recovery periods – you avoid the slowing down of movement speed (or repetition power) as fatigue sets in.

The concept of cluster training is fairly straightforward, however there are a number of variations from antagonistic clusters to Mike Mentzer’s cluster method. One of the more recent variations of a cluster training has been developed by strength and conditioning coach Christian Thibaudeau and is called the Extended 5s.

The Extended 5s

The goal of the extended 5s is to perform a set of 10 reps with a weight that you could normally only lift for 5 reps. The method is similar to rest_pause, an intensity technique in which the lifter completes a set and then after a brief rest period continues to perform more repetitions until failure and does this over and over again to more effectively breakdown the targeted muscle group and promote growth. The key difference between cluster training and rest_pause is that rest_pause is generally used at the end of a standard set and the initial rest period is used up while the muscle fails to go into failure.

The science behind cluster training is based on the rapid replenishment of ATP. ATP is essential for life and plays a prominent role in heavy, short bursts of resistance training, where it combines with creatine phosphate to provide short_term energy for high_intensity work.

Instructions for Extended 5s

A typical set of in Extended 5s cluster training would go as follows:

  • Load the bar with your 5 RM (typically about 85% of your 1 RM)
  • Rack the bar and rest no more than 7_12 seconds
  • Immediately get back under the bar and do another 2_3 reps
  • Complete a final 2_3 reps to finish the cluster set

When finished, you would have done 10 reps with a weight that you normally could of only lifted for 5 reps. Rest 3_5 minutes between cluster sets.

Sample Workout

Hip Extensors

Exercise

Sets

Reps

Weight

Rest

Barbell Back Squat

3

5

40%, 50%, 60% 1 RM

1 min

Barbell Back Squat

3

10

85% 1 RM

3_5 min

Reverse Hack Squat

3

10

10 RM

2 min

Leg Press

3

10

10 RM

2 min

One Leg Lying Leg Curl

3

10

10 RM

2 min

 

 




The Importance of Oral Hygiene and Its Role in Disease Prevention

Oral hygiene plays a crucial role in protecting the body against systemic inflammation and disease ranging from type 2 diabetes to even cancer. Recent studies have shown that a number of natural compounds (nutrients) confer health benefits when applied topically to the mouth. Acting as powerful allies in the fight against periodontal disease, these natural compounds can help safeguard against lethal age_related diseases that emanate from our mouth.

The GUMS: The Incubator for Bacterial Growth and Disease

Our mouths create the ideal micro_environment for microorganisms to thrive in which often results in the decay of our gums, teeth and jaw bone.

Cavities and gum problems such as gingivitis often begin with a local inflammatory reaction such as inflammation of the gums (gingivitis) and eventually moves on to inflammation of the bones supporting the teeth (periodontitis) which has been implicated in the development of a number of systemic diseases and disorders: coronary artery disease, arthritis and even cancer.

Oral Hygiene Basics 101: What You Need to Know

If the above isn’t enough for you to consider taking oral hygiene seriously, I don’t know what is. As we have seen optimizing oral hygiene is a crucial disease prevention strategy. Poor oral health can lead to a wide variety of serious illnesses as discussed above. There are a number of natural compounds such as green tea, aloe vera, lactoferrin, xylitol, folic acid, hydrogen peroxide which can help improve overall oral hygiene by targeting the plaque causing bacteria while supporting overall gum health.

Green Tea

Green tea is well known for its beneficial effects throughout the whole body. Studies have shown that the green tea catechins exert direct anti_bacterial activity against streptococcus mutans, one of the key

Microorganisms responsible for tooth decay. Green tea also helps prevent bacteria from sticking to teeth, in addition to inhibiting the production of amylase which is an enzyme responsible for breaking down starch to sugars which bacteria will use as fuel.

Coenzyme Q10

Coenzyme Q10 is widely known for its cardioprotective effects however Coenzyme Q10 has been shown recently to improve symptoms of periodontitis when applied topically in the oral cavity. The proposed mechanism behind Coenzyme Q10’s benefits in oral health is believed to be due to its ability to reduce the oxidative stress associated with low grade inflammation of the gums and bones.

Additional Beneficial Ingredients for Oral Health

There are a number of natural ingredients which can be used on a daily basis to protect healthy teeth and gums. The natural sweetener xylitol has been found to help prevent tooth decay. Squalene boosts the immune system’s ability to tackle invading microorganisms, while lactoferrin specifically halts the growth of bacteria implicated in periodontitis.

