The Immune Miracle – Chapter 1 – Immunity and Disease

The Immune Miracle

The all-natural approach for better health, increased energy, & improved mood.

Shawn M. Talbott, PhD, CNS, LDN, FACSM, FAIS, FACN

 

Chapter 1

Immunity and Disease

First – let’s make sure we’re all on the same page with a proper definition of the “Immune System.” An immune system is a network of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism’s own healthy cells and tissues in order to function properly.

The key part of that definition is the word “network,” because a properly-functioning immune system encompasses “barriers” such as skin and membranes that block the entry of pathogens into our bodies, as well as a vast array of cells, enzymes, hormones, and other aspects of biochemistry that serve as signals and messengers to identify and destroy invaders. If any part of this complex and coordinated network breaks down, we’re more susceptible to infections, more likely to catch a cold, and even more likely to develop cancer.

The last time we experienced flu pandemic occurred more than forty years ago (1968) – but many experts feel that we’re very close to experiencing an even worse pandemic in the very near future. Whether its the risk of a swine flu epidemic (H1N1) or an avian (bird) flu epidemic (H5N1), our risk for a global flu pandemic has risen steadily over the years for many reasons – including the ease of international travel, the emergence of drug-resistant and rapidly mutating virus strains, and the presence of greater numbers of environmental toxins and stressors in today’s world.

Every year in the United States, influenza results in more than 200,000 hospitalizations and nearly 40,000 deaths (representing more than $10 billion in medical costs). Since nobody wants to get sick – never mind not wanting to be hospitalized or dead – the entire category of “immune support” products is enjoying a significant level of sales growth. Americans spend more than $300 million on non-prescription cold remedies every year. BUT, most of these products tend to base their claims of “immune support” on levels of nutrients such as vitamins A & C and minerals such as zinc & selenium. While these nutrients are certainly needed at proper levels for normal immune system function, they are unlikely to do much of anything towards truly bolstering the immune system when it’s challenged by a pathogen such as influenza or other viruses.

Let’s look at some of the more ridiculous products claiming immune “boosting” capabilities lately. There is the popular Airborne dietary supplement (“formulated by a teacher!”) that paid $30 million to settle a false claims lawsuit, though it remains on the market with similar “boost immune function” claims. Another well-known product Crystal Light drink mix (owned by Kraft) claimed it would help “maintain a healthy immune system” based on a dusting of vitamins A, C, & E, and Green Giant Immunity Boost (a blend of broccoli, carrots, and peppers from General Mills). There are dozens of other silly examples – but how is a consumer to know which (if any) of these foods or dietary supplements really holds any promise for truly helping them to maintain immune function when they need it the most (such as when exposed to a virus, when under stress, or when our defenses are depleted)?

Immunity and Vigor

It’s pretty logical to understand that if your immune system is suppressed in some way, it’s less likely to protect you from pathogens, and you’re more likely to get sick. What many people do NOT understand is that a properly-functioning immune system is also associated with a general feeling of well-being; conversely, a suppressed immune system is one of the primary reasons for feeling fatigued and depressed. Chapter 3 covers the relationship between chronic stress, cortisol (a stress hormone), immune suppression, and low vigor in greater detail.

Vigor is a term from psychology research that measures a combination of physical energy, mental acuity, and emotional well-being (vigor is the opposite of “burnout” or physical and mental exhaustion). When your vigor is low, you not only lack energy and may even be depressed, you also lack the necessary motivation to get up and accomplish the things that you’d like to do. When your immune system is suppressed, your vigor is low — BUT, when you bring your immune system back to optimal levels of functioning, your vigor improves… and you feel great again. This “priming” of immune system activity is covered in detail in Chapter 4.

There are basically three “tiers” to consider when it comes to effective immune system support: Protect – Prime – Promote.

Protect

This first tier is where you do whatever you can to protect yourself from exposure to pathogens. Steps like eating a healthy diet, supplementing with a balanced multivitamin, consuming enough antioxidants, consuming yogurt as a source of pre- and pro-biotics (beneficial bacteria), frequent hand-washing, getting enough sleep, and avoiding or reducing stress all come into play. For example, overexposure to stressful events or sleep loss increases cortisol (the stress hormone) in our bodies; this will dramatically suppress immune system function – as will underexposure to dietary antioxidants (A, C, E, carotenoids, flavonoids, etc).

Prime

It’s important to eat a healthy diet, rich in brightly colored fruits & vegetables and yogurt for its immune-active pre- and pro-biotics (beneficial bacteria). Yet, we also must consider bolstering (or “priming,” but NOT “stimulating”) immune vigilance. Especially during periods of elevated stress (environmental, emotional, physical), the immune system needs to maintain its primary function of protecting the body from harmful invaders. Numerous human research trials of several “immune support” types of dietary supplements have shown that “priming” key immune system cells (macrophages, neutrophils, and natural killer cells), helps them to quickly identify, ward off, and defeat foreign challenges. Research studies show that people with properly primed immune systems have fewer cold/flu symptoms and better indices of well-being, vigor, energy, and mood. The more stress you’re under, the more you can expect your immune system also to be “stressed” (and suppressed), the more likely you are to benefit from a daily regimen of immune system priming.

