Issue 41


Ulcerative Colitis

Case Report

This is a case report of a 27-year-old man with ulcerative colitis who had infantile colic, loose stools and frequent vomiting for the first 5 years of his life. He was atopic and had symptoms of eczema, rhinitis and sinusitis from an early age. The patient suffered from different arthralgias in the neck, back and wrist. Transient muscle aches were also noted.

Generalized body itches were present. He was placed on an elimination diet where a different fruit, vegetable, grain and protein was used daily. Water was the only fluid and salt was the only condiment allowed. The colic, flatulence and diarrhea improved rapidly but it took 6 weeks for the mucous and blood to disappear. Offending foods were pineapple, cottage cheese, milk, beef, wheat, maize, sugar among others. His pustular acne cleared up after 4 weeks and remained that way 30 months later. He has also gained weight.

"Ulcerative Colitis - A Patient Report," Borok, G., South African Family Practice, 1989;10:468-474.

Acupuncture May Alleviate Primary Insomnia and Improve Sleep

Insomnia, Sleep Disorder - Acupuncture, Traditional Chinese Medicine, Traditional East Asian
 Medicine, Electroacupuncture, Electrical Stimulation

In a sham-controlled study involving 60 adult subjects reporting insomnia for 3 or more nights per week for a period of at least 3 months, treatment with acupuncture (electroacupuncture), 3 times per week for a period of 3 weeks, was found to improve sleep. Subjects were divided into 2 groups. One group received real acupuncture (electroacupuncture at points: Yin Tang, DU-20, bilateral ear Shen Men, Sishencong, Anmian), while the other group received a sham treatment (“placebo acupuncture” at the same acupuncture points with Streitberger needles that do not pierce through the skin). As compared to pre-treatment, subjects in both groups reported significant improvements in sleep. Improvements were measured according to sleep diaries, 3-day actigraphy, self-reported questionnaires, and scores on the Insomnia Severity Index. Subjects who received real acupuncture were found to have significantly greater improvement, assessed via sleep diary and actigraphy. Moreover, a significantly greater percentage of subjects in the real acupuncture group were found to have sleep efficiency of 85% or greater, and a significantly greater percentage were found to have less than 30 minutes of wake after onset of sleep. These results suggest that acupuncture may be a safe and effective treatment for patients with primary insomnia - a debilitating disorder that has wide-ranging adverse implications. The authors conclude, “Because of some limitations of the current study, further studies are necessary to verify the effectiveness of acupuncture for insomnia.”

"Electroacupuncture for primary insomnia: a randomized controlled trial," Yeung WF, Chung KF, et al, Sleep, 2009; 32(8): 1039-47. (Address: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China).

Help for Hardening of the Arteries?

Plaque Ease

Homocysteinemia, or elevated plasma homocysteine, is a major factor that can influence poor cardiovascular health. High plasma levels of homocysteine appear to have negative effects on the vasculature, impairing the functional abilities of endothelial and smooth muscle cells. Suboptimal intake of several B vitamins, renal failure, environment, diet, stress, and genetic defects in homocysteine metabolism can all contribute to abnormal homocysteine levels.

Homocysteine is a sulfur containing amino acid that is created in the body from methionine, an essential amino acid derived solely from dietary intake. Methionine is metabolized into homocysteine via an intermediate, S-adenosylmethionine. Homocysteine can be metabolized to produce cysteine, a nonessential sulfur-containing amino acid, or it can be remethylated to methionine. Whether the body needs cysteine or methionine will dictate which path homocysteine metabolism will take.

Production of cysteine from homocysteine requires two specific enzymes for which vitamin B-6 is an essential coenzyme. Without adequate vitamin B-6, homocysteine cannot be metabolized into cysteine. The body can also metabolize homocysteine by remethylating it to methionine. The primary route by which homocysteine is remethylated to methionine requires folate in the form of methyltetrahydrofolate as a methyl donor and vitamin B-12 (methylcobalamin) as a coenzyme. Methyltetrahydrofolate, or L-methylfolate, is synthesized in the body from dietary folic acid. However, L-methylfolate can be used directly by the body, without the need for folic acid conversion via the enzyme 5,10-methylenetetrahydrofolate reductase (MTHFR). In certain populations, the body’s ability to convert folic acid to 5-MTHF by use of this enzyme may be compromised due to genetic differences.

B vitamins, in particular folate, methylcobalamin, and vitamin B-6 are necessary for the body to metabolize homocysteine. A deficiency or suboptimal levels of any of these essential vitamins may cause plasma homocysteine levels to rise. Dietary surveys and epidemiological studies indicate that suboptimal levels of folate, vitamin B-12, and vitamin B-6 are common in many population groups. Elderly individuals, smokers, alcoholics, and medications users, including estrogens and popular medications for cholesterol and blood glucose control, are at risk for subclinical deficiencies of one or more of these B vitamins.

TMG, trimethylglycine, also known as betaine anhydrous, acts as a methyl donor in the methionine/homocysteine cycle. One route of homocysteine metabolism is by methylation to form methionine, using a methyl group from methylcobalamin or from trimethylglycine. Methionine is then converted to S-adenosylmethione (SAMe). Trimethylglycine is absorbed rapidly and has a high volume of distribution due to extensive distribution to tissues, including the kidneys and liver. When taken orally, trimethylglycine can support normal homocysteine levels.† Improvement in plasma homocysteine may be seen within a week, and steady state could be reached within a month.

Choline, also considered a B vitamin, can be oxidized to betaine which serves as a methyl donor to convert homocysteine to methionine. Dietary intake of choline might also support healthy homocysteine level.† The effect of dietary choline intake may be greatest on those with lower folate levels.



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