Hydrogen peroxide which is the most common antiseptic used can be used to minimize gingivitis, fight plaque and promote a clean mouth. Aloe vera has been shown to exhibit anti_inflammatory properties and can be used to help heal cuts and abrasions to gum tissue.

Vitamins such as the B vitamin, folic acid promotes healthy gums by reducing the redness and bleeding of these tissues. Vitamin D, which we have been hearing so much about, is necessary to ensure gum health as well.

There is a new product that I have personally used and have been referring my patients which is remarkable. It is called ACS 200 and check out the product information below.

 

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Kill_time data compiled from individual manufacturer's published research.



B. burgdorferi Titer Log Reduction Kill Time
ACS 200 38,000,000 5.95/99.99989% < 8 minutes
ASAP silver No testing available
Meso Silver No testing available


MRSA Titer Log Reduction Kill Time
ACS 200 2,170,000,000 6.64/99.999984% < 3 minutes
ASAP silver 1,900,000 4.98/99.9989% 60 minutes
Meso Silver 1,200,000 Log not provided claimed kill 5 hours


C. albicans Titer Log Reduction Kill Time
ACS 200 445,000,000 5.95/99.99989% 2 minutes
ASAP silver 1,300,000 4.83/99.9985% 60 minutes
Meso Silver 12,000 Log not provided claimed kill 24 hours


S. aureus Titer Log Reduction Kill Time
ACS 200 234,000,000 > 5.37/99.9996% 15 seconds
ASAP silver 2,300,000 > 5.06/99.99914% 60 minutes
Meso Silver 830,000 Log not provided claimed kill 24 hours

 

How Do I Purchase These Products?


Results RNA® distributes their products through licensed, health care practitioners. If you are currently seeing an Integrative Medical Practitioner, we urge you to recommend incorporating ACS 200® and ACZ nano® into their clinical practice on your behalf. You may also contact us directly by phone and we will help you locate a prescribing practitioner in your area. 1 888 823 3869

To become a participating practitioner, please register here.

SUPPLEMENT FACTS


Serving Size
5 sprays; 175 mcg cellular silver per serving

Other Ingredient
Nano Distilled Water

Offered in 2 oz and 4 oz Intra_oral Sprays

Dosage Guidelines
Maintenance Dose
Take 5 sprays by mouth 2 _ 3 times daily.

Higher Dose
Take 10 sprays by mouth 4 times daily.

For Best Results: Take AC2 200® Extra Strength and ACZ nano ® Extra Strength daily to maintain optimal health and total body detoxification.

Purity and Quality Guaranteed: ACS 200® Extra Strength is produced under strict GMP manufacturing controls in conformance with guidelines for dietary supplements set forth in USP XXVII. For purity and quality, ACS 200 ® Extra Strength contains no preservatives • no alcohol • no artificial coloring or flavoring. For customer support, please call 1 888 823 3869.



Recap of Nutrient Timing

Physiological and Metabolic Changes During Exercise

ATP Replenishment
ATP=>muscle contraction for few seconds.
CP=>primary source for ATP formation but CP supply is limited in 10 to 12 seconds after intense workout.

Effect on Protein Pool
During sustained exercise, a net muscle protein loss occurs. Due to increased use of Branched Chain Amino acids (BCAA).
Glutamine levels decline as well. Since glutamine provides fuel for the immune system prolonged exercise can deplete glutamine stores and compromise immune function.

Muscle Damage
Physical cause=>lengthening and contracting of muscle fibers=>inflammation.
Hormonal cause=>cortisol stimulate muscle protein breakdown.
Free Radical generation=>damage muscle protein

Immune Response
Response to different types of injuries by increasing white blood cells, natural killer (NK) cells and T cells.
Strenuous exercise depresses the immune response=>depends on intensity and duration of exercise=>can last up to 72 hours post_exercise.

Increase Nutrient Delivery to Muscles and Spare Muscle glycogen and Protein
CHO/protein drinks during workout can preserve muscle glycogen.
Taking CHO/protein drink at the beginning of exercise can increase protein synthesis after exercise.