Promote

This is your last resort – after you’ve tried the first two tiers and you’re down for the count with an established infection (i.e. you have a cold or the flu). The best approach to temporarily promoting or stimulating immune system activity above normal levels is to start consuming higher levels of vitamin C at the first sign of a sore throat or related cold symptom. You can drink more orange juice, eat lots of strawberries, or get an inexpensive chewable vitamin C tablet — and shoot for an intake of 500mg every 3-4 hours (up to 3,000mg/day for 4-7 days). This simple, safe, and inexpensive approach is a good way to help your immune system get a jump on the infection; it might reduce your symptoms by a couple of days.

Avoid Antibiotics and Immune Stimulants

If you can help it – DO NOT assume that you need an antibiotic drug to treat your symptoms (antibiotics only work against bacterial infections, NOT against viral infections like colds or the flu). As many as HALF of the 100 million antibiotic prescriptions written each year are given to people who have viral upper respiratory infections. This is a leading cause for the development of antibiotic-resistant organisms like E. Coli H157 and MRSA (methicillin-resistant Staphylococcus aureus)! Also consider that side effects of antibiotics (such as allergic reactions) result in more than 140,000 emergency room visits annually. Think of antibiotics this way: you probably do not need one; they only work on bacterial infections, and they are highly likely to make you sick (or at least give you diarrhea due to destruction of beneficial gut bacteria). Skip them unless you’re on your deathbed.

The vast majority of the herbal immune “boosters” on the market are plant extracts containing a combination of polysaccharides that “irritate” the immune system into action. This is a clumsy approach that may certainly “ramp up” immune activity – but it’s is really an old-fashioned shotgun approach that makes little sense when we can scientifically prime our immune activity when we need it (vs. when we don’t want it). Supplements such as Arabinogalactan (Larch tree extract), Echinacea, Ginseng, and some medicinal mushroom extracts (Reishi, Maitake, AHCC, etc.) all show evidence for reducing the duration and severity of URTIs (upper respiratory tract infections). However, direct-stimulation of immune activity is an approach that you only want to employ infrequently, because too-frequent stimulation of immune activity is likely to lead to allergies (ragweed, seasonal), autoimmune diseases such as celiac disease, thyroiditis, lupus, rheumatoid arthritis, and multiple sclerosis, and other problems associated with over-activity of the immune system (such as chronic inflammatory conditions).

Summary

The immune system is one of the most complex body networks – but, maintaining its proper balance and optimal function doesn’t have to be complicated. Protect your immune function with a healthy diet (antioxidants from fruits/veggies and probiotics from yogurt). Maintain balanced immune function, especially during times of stress with proper Priming, and Promote immune activity above normal only as a last resort (and then only for a short period of time).

The chapters that follow in The Immune Miracle will take you step-by-step toward an understanding of how the immune system works, how stress interferes with immune function and leads to low vigor, and how a properly primed immune system can protect you from disease while helping you to feel better than you’ve ever felt before.

The Immune Miracle – Introduction

The Immune Miracle

The all-natural approach for better health, increased energy, & improved mood.

Shawn M. Talbott, PhD, CNS, LDN, FACSM, FAIS, FACN

 

Introduction

Every year, near “back to school” time, people start thinking about their immune systems. Right around that same time, I also get bombarded with questions about “stimulating” or “maintaining” immune system health. Maybe it’s because when kids go back to school, they’re exposed to germs from the other kids and they tend to get sick more often. It might also have something to do with the media reports of swine flu or bird flu that tend to air every year in the Fall. And it might just be because we’re heading into the beginning of the cold/flu season, which can run from early October to as late as April.

The sudden interest every year in “boosting” our immune system function in order to ward off or overcome a cold or the flu always makes me shake my head in dismay. Why? Because keeping our immune system strong should be something that we think about EVERY day of the year – not just when we have a “problem” such as an active cold, flu, or other infection. Just as we maintain optimal health by thinking about our daily nutrition, our daily exercise, or our daily amount of sleep, we should think about nourishing our immune systems every single day. By keeping our immune system properly “primed” for activity, we not only improve its ability to fight off viruses, bacteria, and even cancer – but we also help ourselves feel better, enjoy higher levels of energy, better mood, and improved vigor (mental/physical well-being).

Chapter 1 provides a brief discussion about immunity and disease– and what it means to “prime” versus “stimulate” our immune system function so we can optimize day-to-day immune protection. The Chapters that follow will delve into greater detail about how the immune system functions (Chapter 2), how stress can suppress immune function (Chapter 3), why priming your immune system is important for optimal functioning (Chapter 4), how to eat and supplement your diet for proper immune system nourishment (Chapter 5), and how a natural yeast extract may be the future of immune system support (Chapter 6).

The Immune Miracle

Reminder of the video class that I did recently on ways to strengthen your immune system – posted HERE on YouTube.

With all the cornea virus news, I thought it might be a good idea to repost the text of my 2012 book about supporting immune strength – The Immune Miracle.

The paperback is available for $14.95 from Amazon HERE – it’s a quick 80-page read.

I hope everyone finds this information to be informative and helpful during this crazy time!

I will post the text of the book chapter-by-chapter – here is what is covered in each post…

 

The Immune Miracle

The all-natural approach for better health, increased energy, & improved mood.

Shawn M. Talbott, PhD, CNS, LDN, FACSM, FAIS, FACN

Table of Contents

Introduction

Chapter 1 – Immunity and Disease

Chapter 2 – Immune System Overview

Chapter 3 – Stress and Your Immune System

Chapter 4 – Priming Your Immune System

Chapter 5 – Eating for Immunity

Chapter 6 – Priming: The Next Frontier of Immune Support

References

Why Bill Gates is Investing in the Microbiome

Drugs From Bugs: Why Gates, Zuck And Benioff Think The Next Blockbusters Will Come From Inside Your Gut

This was a terrific story in the March 31, 2020 issue of Forbes Magazine – also appearing online on Feb 7, 2020.

As you’ll see, this article focuses primarily on how numerous biotech and Pharma companies are exploiting the microbiome to develop synthetic drugs. Not necessarily a “bad” thing – but what if you could naturally modulate your microbiome environment with personalized nutrition regimens and target dietary supplements?

Our group has already shown how targeted nutrition interventions (e.g. probiotics, prebiotics, etc) can improve microbiome balance (American College of Nutrition 2017); may enhance post-exercise recovery and sports performance (American College of Sport Medicine 2018); reduce stress and enhance mood (Functional Foods for Health & Disease Journal 2019); and optimize metabolism for glucose/weight control (Functional Foods for Health & Disease Journal 2020).

Read the original Forbes article here = https://www.forbes.com/sites/susanadams/2020/02/07/drugs-from-bugs-why-gates-zuck-and-benioff-think-the-next-blockbusters-will-come-from-inside-your-gut/ and see my highlighted version and notes below…

Sharp pains shot through the patient’s stomach, and he had constant diarrhea. Seven rounds of antibiotics over 18 months had only made him feel worse. A previously healthy man in his 20s who wishes to remain anonymous, he had contracted a recurring case of Clostridium difficile, or C. diff, after having his gallbladder removed in 2012. Hospital patients are prone to C. diff since antibiotic treatment for other maladies decimates the infection-fighting capacity of what scientists call the gut microbiome, the trillions of cells that move through the human digestive system. “It didn’t just affect my gut,” he says. “I was exhausted all the time. I had really bad brain fog. I couldn’t concentrate.” Doctalbott Note = the microbiome has been linked to effects on both physical health and mental wellness.

Desperate, he researched possible therapies and discovered articles about fecal transplants wiping out the infection. But his gastroenterologist refused to perform the procedure. So he took matters into his own hands. He asked his roommate to supply a stool sample, bought an enema kit from CVS, pulsed the mixture in a blender, strained it through a coffee filter and pumped it into his gut. As though a wizard had cast a spell, he made a full recovery within days. Doctalbott Note = having seen the benefits of microbiome optimization firsthand in thousands of people, it often seems like “magic” because of the widespread health benefits that emerge.

Welcome to the most promising new frontier in medicine: poop. By focusing on what’s coming out of patients’ rear ends, a growing body of scientific research over the last 15 years has highlighted the crucial role the microbiome plays in human health. That new understanding could lead to breakthrough treatments for a huge range of illnesses, from obvious ones like digestive ailments and food allergies to surprising ones like cancer and autism. A microbiome-derived drug is already in the works to prevent childhood asthma. Doctalbott Note = some of the most promising microbiome interventions involve “mental wellness” benefits for depression, anxiety, stress, and other effects that you can FEEL relatively quickly.

“It’s only in the past 15 years that we’ve come to understand the incredible diversity of the microbiome. It’s almost like a rainforest inside our bodies. There are 100 times more bacterial genes than human genes,” says Smith

Put crudely, the idea is to use gut bugs as drugs. Doctalbott Note = but why not utilize this “internal pharmacy” to naturally produce our own “drugs” on-demand when we need them? More than 50,000 scientific papers in the last five years have explored the microbiome’s effects. Various kinds of gut bacteria appear to stimulate or suppress immune responses in the body, while others seem to fight off disease-causing microbes. A groundswell of cutting-edge research has the potential to deliver a burst of new therapies that will vastly reduce human suffering—and generate huge paydays for the field’s pioneers.

When scientists transferred gut microbiome cells from obese mice into lean ones, the recipients gained weight. In one study, melanoma patients with the most diverse microbiomes had the best response to immunotherapy. And mice injected with gut bacteria from marathon runners ran longer distances. A new drug for obesity alone could be worth more than $20 billion.