Limit Immune System Suppression
Moderate intense exercise=>immune system is heightened
Strenuous exercise=>increases cortisol levels=>immune system is depressed
A 6% carbohydrate (CHO) drink given during exercise has reduced cortisol levels  by up to 80%.

Minimized Muscle Damage
CHO intake during exercise reduces cortisol=>reduces pro_inflammatory substances.
Vitamin C , E and BCAA can reduce muscle damage.

Recommendations for the Energy Phase
l. Take CHO/protein 10 minutes before exercise=>increase blood glucose and insulin levels=>increase glucose uptake into muscle=>limits muscle glycogen loss during exercise and increases endurance.
2. Take CHO/protein drink immediately before exercise=>greater protein synthesis after exercise. Consume every 15 to 20 min. during exercise.
3. CHO/protein drink reduces blood cortisol levels
4. The ideal CHO is high glycemic ones such as sucrose, glucose and maltodextrin.
5. The protein of choice is whey plus a high percentage of glutamine and leucine
6. The ratio of CHO to protein should be 4:1

Nutrient Timing Anabolic Phase
The rise in cortisol during exercise continues in the postexercise period.
Free radicals generated during exercise attack muscle cell many hours after exercise.
Rate of protein degradation exceeds rate of protein synthesis.

Metabolic Cost of Nutrient Delay
Window of Opportunity=>45 minute immediately postexercise=>Anabolic Phase=>within minutes after stopping exercise it begins to close.
Two to 4 hours after workout=>insulin resistance develops=>even the perfect combinations of nutrients will be much less effective.

Timing and Glycogen Replacement
Muscle glucose uptake following exercise was 3 to 4 times faster when supplementation was given immediately after exercise than 2 to 3 hours later.
The CHO supplement stored twice as much glycogen.

Timing and Protein Synthesis
Muscle amino acid uptake is controlled in part by blood amino acid levels. In addition, the level of amino acids in the blood is a critical initiator of protein synthesis.
When blood amino acids are reduced below normal, amino acids are released from muscle and protein synthesis declines.
Activation of protein synthesis by amino acids is most responsive immediately following exercise.
Protein synthesis was almost 25% higher and a.a. uptake almost twice as high when a CHO/protein liquid supplement was given immediately after exercise vs two hours after exercise. There was also an increase in fat oxidation.

Nutrient Timing Goals for the Anabolic Phase

l. Shift Metabolic Machinery from Catabolic to Anabolic State
CHO/protein supp will stimulate insulin and blunt cortisol release
Insulin response: CHO/protein>CHO>Protein

2. Speed Elimination of Metabolic Wastes by Increasing Muscle Blood Flow
When lactic acid levels are high, it takes longer for Creatine Phosphate (CP) to be restored.
Insulin could increase muscle blood flow two_fold=>stimulates Nitric Oxide (NO) pathway.

3. Replenish Muscle Glycogen Stores
The higher rate of insulin response, the greater rate of muscle glycogen synthesis.
Restoring muscle glycogen: CHO/protein>CHO>Protein

4. Initiate Tissue Repair and Set Stage for Muscle Growth
Protein Synthesis: CHO/protein>Protein>CHO
CHO/protein taken postexercise may replenish glutamine stores faster.

5.Reduce Muscle Damage and Bolster Immune System
Take CHO/protein drink containing Vitamin C, E and glutamine reduces free radicals
Glutamine may be related to effects on immune system.

Recommendations for Anabolic Phase
Whey protein

  • Very digestible
  • Hi concentration of BCAA
  • Fast gastric emptying

HI Glycemic Carbs
For post exercise supplementation=>sucrose,glucose, maltodextrin
Avoid high percent of fructose or galactose.

Carbohydrate/Protein Ratio
A 3:1 to 4:1 ratio is superior for glycogen replacement and protein synthesis

Ideal nutrient composition
Whey protein......................13 to 15 g
Hi glycemic CHO...............40 to 50 g
Leucine..............................1 to 2 g
Glutamine..........................1 to 2 g
Vitamin C..........................60 to 120 mg
Vitamin E..........................80 to 400 iu

Nutrient Timing Growth Phase
About 2 hours after exercise, insulin resistance begins and can continue up to 16 hours or longer

Maintain Insulin Sensitivity
Ability of muscle cell to replenish glycogen stores is 50% less two hours after exercise than immediately after.
Sufficient CHO and protein during this phase can replenish 65 to 75% glycogen stores within 2 hours post_exercise. Once this level of glycogen is attained, a lower consumption  will provide sufficient stimulus to keep blood insulin levels elevated.
A CHO/protein drink during exercise and post_exercise prevents development of insulin resistance to the degree that you can extend the muscles insulin sensitivity for up to 3 to 4 hours after the anabolic phase.