So far, the most compelling microbiome-derived therapy is a live fecal transplant for C. diff, which strikes half a million Americans annually, killing 15,000. In 2013, the New England Journal of Medicine published a paper that caught the scientific community by surprise and jump-started investment in microbiome drug development. In a randomized trial, 94% of recurrent C. diff patients recovered after receiving fecal transplants. To put that in context, cancer drugs with efficacy rates as low as 10% have been approved by the FDA.

“I don’t think there’s any other field of medicine today that holds as much promise for the future of medicine as the microbiome,” says Olle.

Billions of dollars are pouring into microbiome medicine. Gbola Amusa, a medical doctor and partner at Chardan, a health care–focused investment bank in New York, pegs the total amount invested since 2014 at more than $5 billion. Techie billionaires including Bill Gates, Salesforce founder Marc Benioff and Silicon Valley venture capitalist Vinod Khosla are funding microbiome startups, and Gates, Benioff and Mark Zuckerberg have all made donations to support microbiome research at institutions including Stanford, Washington University in St. Louis and the University of California, San Francisco.

The race is on for FDA approval of the first drug made from gut bacteria. But the science is young and unproven. At Oppenheimer in New York, Mark Breidenbach says investor enthusiasm in microbiome companies is on a downswing because “there is no consensus about what the microbiome can do.”

Amusa is more bullish. “The science is turning,” he says. “When it comes through with proof, these biotech companies will be worth not hundreds of millions of dollars, but billions.”

Somerville, Massachusetts–based Finch Therapeutics is one of the most promising startups developing microbiome drugs. Cofounder Mark Smith, 33, was a microbiology grad student at MIT when the 20-something C. diff patient begged him for help. “I had to tell him, I’m a microbiologist, not a doctor,” Smith says.

The patient’s ordeal motivated Smith to create OpenBiome, the equivalent of a public blood bank for human feces, while Smith was still at MIT in 2013. The Cambridge, Massachusetts, nonprofit, the first of its kind in the world, has since supplied stool for more than 53,000 transplants in 1,200 hospitals and clinics.

Inspired by the demand for transplants, Smith cofounded for-profit Finch (named for the diverse group of finches Charles Darwin discovered in the Galápagos Islands) in 2016 to develop an FDA-approved C. diff pill. Currently, most doctors perform fecal transplants through a colonoscopy, which can cost as much as $5,000. The procedure is not FDA-approved or reliably covered by insurance.

Smith and his 80 employees occupy two floors in an industrial park that formerly housed administrative offices and storage space for the Harvard Art Museums. Tall and slender with piercing blue eyes, he welcomes the inevitable jokes that come with being a human-feces entrepreneur. On Halloween he wore a poop-emoji costume (“I was a pooper trooper”) to the office, where the copiers have names like Squatty Potty and Magic Stool Bus.

But he has raised serious capital. Venture funds have put in $130 million, and Finch has a partnership with Tokyo-based pharma giant Takeda to develop drugs for ulcerative colitis and Crohn’s disease, which together have 10 million sufferers worldwide. Finch is also working on an autism drug.

“It’s only in the  past 15 years that we’ve come to understand the incredible diversity of the microbiome. It’s almost  like a rainforest inside our bodies. There are 100  times more bacterial genes than human genes.

Traditionally, scientists start with data gathered through experiments on mice. Finch is taking a “human-first” approach, skipping the rodents and analyzing the stool of human patients who have recovered after receiving fecal transplants. “We’re looking at what works in patients and figuring out how to make our drugs from the top down,” Smith says. “It’s called reverse translation.”

For one of its C. diff drugs, Finch is extracting what Smith describes as the “full spectrum” of bacteria in a human stool sample from a carefully screened healthy donor, freeze-drying it and delivering the equivalent of a fecal transplant in a single pill. It’s also working on simpler drugs made from five to 10 key bacteria. It expects results from its first Phase 2 trial (which demonstrates efficacy) of the full-spectrum C. diff capsule by the end of the second quarter of 2020.

“Even if only a few of the microbiome therapies scientists are working on come to fruition,” Smith says, “it will have a huge impact on public health.”

Another MIT Ph.D., Bernat Olle, 40, is running Vedanta Biosciences, a nine-year-old Cambridge, Massachusetts–based microbiome drug developer with $112 million in funding, including $10 million from the Bill & Melinda Gates Foundation. The Gates investment supports preclinical research at Vedanta aimed at developing a gut bacteria–derived drug that would prevent child malnutrition in the developing world. Nearly 200 million children under age 5 suffer from either wasting or stunting, resulting in at least 1.5 million deaths a year. “Malnourished children struggle to gain weight even when fed enough,” Olle says. “Emerging research suggests that this is because their gut microbiota develop abnormally, and that beneficial gut bacterial strains may help correct this imbalance.”

“I don’t think there’s any other field of medicine today  that holds as much promise for the future of medicine as the microbiome.” Bernat Olle, cofounder and CEO of Vedanta Biosciences.

Vedanta also has two partnerships with big pharmaceutical companies, including Bristol-Myers Squibb, to develop drugs aimed at boosting the effectiveness of immunotherapy to treat melanoma and colorectal and gastric cancers. Like Finch, Vedanta is developing a drug to treat recurrent C. diff.

Inside Vedanta’s maze of labs and storage rooms is an oversized freezer containing fecal matter from 275 donors on four continents, including an indigenous tribe in Papua New Guinea. Vedanta is isolating and then testing bacteria from each sample in the hope of determining which strains make the most effective drugs.

A wiry Catalan immigrant with close-cropped salt-and-pepper hair who bicycles to work, Olle came to the U.S. in 2002 to study chemical engineering at MIT, where he focused on the emerging science of using live organisms like bacteria to produce drugs. In 2007, after earning both an MIT doctorate and an MBA from the Sloan School, he joined PureTech Health, a Boston biotech firm.

In 2010 PureTech backed him in launching Vedanta with five cofounders, all scientists, including big names such as Kenya Honda, a microbiology professor at Keio University medical school in Tokyo. Honda had published a groundbreaking paper on the connection between gut bacteria and regulatory T cells, known to prevent inflammatory diseases. “Think of them as the U.N. peace forces of the intestine,” Olle says. “Honda’s work suggested that the cells encoded in human DNA are influenced by the bacteria that live within you.”

“This work has forced me to rethink what it means to be human,” Olle says. “We are not just the product of the Homo sapiens genome.”

Every gold rush attracts its share of charlatans and claim jumpers. More than a half-dozen startups are using the microbiome as a marketing buzzword to sell stool-analysis tests. The kits, which require the consumer to mail a small sample to a lab, purport to convey valuable personalized health data and nutrition advice. That despite a consensus among scientists that it’s not yet possible to draw useful dietary recommendations from a person’s poop. To avoid hostile oversight by the FDA, the kit sellers are careful to make no specific claims about diagnosing or treating particular diseases.

Four years ago, former InfoSpace billionaire Naveen Jain, 60, launched Bellevue, Washington–based Viome, which sells a $119 “gut intelligence test” online. After analyzing a pea-sized stool sample, it sends customers a customized 60-page report with dietary recommendations “aimed at balancing your overall microbiome.” It might recommend, for instance, increasing consumption of “superfoods” like alfalfa sprouts and anchovies or avoiding green beans and kombucha. Jain says Viome has sold more than 100,000 kits and banked more than $15 million in revenue last year. Doctalbott Note = 60-pages?!?! I’m not sure most people actually want that level of information overload – it’s not usable information. What if you had a simple “overall score” and a few understandable and actionable targets that you could easily, quickly and inexpensively track over time? I think a LOT of people might be interested in that. 

“Viome’s claims are not supported by any scientific literature,” says Jonathan Eisen, a medical microbiology professor who directs microbiome research at the University of California, Davis. “What they’re saying is, in fact, deceptive.” A dozen former Viome staffers say they believe the company was selling a product of dubious value. Six of those ex-staffers describe the food recommendations as “pseudoscience.”

“Anyone who says this doesn’t understand how our science works and how we make recommendations,” Jain counters. “It’s not my job to convince everyone; it’s my job to continue to help make the world a better place.”

A nonstop talker prone to enthusiastic, stream-of-consciousness self-promotion, Jain immigrated to the U.S. from India in 1982 and worked at Microsoft from 1989 until 1996, when he founded InfoSpace, also in Bellevue, which delivered internet content to early cellphones. His net worth ballooned to $8 billion, then crashed to $220 million when the first internet bubble burst. A flood of shareholder suits followed, and the InfoSpace board fired him as CEO in late 2002. Before he left InfoSpace, he bought a $13 million stucco mansion on the shores of Lake Washington not far from Jeff Bezos’ and Bill Gates’ pads.

Despite having no background in science or medicine, Jain has managed to raise $75 million from investors including Benioff and Khosla. Both declined to comment on their microbiome investments. But Alex Morgan, a Khosla Ventures principal with an M.D. and Ph.D. from Stanford, suggests Khosla’s decision to back Viome has nothing to do with nutritional advice. Instead, he says, the firm invested because Viome hired a team of scientists from the U.S. Department of Energy’s Los Alamos National Laboratory. In addition, Viome had made a deal with the lab to license a valuable tech platform that has a unique ability to sequence the biochemical activity in microorganisms.

“The goal is to scientifically show that it’s not voodoo stuff or a placebo,” says Jain

So even if Jain is selling snake oil, Viome might have significant value. Indeed, British pharma giant GlaxoSmithKline struck a royalty deal with Viome in November 2019 to use its tech to help develop microbiome-derived vaccines. Jain’s investors could make out handsomely.

At Caltech in Pasadena, California, microbiologist Sarkis Mazmanian, 47, is considered one of the foremost gurus of microbiome research. In 2012 the MacArthur Foundation gave him a $500,000 “genius” grant for his work on the microbiome’s role in disease. Since then, he’s been exploring one of the most intriguing connections in human health: the “gut-brain axis.” The working thesis is that the bugs in your belly have a direct impact on your neurological health, which has profound implications for autism, Parkinson’s and Alzheimer’s. Doctalbott Note = our group has made more than a dozen peer-reviewed scientific presentations showing how natural microbiome modulation dramatically improves psychological mood states including depression, tension, stress, burnout, and fatigue.