Maintain Anabolic State
Protein synthesis increased only when insulin is elevated.
Leucine may also help maintain high anabolic activity. Leucine stimulates protein synthesis independent of its effect on insulin.

Maintain Positive Nitrogen Balance and Stimulate Protein Synthesis
The RDA protein intake is 0.8 grams per kg per day
Data indicates that 20% of protein consumed in excess of maintenance amount is retained. The more protein is ingested, lean body mass is increased.
Positive nitrogen balance could be maintained up to 50 days on a diet that was 3 times the RDA for protein
Based on studies, strength athletes will benefit from consuming between 0.9 and 1.2 g protein/kg/day when training intensely.

Promote Protein Turnover and Muscle Development
Protein synthesis may continue after exercise for up to 48 hours. Net protein balance remains negative unless the appropriate foods or amino acids are consumed.
Important to maintain elevated blood levels of amino acids. Eat a high protein meals and snack between meals. Consuming protein in one large meal is less effective than smaller meals throughout the day.
Evidence that consuming fewer calories than are expended will adversely affect nitrogen retention.

Recommendation for Growth Phase
Whereas a CHO/protein containing more carbs to protein (3 to 4 g CHO/1 g protein) is ideal to turn on the anabolic machinery, supplementation during the Rapid Segment can rely on much lower CHO/protein ration (1g CHO/5 to 8g protein) If too much CHO is consumed it can be converted into fat.
Keep insulin levels elevated for a sustained 4 hour period prevents insulin resistance.
During the Rapid Segment you consume leucine and glutamine=>anabolic action on protein synthesis and immune system parameters.
The supplement during the Growth Phase is a high protein snack that can be used between meals. and at bedtime.Whereas insulin is essential at specific times, continued elevation of insulin along with high carb is not desirable.  A high protein snack does not stimulate insulin which does not stimulate fat deposition, elevated blood cholesterol and metabolic disorders.

 




Communicating Fascia

Introduction
In classical latin the term “fascia” meant nothing more than band (a long and narrow piece) of material.  In the 19th century gross anatomy texts often refer to fascia as undifferentiated tissue that wraps around more “specialized” tissues or that forms a packing material between them.  Take, for example, the description in Quain’s Elements of Anatomy: “to signify those membranous sheets of reticulated or felted fibrous tissue, which invest or intervene between the soft parts, especially muscles. 

Discussion
Anatomists are more precise when talking of superficial and deep fascia.  These terms indicate that topographic relationships of the tissue with respect to the skin.  Recently, there has been a resurgence of interest in the biomechanics of fascia, in part motivated by interest in the pathophysiology of musculoskeletal pain and its treatment with both conventional and alternative manual therapies such as massage, chiropractic, rolfing and osteopathy.  The term fascia in this context refers mostly to a form of connective tissue that equates histologically to dense irregularly arranged connective tissue.  To the anatomist however, “fascia” may also be the so_called “loose” (areolar) connective tissue, dense connective tissue, or a combination of the two – with or without fat.

Dense Connective Tissue
Dense connective tissue is connective tissue containing closely packed fibers.  The fibers are predominantly collagen, although in some sites, elastic fibers may be present in abundance (for example, ligamentum nuchae and flavum).  The high collagen content imparts high tensile strength and high stiffness once the network is stretched sufficiently to align more fibers, if this is not already the case.  If the functional requirement is to resist stretch from many different directions, the fibers will be arranged in a mesh (as in many parts of joint capsules, except the ligaments).  This tissue is not woven – that is, it does not have fibers crossing each other systematically in an alternating way.  Such tissue is best described as a dense irregular (multidirectionally stranded) connective tissue.  However, if functional demands dictate that the tensile loading is predominantly in one or only a few directions, it follows that the collagen strands will be in a parallel arrangement along the direction of the loads imposed.  Such a connective tissue typifies most tendons, ligaments, aponeuroses, and intermuscular septa, and is referred to as dense regular connective tissue.  In both regular and irregular dense connective tissues, the cells embedded within the collagen_reinforced matrix are predominantly fibroblasts.