In 2008, two years after joining the Caltech faculty, Mazmanian published a cover story in Nature that documented his successful treatment of inflammatory bowel disease in mice with human gut bacteria. A Caltech colleague, Paul Patterson, who was researching autism in mice, saw a possible connection to the digestive problems suffered by as many as 60% of children with autism.

Together they started testing whether human gut bacteria could induce and ameliorate autism-like symptoms in mice. In the midst of their early work, Patterson was diagnosed with fatal brain cancer. In a hospital room at UCLA where Patterson was awaiting surgery in May 2014, Mazmanian signed papers giving Patterson a stake in a company that would develop drugs from their experiments. “I wanted Paul to get the recognition of his contribution,” says Mazmanian. Patterson died the following month.

In a trailblazing study,  he transferred gut bacteria from humans with autism into sterile mice who then exhibited autism-like  behaviors. “The most rigorous clinicians and investors,” he says, “realize this is a long journey we’re on.”

Mazmanian is carrying on their research in his sub-basement lab at Caltech, where 1,000 germ-free mice, delivered by Caesarean section in sterile conditions to ensure they are bacteria-free, live inside plastic-encased rectangular bubbles. Grad students douse the animals’ food with various gut microbes to test which bacteria promote tremors and motor problems in mice that correlate with Parkinson’s symptoms in humans.

In 2016, David Donabedian, a chemistry Ph.D. who was then a partner at Longwood Fund, a Boston venture capital firm, volunteered to raise the money and research power to move Mazmanian’s biotech venture forward. The company, Waltham, Massachusetts–based Axial Biotherapeutics, has $55 million in backing and 30 employees. Under Donabedian as CEO, Axial is in the early stages of developing synthetic drugs made of small molecules it hopes will absorb the particular gut-bacteria byproducts (called “metabolites”) that appear to exacerbate autism symptoms. It’s also working on a drug to treat the digestive problems suffered by many people with Parkinson’s. Doctalbott Note = again, lot’s of people are likely to prefer a natural approach to optimizing their microbiome metabolism – and we can do that!

In the U.S., more than a million people suffer from autism, and there are no drugs to treat it; an additional million have Parkinson’s. What would be the value of an FDA-approved drug for either condition? “I can’t give you a market size,” says Donabedian. “But if either one hits, it will be huge.”

Chris Howerton, a biotechnology analyst at Jefferies, a New York investment bank, is less shy. “If every single microbiome paper turns into a proven therapy, it could impact the drug markets for most major categories of disease, which together were worth $350 billion in 2018 in the U.S. alone,” he says. “The breadth of the microbiome’s potential application is really tantalizing.” Doctalbott Note = AGREED!

ADHD in Adults

An excellent article in today’s Wall Street Journal about ADHD in older adults – a diagnosis that lots of people have considered solely a problem for “kids and teens” – but is increasingly being seen as a massive problem for productivity and achievement (and general well-being) in middle-aged and older adults.

I personally use two different mood/focus herbal products to improve mood, enhance focus, and boost stress resilience. Every morning, I use Mood+ and most afternoons I use Kid’s Mood+  (both from Amare Global and both of which I formulated).

Each supplement works in different ways to keep me on track mentally and creatively, especially during stressful periods (which seems like “always” these days).

See the original WSJ article here (behind pay wall for subscribers) = https://www.wsj.com/articles/an-unexpected-new-diagnosis-in-older-adults-adhd-11582558978

See my highlighted notes below…

An Unexpected New Diagnosis in Older Adults: ADHD

For years, ADHD has been considered a disorder of kids and younger adults. Now, doctors are realizing older people have it too—and it’s sometimes mistaken for dementia.

Many seniors get diagnosed with conditions like dementia or heart disease.

Not Timothy McMichael. At the age of 60, he was diagnosed with a condition most often associated with school children: attention-deficit hyperactivity disorder. He started taking a low dose of a stimulant about a year-and-a-half ago and says his attentiveness and concentration at work have never been better. (DocTalbott note = why would you take an addictive synthetic stimulant if you could get superior benefits naturally – probably because you simply did not know any better?)

“I’ve been fairly successful in my life and career, and did not think of ADHD as an adult thing,” says Mr. McMichael, a 61-year-old Leonardtown, Md., resident and engineer for the Department of Defense. “But I had spent the last 40 years coming up with coping mechanisms.”

Like many older people diagnosed with ADHD for the first time, Mr. McMichael didn’t consider the condition until his then-11-year-old son went through the diagnosis and treatment process about five years ago. He recognized many of the symptoms and struggles of his son and raised the issue with his son’s psychiatrist, David Goodman.

Dr. Goodman, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, sees patients between the ages of 15 and 85. He has a particular interest in ADHD patients who are over 50 and have never been diagnosed.

Until just a few years ago, older adults were hardly ever diagnosed with ADHD. But as awareness of the condition among younger people has surged, doctors are beginning to make the diagnosis more often in seniors as well. (DocTalbott note = an prescribing more and more addictive synthetic stimulants – again, probably because they simply do not know any better?)

Doctors don’t believe the actual prevalence of the condition among seniors has increased, or that they are developing the condition as they age. Instead, doctors suspect many seniors have lived their whole lives with ADHD, and only now are getting diagnosed. Many found ways to manage their symptoms in earlier stages of life, but hit a new hurdle as they aged that prompted a flare-up—or simply recognized the symptoms after a younger relative’s diagnosis.

People with ADHD experience symptoms of inattention, disorganization and hyperactivity. Often hyperactivity diminishes with age, but challenges with attention and organization don’t.

Research on ADHD in seniors is nascent, but one study estimated the prevalence rate in people over 50 at 3%. That compares with about 8% in U.S. children and about 4.5% in adults under age 45. Some studies have found that about half of the children diagnosed with ADHD no longer meet diagnostic criteria by the time they reach adulthood.

One challenge to diagnosing ADHD in seniors is that symptoms look similar to age-related ailments. Cognitive difficulties in older people are often attributed to memory impairments or early signs of dementia, says Dr. Goodman. For women in their early 50s, such complaints are often attributed to perimenopause, the time before a woman reaches menopause.

Treatment presents another hurdle. The most common ADHD treatment among younger people is stimulants. But those are riskier in older adults because they can raise heart rate and blood pressure, so they need to be monitored closely.

Kathleen Nadeau, founder and clinical director of the Chesapeake Center, an ADHD, learning and behavioral health clinic based in Bethesda, Md., says she has seen three typical patterns for a diagnosis in seniors. Some patients were in treatment for another condition, like depression, and their psychiatrist suggested they get evaluated for ADHD. Another group had a relative or friend diagnosed. A third had a change in their life that increased the demands on them and they couldn’t cope.

She says ADHD symptoms rise and fall in people depending on how stressful their circumstances are. (DocTalbott note = which REALLY screams out for a natural solution that both improves focus AND bolsters stress resilience – which is not what the synthetic stimulants do – and which can actually increase feeling of stress) “If you don’t have to work or raise children anymore, it may look like you have less ADHD, but you actually have less demands,” says Dr. Nadeau. “If you’re put back in a situation you may have similar difficulties. This doesn’t go away and people still need help” at older ages.

Lenard Adler, director of the adult ADHD program at NYU Langone Health, says more people over the age of 60 are coming in with ADHD symptoms. Of the older patients he’s treated, some found him after other psychiatrists were unwilling to treat them, he says. One patient had a history of hypertension and cardiac problems. He was able to successfully treat the patient with a long-acting amphetamine.

Dr. Alder says it’s important to distinguish between memory and ADHD issues in seniors. “We’re dealing with a population that may have some age-related memory decline,” he says.

In some cases, patients may mistakenly be diagnosed with mild cognitive impairment, often a precursor to dementia. But other times families may be looking for any diagnosis besides cognitive decline. One family brought in their loved one hoping it was ADHD and not dementia. The patient, says Dr. Adler, was “having a substantial cognitive decline and it obviously was dementia. So it can go both ways. It’s important to get the diagnosis right.”

Doctors say that age-related memory impairments come on later in life and are primarily memory deficits, while ADHD symptoms start in childhood or early adolescence and revolve around inattention. While neuropsychological tests can’t distinguish between the two, certain cognitive impairments are associated with pre-dementia, such as difficulty remembering a word or getting lost while driving a familiar route.

Treatment of ADHD in older adults is similar to that of younger patients. Treatment can combine prescription stimulants with non-medication approaches such as cognitive behavioral therapy and organizational skill work. A study published last year showed that CBT was an effective treatment for older ADHD patients. (DocTalbott note = and why not also try a natural approach like saffron – see a short clip about it from ABC7 in Los Angeles = http://blog.amare.com/health-benefits-of-saffron-in-amares-kids-mood/)

Dr. Goodman says most ADHD studies of stimulants don’t include seniors because of greater risks with heart rate and blood pressure. There is also a risk of developing insomnia, agitation and psychosis.

Dr. Goodman’s experience in treating some 800 seniors over the past three decades has shown few side effects, he says. He says diagnostic accuracy is crucial in seniors before prescribing any medications. “Dosing is thoughtfully slow while monitoring improving cognitive symptoms, side effects and blood pressure,” he says.

Sandra Kooij, an associate professor of psychiatry at Amsterdam University Medical Center, studies ADHD in seniors in the Netherlands. At her clinic they have treated about 150 seniors age 55 and older with stimulants, in addition to psychoeducation and cognitive behavioral therapy, for ADHD.