Non_Dense (Areolar) Connective Tissue
Non_dense (areolar) connective tissue contains more sparsely arranged fibers and strands (both collagen and elastic) that are not arranged in any predominant directions.  Commonly, such connective tissue is called “loose connective tissue”. 

The most common form of non_dense connective tissue by far is areolar connective tissue.  The fibers are far less numerous in this tissue than in dense connective tissue, and although fibroblasts are also present, other cells of a wider range of types are typically present as well.  In particular, areolar connective tissue can contain a variable population of white blood cells (or their differentiation products) that have entered from the small blood vessels passing through.  The number of such cells are greater when an infection is present.

Areolar connective tissue also contains neurovascular bundles and small branches of sensory nerves that may terminate in the dense or areolar connective tissue layers.  An important function of areolar connective tissue is that it can allow some amount of shear deformation to occur between adjacent dense connective tissue layers such that they can “glide” past one another.  This function has been demonstrated in dynamic ultrasound imaging of layers within the thoracolumbar fascia.

Superficial Fascia
The superficial fascia (synonymous with fascia superficialis, tela subcutanea, hypoderm, hypodermis, stratum subcutaneous, subcutis, panniculus adiposus) is an enveloping layer directly beneath the skin and thus continuous with the dermis, this location being the only certain implication of referring to a tissue as “superficial fascia.”  Thus, although loose connective tissue or fat is common in the superficial fascia, a delicate three dimensional meshwork of dense irregular connective tissue  (with loose connective tissue and fat within its meshes) or more obvious sheets of tissue (for example, in association with the great saphenous vein as it courses through the superficial fascia of the lower limb) may also be present.  Superficial fascia can even contain skeletal muscle, well exemplified by the muscles of fascial expression that enable humans to smile, laugh, cry and frown.

Deep Fascia
Deep fascia (synonymous with fascia profunda) is typically a continuous sheet of mostly dense irregular connective tissue keeping an underlying structure (particularly muscle) in position.  It is thus classically a tight_fitting “ensheathing fascia” that needs a degree of tensile strength so that it can maintain the form of the body part and preserve the associated surface contour; hence, its dense connective tissue character.  So close is the association between deep fascia and muscle in some regions of the body that the fascia can be firmly adherent to the underlying muscles and thus form an aponeurosis for them.  It should also be noted that, in some parts of the body (for example, the neck), the association between fascia and the underlying muscle is formally recognized by referring to the deep fascia of the region as “investing fascia.”  Readers need to be aware that deep fascia is not always synonymous with dense connective tissue, for it can contain varying amounts of less_dense connective tissue (both areolar connective tissue and fat).

Aponeurosis
In modern anatomy, an aponeurosis is often considered a flat tendon.  This sheet_like part is likely, because of differences in morphology, to have mechanical properties different from those of a tendon.  So this difference should be expected even if tendon and aponeurosis were to be put together using identical materials with identical material properties.

The aponeurosis may have extra_ as well intramuscular parts (for example, the human m.gastrocnemius).  Muscle fibers attach to the intermuscular parts and are thus connected via the aponeurosis to tendon and to the bone.  Notably, however, many muscles have muscle fiber origins or insertions on intermuscular septa, interosseal membranes, or even the deep fascia.  For example, most of the fibers of the human gluteus maximus muscle (on average 82% of its mass – in some individuals, 100%) insert on the fascia lata.  In such muscles, the fascial structure operates as the intramuscular aponeurosis for the muscle.  It is likely that such intramuscular aponeuroses are less independent than their counterparts mentioned earlier, because they are connected to bone in many directions.  Muscular aponeuroses that are only a section of a fascial sheet may give the impression that they will not be reshaped into a tendon closer to the bone.  However, such fascial sheets may be continuous and thus supported by or even hanging from ligaments or crossing a joint.  In such a case, some similarity in structure to the classical aponeurosis – tendon combination may be seen. 

Summary
We do not recommend that the term fascia be given such a wide meaning that it also includes all tendons and ligaments, for that is simply acknowledging that tendons and ligaments are forms of connective tissue and equates “fascia” with connective tissue in general.