Dr. Kooij says they are analyzing the treatment and side effects for a study they hope to publish later this year. Overall efficacy has been similar to younger adults, and the medications were well tolerated with appropriate management of cardiovascular risks, she says. Patients were also treated for conditions like anxiety and depression that often present in ADHD patients, and sometimes occur as side effects of stimulants. (DocTalbott note = great – so now the stimulant used to “treat” ADHD leads to depression/anxiety that has to be “treated” with antidepressants and anti-anxiety drugs – so you get another set of symptoms and side effects – brilliant!) 

Seniors that have lived with ADHD all their lives and don’t feel impaired shouldn’t be treated, she notes. “Only people who feel impaired by their symptoms should be treated,” she says.

Joan Friess, a 76-year-old who lives in a senior community in Coconut Creek, Fla., was diagnosed with a precursor to Alzheimer’s disease about five years ago and started taking medication for it, says her son, Steve Friess, a freelance writer who lives in Ann Arbor, Mich.

But Ms. Friess never believed the neurologist who diagnosed her, both mother and son say. She is an advanced bridge and mahjong player and sings with an elite choir with no problem.

After her husband died and she moved to a different part of Florida, she decided to see a different neurologist.

Mr. Friess talked to the neurologist, who asked him if his mother’s behavior was different than most of her life. “I said, ‘No, not really,’ ” he recalls. “She was always losing things and a bit forgetful.”

The neurologist did some brain scans. Comparing them with previous scans, she said she saw nothing to indicate Alzheimer’s disease or dementia. Instead, she diagnosed Ms. Friess with ADHD.

Ms. Friess says she was relieved to confirm what she knew all along. “My husband thought I was forgetting things, but I knew there was nothing wrong with me,” she says.

Mr. Michael, the Department of Defense engineer, says even though he’s had a successful career, he can’t help but wonder how earlier treatment might have helped him. He says even his colleagues noticed his improved performance at work. “I’m much more focused on individual tasks,” he says. “I’m more efficient in how I use my day. I think my life absolutely would have been a lot easier had I known.”

Hawaii Health Professionals – Gut/Heart/Brain Axis for Mental Wellness Seminar

Had a wonderful SOLD OUT seminar last night in Honolulu to educate a diverse audience of health professionals about the role of the microbiome, gut-brain-axis, and heart-brain-axis in optimizing mental wellness.

We live-streamed to Facebook and you can also see the video at YouTube.

Slides are here = Hawaii Health Pro 021820 Gut Heart Brain Mental Wellness

 

Gut-Brain-Axis Optimization for Peak Performance – Interview with NeuroPeak Pro

Here is a interview that I did with the great Joe Martinez at NeuroPeak Pro.

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Hunger Buster Smoothies

Heading into the end of January – I can HEAR your stomach growling!

This is the time of year when a lot of people start to fall OFF their New Year’s resolutions to lose weight and get in shape – and a BIG reason for that fall off is because you’re HUNGRY!

I visited KUTV’s Fresh Living on Thursday (Jan 23) to talk about foods that can help reduce appetite – you can see the segment HERE.

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Both of my Hunger Buster Smoothies include specific foods that are known to enhance SATIETY (reducing overall appetite and increasing feelings of fullness for longer).

Each of these foods is high in a phytonutrient called Falcarinol – it’s a naturally-occurring plant compound that helps to protect vegetables and herbs from insects – so in some ways it’s like the plant’s own natural insecticide.

Among the highest falcarinol-containing foods are carrots, parsley, celery, fennel, and mint.

In small amounts, falcarinol protects plants from bugs, but it also inhibits important appetite centers in the brain (CB1 receptors) – so we feel less hungry and more full for longer – which is exactly what many of us need to help us stay on that healthy eating plan.

Here are two of my go-to simple smoothie recipes – they only take a couple minutes to blend together.

The first one is really more of a morning Green Detox Juice – and the second is a more substantial Chocolate Mint Protein Shake.

Green Detox Juice

  • 1 stalk celery
  • 1 stalk fennel
  • 1/2 apple
  • 1 handful fresh parsley
  • 1 pinch each of paprika and salt
    • Blend together with 1 cup of cold water and handful of ice cubes

Chocolate Mint Protein Shake

  • 1 cup milk (of your choice) and a handful of ice cubes
  • 2 scoops Amare GBX Protein (Chocolate)
  • 1 carrot
  • 2 fresh mint leaves
    • Blend together with 1 cup of milk (of your choice) and a handful of ice cubes

Amare Product Overview (Jan 14, 2020)

Here is a recent video and slides (Talbott Amare Product Training SHORTER) from our regular weekly zoom call – where I cover an overview of how the Amare products help improve Mental Wellness by naturally modulating the Gut-Heart-Brain-Axis.

We do this call every week (and lots of others) – which you can find out how to join at HERE (hope to see you there)!

Project b3 on WTMJ Milwaukee

Had a nice visit with the hosts of The Morning Blend to discuss Amare’s unique approach to both physical health (weight loss) and mental wellness (mood, energy, stress).

See the segment here = https://www.tmj4.com/shows/the-morning-blend/putting-the-pieces-together-for-optimal-health